Sex in Menopause: Grin? Or Just Bear It?

Many women, however, complain that the local estrogen creams are messy, and they worry that too much of the hormone may be absorbed into the general bloodstream. Dr.Allen favors the increasingly popular pre-emptive medication Vagifem. It is a tiny estrogen tablet that is inserted into the vagina. It is easily absorbed, locally, but not absorbed into the general bloodstream, so it does not carry the risks that overall hormone therapy present.

One of Dr. Allen's patients insisted upon a prescription for the cream version before she took a vacation trip to the Grand Canyon. After a week, the woman called from her mobile phone while riding a packhorse. She sounded frantic: "My labia looks like a baboon's ass."

"What have you been doing?" the doctor asked.

"It must be this cream you gave me."

The doctor reviewed her notes. The patient had insisted upon using the cream when her insurance company refused to cover Vagifem. "You must be allergic to the cream," the doctor told her. "Stop using it. Try a cold compress, a little antihistamine, and get off those pack horses!"

After two hours of conversation in my living room, Bernice, a svelte, silver-haired dynamo who still works full-time as a retail manager, felt comfortable enough to tell us her age -- 75. But the more startling confession, she said, was the one her 93-year-old mother made as she reminisced about her half century of married life.

"We didn't have enough sex."

No matter how old we are, we never lose the hunger for a loving touch and emotional closeness. Among women of a certain age, those aspects of a relationship are often more important than the sex or, at least, the starting point for satisfying sex.