How to lose weight during menopause! Meet Katie Heaney, RD.
In my practice, I see so many menopausal women who tell me that when they go through menopause, their metabolism slows down, and they’re gaining weight. They tell me that they watch what they eat, they make healthy choices, they exercise, and they just can’t lose weight.
This can be really frustrating because menopause is a big transition in life. I see many menopausal women struggling with those last 15 pounds! As women journey through the lifecycle, their bodies naturally shift in response to hormonal changes that usher them out of the fertile phase of life. Menopause is frequently accompanied by weight gain, muscle loss, and lack of energy, making it challenging to achieve a healthy weight. Many women who have gone through menopause or are going through menopause come to us to help them with weight loss and muscle gain.
Link: https://www.youtube.com/watch?v=9s9UNax-QQ0
Dr. Lynn: Hello, I’m Dr. Becky Lynn. I am here with Katie Heaney, RD. I’m a gynecologist, and a menopause and sexual health specialist.
Katie: I am Katie Heaney. I’m a registered dietitian working with Dr. Lynn. I specialize in weight management, obesity interventions, nutrition for the whole family, and some sports nutrition.
Dr. Lynn: Well, fantastic! One of the reasons I wanted to bring Katie here today is because I see so many menopausal women who tell me that when they go through menopause, their metabolism slows down, and they’re gaining weight. They tell me that they watch what they eat, they make healthy choices, they exercise, and they just can’t lose weight.
Katie: This can be really frustrating because menopause is a big transition in life. I see many menopausal women struggling with those last 15 pounds! As women journey through the lifecycle, their bodies naturally shift in response to hormonal changes that usher them out of the fertile phase of life. Menopause is frequently accompanied by weight gain, muscle loss, and lack of energy, making it challenging to achieve a healthy weight. Many women who have gone through menopause or are going through menopause come to us to help them with weight loss and muscle gain.
When people see me and want to make healthy changes and lose weight, I start by getting as much information as I can about their current eating habits. I discuss what healthy weight loss looks like and realistic timelines. There is so much that goes into healthy eating and weight loss. It isn’t just about calories in and calories out. I do a deep dive into what they’re eating, when they are eating it, do they exercise, and if they are getting enough sleep. Sleep is so important. It is one of the first things we talk about. We are more likely to make unhealthy choices when we are sleep deprived.
Dr. Lynn: During the years before your periods stop (the perimenopause) and then for a few years after they stop, many women have night sweats and they can’t sleep at all or have awakenings in the middle of the night. This is not good for those carbohydrate cravings!
Stress
Katie: Stress plays a role too. Having a lot of stress in your life affects how hungry you feel.
Dr. Lynn: Stress hormones like cortisol increase, which leads to insulin increase which makes you deposit fat and crave carbohydrates. So, how would you define healthy weight loss?
Defining Healthy Weight Loss
Katie: It depends on where we start. Generally, we say half a pound to a pound a week of weight loss. It is a bit controversial with dieticians – like counting calories or not. I like to discuss mindful intuitive eating. We try to figure out how to be mindful of caloric intake. I also calculate women’s resting metabolic rate and their activity level in order to calculate how much or how little they need to take in to lose weight. Research show that the average weight gain during menopause is a little more than 1 pound per year. With reduced calorie needs as women age, weight gain is expected if they don’t eat healthfully and increase physical activity. Lifestyle factors are extremely important to consider when talking about weight gain.
Measuring Resting Metabolic Rate
Dr. Lynn: How do you measure the resting metabolic rate?
Katie: I use an equation called the Mifflin-St Jeor equation. It is based on an algorithm that uses your age, gender, activity level, and height and weight (of course). It is an estimate, but you can also use a special kind of breathing machine. You breathe into it and based off of your oxygen level and carbon dioxide level, it measures how much energy you use at rest just to run your body. This is your basal metabolic rate. It is very useful information.
Dr. Lynn: It gives you the calories you burn each day?
Katie: Resting metabolic rate is the total number of calories burned when your body is at rest. From there we use the activity level to calculate how many calories you need for healthy weight loss, because the breathing machine only gives us the calories you would need at rest. Also, I have clients that will take multiple measurements over time, because as you lose weight, there is less of you to feed, so your resting metabolic rate decreases. The way you can increase or maintain your resting metabolic weight is to build muscle as you lose weight. I am not a personal trainer or a physical therapist, but I encourage 2-3 days a week of weight training and building muscle because that can really help boost your metabolic rate. Your metabolic rate tends to go down as we age and as women go through menopause.
Dr. Lynn: So it is funny that you say that because (and I am not a dietitian), but I always think that when you’re trying to lose weight, you need to do aerobic exercise, get your heart rate up and burn calories. And so, I have said in the past, if you have limited time, concentrate on the aerobic exercise. I have changed my tune on exercise over the years. Now I see the value in strength training, especially for menopausal women because menopausal women lose muscle mass when they lose the hormones their ovaries used to make.
Katie: Resistance training is great for muscle building!
Resistance Training and Aerobic Calorie Burning
Dr. Lynn: What would be the optimal mix of resistance training and aerobic calorie burning?
Katie: That is a really good question. I don’t think it’s either or; it is hopefully both. I would start with looking at what you are willing to do. Many times I have clients say, “yeah I’m just not going to lift weights, but I would like to get my heart rate up and start exercising more.” I focus on where the client wants to start. If I say to someone, “do all of this,” it can get overwhelming, and they may not start at all.
I just had a client the other day say “I’ll do ten minutes a week and that is all I will do”. I have another client who is already doing three days a week of Krav Maga, high intensity interval training, and she said, “I’ll go up to four days a week!” So, it just depends on the person, but ideally the recommendation for adults, is 30 minutes a day, or 210 minutes per week. It can be 30 minutes a day or it can be three 1-hour long sessions a week. I try to choose something that works for each person. If it were up to me, I would say the 30 minutes a day, because then maybe we can incorporate two days a week of strength training for 20 minutes.
Logging Your Data
Dr. Lynn: Okay, so you talk about sleep habits, you talk about exercise, but then do you have them write down what they eat?
Katie: Every client is different. Generally, when they come in, I want to know what they’re eating. Some of them come in with a notebook, and many, many, many clients come in using My Fitness Pal. I think you’re familiar with it?
Dr. Lynn: Yes! My Fitness Pal synchs up with our electronic medical record.
Katie: Some people come in and they have it all recorded, so we can go through that. Typically, I get a verbal intake of what you are eating on a typical weekday, and I usually get a couple samples of meals and schedules. For the weekend, schedules change. So, I also get a weekend day. From there, we talk about eating habits. For example, “do you skip meals? Do you eat when you’re stressed, bored, angry…” Emotional eating is common.
Dr. Lynn [humorously]: That’s me!
Emotional Eating
Katie: We have to eat all the time and we are always thinking about food. So, there is a lot of eating that goes with emotions. I also ask about binge eating habits or eating disorders, and I usually refer to a specialized therapist for those.
Dr. Lynn: Yes
Katie: I am not a therapist. I sometimes introduce cognitive behavioral therapy(CBT) in sessions as a behavior change technique, but I usually refer to a trained counselor or therapist for more detailed training on CBT.
Katie: I also talk about hunger with my clients. For instance, I go through the hunger scale. I usually compare fuel for my body to gas for a car, so when the gas is empty, the car stops. When you’re really, really hungry, your body doesn’t work as well as it should. Your brain doesn’t work as well as it could.” I always say 10 is like Thanksgiving Day, when you eat so much, and you can barely move. Ideally, we want to stay between a 4 and a 6, so you don’t allow your body to get too hungry and you stop when you’re at a 6 versus eating until you’re stuffed. Achieving a healthy weight is about eating enough, but not too much. I talk a lot about what people are eating, but I also talk about how much.
Portion Control
Dr. Lynn: Portion control basically. We all know that we have large portions. If you go to a restaurant, there are sometimes a thousand calories in one meal, if not more. I feel like we are used to large portions, so a smaller portion seems too small. If you read labels and look at serving sizes, a serving might be much smaller than the amount you would normally eat.
Katie: It can be shocking to show what a healthy portion of rice is… it’s half a cup!
Dr. Lynn: Right, it looks like three bites!
Katie: Yes! After we calculate your calorie needs, I create a meal plan together with your idea of what that looks like. That way it fits with your lifestyle and habits. I also talk about having all the food groups in a meal, having a healthy amount of carbohydrate, fat, and protein. I focus quite a bit on protein. I try to create meal suggestions that incorporate all the different food groups, like starch (especially whole grains), vegetable, fruit, fat, and a meat or protein.
Katie: Protein is really important in achieving a healthy weight and having energy. If you’re incorporating exercise you have to have enough protein to maintain your muscles, but not too much. I focus a lot on portion size and a tool I have been using lately, which is pretty basic but helps you visualize, is divide your plate into fours.
Dr. Lynn: I think I’ve seen that before.
Katie: It is through choosemyplate.gov, which is an updated food pyramid.
Dr. Lynn: mm-hmm!
Katie: I recommend that women practice mindful eating, control portions, and focus on nutrient-dense foods such as fruits and vegetables.
Fruits and Vegetables
Dr. Lynn: Right. I have a question about that. I tend to eat a lot of fruit, but not as many vegetables. So, if you say 8-10 servings of fruits and vegetables a day and nine of those ten are fruits, am I still missing something? Should I try to balance it out a little bit?
Katie: 2-3 of those servings should be vegetable. You don’t have to go up to 7 vegetable servings tomorrow but try to find some recipes. I see many clients who just don’t like vegetables because the only way they’ve eaten them is boiled or steamed. I talk a lot about roasted vegetables. They are so much better! If you roast brussel sprouts, asparagus, cauliflower, or broccoli, they don’t quite taste like French fries, but they have a nice crispy texture. Or some people like vegetable soup. Vegetable soup can be store bought or made. If bought, then it isn’t labor-intensive and you still get your vegetable servings.
Dr. Lynn: We all probably need to eat more vegetables…. Me especially.
Katie: Amen! I agree!
Dr. Lynn: Thank you so much Katie for helping our patients the way you do. I am lucky to be working with you!
Dr. Becky Kaufman Lynn is a gynecologist and the founder of the Evora Women’s Health. She is a North American Menopause Society Certified Physician who has been treating menopausal women for over 20 years. Her practice is located in Chesterfield just outside of St. Louis, Missouri. Dr. Lynn offers a comprehensive midlife health program including helping women lose those pesky last 15 pounds! Go to evorawomen.com for more information about her practice or to schedule an appointment or send us an email at info@evorawomen.com
Katie Heaney is a registered dietician working with Dr. Lynn at the Evora Center for Menopause and Sexual Health. She holds an undergraduate in Nutrition and Dietetics. She completed her dietetic internship at Yale-New Haven Hospital and then obtained a Certificate of Training in Obesity Interventions for Adults. She is a member of the Academy of Nutrition and Dietetics and the national and local chapter of the Academy of Nutrition and Dietetics. Click here to schedule an appointment with Katie.
5 facts about (peri)-menopause you didn’t know!
We aren’t taught much about what happens during menopause and the few years before. Read on for some things you didn’t know were related to the loss of estrogen that your ovaries used to make!
We aren’t taught much about what happens during menopause and the few years before.
Read on for some things you didn’t know were related to the loss of estrogen that your ovaries used to make!
1. Vaginal dryness may be due to menopause!
You may not realize that dryness is related to the loss of estrogen. You may not get aroused as easily during sex. You may not be able to reach orgasm; orgasms are not as strong, or it takes too long and too much work to get there. Sex may even become painful. No worries, low dose vaginal hormones help treat all of these, (and you are normal if this is happening to you)! Giving back the estrogen helps the vagina lubricate. It also makes the vagina stretchy, with good blood flow, and more nerves going to it, which makes sex feel better! The good news is that vaginal hormones don’t have the same risks that go along with other hormone use. They do not increase your risk of breast cancer, heart attack, or stroke.
2. Menopause makes it harder to lose weight.
It is not that you are lazy or crazy. During menopause women become more insulin resistant. This means your body needs to pump out more insulin to get the same amount of glucose into the cells. Insulin makes your body deposit fat, which is not good for your waistline. Menopause leads to fat deposition around your middle instead of your hips and bust. This “apple” shape, as opposed to the typical female “pear” shape, leads to an increased risk of cardiovascular diseases like heart attack or stroke. Diet and exercise are the first step to losing weight and making your body less resistant to insulin. Some women may need the help of some of the medicines that are available to help you lose weight.
3. Anxiety, depression and mood swings may worsen around the time of menopause.
Typically, hormone levels become erratic before periods stop. Women may feel like they are on a roller coaster ride of emotions. Also, this is the time the kids leave the home and women may be dealing with an empty nest or a lost identity. They may also be taking care of aging parents or have financial stressors. There are plenty of ways to manage anxiety, stress, or depression. Some are with appropriately chosen medicines, other times yoga or soothing apps like CALM may be all you need.
4. Word finding difficulties, forgetfulness happens.
This can be incredibly scary for menopausal women. You can’t seem to remember why you walked into the kitchen or what task you were supposed to complete today. The good news is that brain exercise helps. Learn a new language or learn how to play an instrument. Exercise and diet also keep the brain “fresh”. Be sure to eat a healthy diet, including omega 3 fatty acids which are found in oily fish like salmon or tuna. A healthy lifestyle lowers your risk of Alzheimer’s Disease and delays the progression of Parkinson’s Disease.
5. Low libido.
Menopause is not all about estrogen. By the time women stop having periods, their testosterone is much lower than it was in their 20s and 30s and this may lead to low or loss of sex drive. Loss of sex drive may significantly impact a women’s relationship, and couples that don’t have sex tend to grow apart. There are plenty of hormonal and non-hormonal ways to improve your sex drive.
Make sure you find a practitioner who is well versed in menopause and sexual health.
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed to practice medicine in Missouri, Tennessee and Illinois. She she sees patients in her St. Louis office and offers telehealth consults to Illinois and Tennessee. Call today to schedule your appointment. (314) 934-0551 or click click here to schedule.
Testosterone for Women: Miracle Drug or Bogus Science?
Testosterone. That lovely hormone of desire, of sex, of muscles and power and strength. We think of manly men with hairy chests when we think of testosterone. But did you know women have testosterone too? They even make more testosterone than they do estrogen. Testosterone is one thing that controls sex drive in women and does a whole host of other things. It starts to decline in your late 20s. This can contribute to low libido in women. So should testosterone be replaced? I hope to answer this question for you with answers based on scientific studies- not bogus internet marketing claims. Does testosterone make for better sex?
If you are a midlife woman, peri or postmenopausal, then in some instances the answer is yes! Testosterone has been shown to definitively improve several aspects of sexual functioning. Testosterone improves sex drive, arousal, helps you have more and better orgasms, and increases pleasure and responsiveness.
Testosterone. That lovely hormone of desire, of sex, of muscles and power and strength. We think of manly men with hairy chests when we think of testosterone. But did you know women have testosterone too? They even make more testosterone than they do estrogen. Testosterone is one thing that controls sex drive in women and does a whole host of other things. It starts to decline in your late 20s. This can contribute to low libido in women. So should testosterone be replaced? I hope to answer this question for you with answers based on scientific studies- not bogus internet marketing claims. Let’s get started.
Does testosterone make for better sex?
If you are a midlife woman, peri or postmenopausal, then in some instances the answer is yes! Testosterone has been shown to definitively improve several aspects of sexual functioning. Testosterone improves sex drive, arousal, helps you have more and better orgasms, and increases pleasure and responsiveness. Who wouldn’t want all this at a time when your sex life tends to get a little dull and unsatisfying and in some women, a whole lot of work as well. When a midlife woman is suffering from low sex drive, testosterone can be used to improve it. This is a big deal for many women because low sex drive is uber common in midlife women and many are very distressed by it. Low drive can add a lot of stress to a relationship.
What are the benefits of testosterone?
Apart from improving your sex life, some data shows that testosterone may also help build muscle mass, improve fatigue and help with weight loss. The data isn’t definitive though and it isn’t recommended to use testosterone for these reasons.
What are the risks of testosterone?
There are no medicines without risks or side effects so don’t believe anyone who tells you a medicine has no risks. Testosterone is a hormone. It gets converted to estrogen in the body. Like estrogen, it increases your risk of blood clot. The medical term for a blood clot is deep venous thrombosis (DVT). DVTs can be quite dangerous because the clot can break away from the blood vessel and travel to your lungs and prevent you from getting oxygen. Good news though, if you don’t have a clotting disorder, are a normal weight, don’t smoke and don’t have certain other medical conditions, your risk of having a blood clot is very low. It is much lower than when a woman is pregnant or on birth control pills.
What about bioidentical hormones? Do they have risks?
Even “natural” things have risks, so don’t be fooled by the term bioidentical. Bioidentical means that whatever you are getting has the same chemical structure as the hormones that your own ovaries used to make or are currently making. Compounded “bioidenticals” are no safer than standard prescription hormones and on the flip side, there are prescription hormones that are bioidentical. Stick with the prescription ones. The companies that make them have to prove to the FDA that they are effective and safe. Compounding pharmacies don’t.
What are the side effects?
When appropriately replaced, some women on testosterone will develop acne or a little bit of facial hair. If the testosterone level in the blood gets into the male range, way too high, there can be some significant and permanent side effects like a lot of facial and body hair, deep voice, male pattern balding, and an enlarged clitoris. Your prescribing physician should be checking your blood levels to make sure you stay in the correct range. Most women do not have these side effects.
How should testosterone be given?
Testosterone should be given in a topical form, either a gel or a cream that gets absorbed through the skin daily. I prescribe testosterone as a topical cream for my patients. Women put some of the cream on their calf. This mode of delivery gives a very steady blood level of testosterone and if there is a bit of local hair growth, you can just shave it off. I don’t like the intramuscular injections of testosterone because they give you a very high dose right after you inject, then your body metabolizes it and the level goes down until your next dose when you get a whopper dose again. This creates a lot of ups and downs in your hormone levels. Not my favorite.
What about hormone pellets?
I don’t recommend certain hormone pellets-namely BioTe. Some of these tend to give women very high levels of hormones. I have seen numerous women with the same blood levels of testosterone as a man would have. At these levels, women grow beards, have deepening of the voice, male pattern balding and the clitoris grows. These changes can be permanent.
Also, pellets have not been studied in women in peer reviewed published medical studies. They haven’t been proven to be any better, safer or more “natural” than anything that has been studied. The North American Menopause Society and the American College of Obstetrics and Gynecology specifically do not recommend treatment with pellets because their safety has not been proven. For BioTe, go to their website and check out the disclaimer at the bottom of the website. It says these are not intended to treat or cure anything!
I will say women come to me feeling fantabulous on their testosterone pellets. They have amazing libido! That is because they have as much if not more testosterone floating around in their blood as their male partners and maybe as much facial hair too. Just keep in mind the permanent changes pellets may cause.
What's the best way to find out if testosterone is a good option for me?
If you are in your 40s or 50s, peri or postmenopausal, testosterone may be a good choice for you to boost your libido, barring certain medical conditions. Make sure to see a provider with experience in treating sexual conditions. A sexual medicine specialist will also look for other factors that may be contributing to your low libido like a not-so-nice partner, depression or certain medications. Testosterone is not going to improve your libido if your partner is a jerk.
TO SEE IF TESTOSTERONE IS RIGHT FOR YOU CLICK HERE
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed to practice medicine in Missouri, Tennessee and Illinois. She she sees patients in her St. Louis office and offers telehealth consults to Illinois and Tennessee. Call today to schedule your appointment. (314) 934-0551 or click click here to schedule.
How having breast cancer affects your intimate life
Breast Cancer- that thing that turned your world upside down, breast cancer survivor. Time to get your life back. But no one told you what was going to happen to your sex life!
Did you know your breast would look funny or that you would lose sensation in your chest? Your nipples would be gone? Did they tell you what lack of estrogen does to the vagina? Did anyone mention that sex was going to become excruciatingly painful or you would never want to do it again? No, no and no. Because, as they should be, everyone is working on making the cancer go away for good. At the end of the day, you still have to lead your life. But should you even worry about sex when you should feel lucky to be alive?
The answer is YES! Sex and intimacy matter! There are things you can do to improve your sex life. Giving up is just not an option.
Breast Cancer- that thing that turned your world upside down, breast cancer survivor. You never thought it would be you. No family history, you eat right, you exercise, but somehow you found a lump that turned out to be cancer. And you are young! Cancer is for old people. But no, now you embark on the road to recovery, see the oncologist, the breast surgeon, the plastic surgeon, the radiation oncologist so you can fight this disease. You get your care and it’s done. Time to get your life back.
But no one told you what was going to happen to your intimate life!
Did you know your breast would look funny or that you would lose sensation in your chest? Your nipples would be gone? Did they tell you what lack of estrogen does to the vagina? Did anyone mention that sex was going to become excruciatingly painful or you would never want to do it again? No, no and no. Because, as they should be, everyone is working on making the cancer go away for good. At the end of the day, you still have to lead your life. But should you even worry about intimacy when you should feel lucky to be alive?
The answer is YES! Intimacy matters! Sex Matters!
Finding your new sexy
Sex is going to be different now. One of the most common issues in women with breast cancer is vaginal dryness that causes painful sex.
Vaginal dryness
If your breast cancer is estrogen and/or progesterone receptor positive, then the treatment to prevent it from coming back is to prevent estrogen from working or to get rid of as much estrogen as possible so there isn’t any left to stimulate a breast cancer cell to grow. Vaginal dryness is the most common side effect of low estrogen levels. Lack of estrogen changes the vagina. When your body is making estrogen, the vaginal tissue is thick and moist and it stretches. It has proteins like collagen and elastin that help it stretch so a baby can fit out of it or a penis can fit into it. It also has special cells that make moisture when you get aroused or excited. When there is estrogen around there is a lot of blood flowing to the vagina and this makes a difference in sensation, how good sex feels. When there is minimal estrogen, the vaginal tissue gets thin and dry. It loses its collagen and elastin so it doesn’t stretch when you try to put something in it. This can cause a lot of pain, especially on initial penetration. Also, there isn’t as much blood flowing to the vagina so some women say there is a lack of sensation.
What to do about vaginal dryness
First of all, throw away your water based lubricants. Some of you may have already purchased a lubricant and yes this is the first step. Put some in your hand, put it on the outside of the vagina which is called the vulva and put some on your partner’s parts, penis or otherwise. Invest in some silicone based lube or olive oil. (unless you are using condoms, then you have to stick with the water based). Water based lubes pull the moisture out of the vagina and make dryness worse. Avoid any lubes with flavors or tingly sensations. I recommend the silicone based lubes Uberlube or Wet Platinum.
You can also moisturize the vagina. Just like you use hand lotion for dry skin, you can use a vaginal moisturizer for the vagina. There are many available on the market, but my recommendation is plain and simple, coconut oil or solid vegetable oil (Crisco). You can use as much or as little as you prefer. There is no right or wrong way to do this. If you use too much, you will feel greasy or messy. If you use too little, you won’t notice any difference at all. Put it where you feel dry on the vulva or in the vagina.
Lubes and moisturizers do a fantastic job at decreasing friction during sex. They don’t do much for increasing the stretchiness of the vagina or bringing more blood flow to it. Only low dose vaginal hormones do that. But you thought hormones were out of the question, right? Well, there are several national organizations like the North American Menopause Society who have evaluated the medical research about this and come up with some recommendations. If lubes, moisturizers and other nonhormonal treatments have not worked, women with breast cancer can discuss the risks and benefits of using low dose vaginal estrogens or intravaginal DHEA (a different hormone) with their providers. Treatment should be individualized, taking into consideration quality of life, risk of the cancer coming back and how bad your symptoms are. Yes, you can consider the use of vaginal hormones in consultation with your cancer doctor after a thorough discussion of risks and benefits.
Quality of life matters, relationships matter, human touch and intimacy matter. So bring it up with your doctor. Talk about it with your partner. Don’t just accept sex as a thing of the past. Find the right provider who can help you. You need honest and accurate answers.
Don’t just survive. . . . . THRIVE!
Coming soon, a discussion of low libido in breast cancer patients and survivors. Stay tuned!
I am a Sexual Medicine Gynecologist
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed to practice medicine in Missouri, Tennessee and Illinois. She she sees patients in her St. Louis office and offers telehealth consults to Illinois and Tennessee. Call today to schedule your appointment. (314) 934-0551 or click here to schedule.
Schedule an appointment with Dr. Lynn
Check out my website for more information.
Or call 314 934 0551 to make your appointment today!
Why can't I climax anymore?
Menopause can wreak havoc on your sex life. Difficulty with or inability to reach orgasm is just one thing menopausal women face. Great news though there is a way to get back to your normal sexual self again!
Why can’t I climax anymore?
“I just have to work sooooo hard to reach orgasm nowadays”, said my patient. My husband thinks it is him and it’s not. “I just don’t know what is wrong with me”. I hear this from my menopausal patients day in and day out. They feel bad, they are worried something is wrong with them, it is causing concern in the relationship.
You can blame menopause.
Difficulty reaching orgasm or inability to orgasm is super common during menopause. During menopause your ovaries pretty much stop making estrogen and by this time they aren’t making much testosterone either. Both the vagina and the clitoris need these hormones to function normally. So, reaching orgasm requires a lot more work, for some women. Some women then decide to forgo that elusive orgasm (or they fake it). “oh, don’t worry about taking care of me” my patient says to her partner. “You can get me next time”.
The problem with this scenario is that for the woman, the sex isn’t always that great when she doesn’t get that pleasure release of orgasm. When a woman reaches orgasm, she gets a flood of dopamine in her brain. Dopamine is that feel good hormone, it is the one that is released if you do heroin or cocaine that keeps you coming back for more. (NO, don’t do heroin or cocaine). After orgasm, your body releases oxytocin, the cuddle hormone, that makes you want to curl up next to your partner. A good orgasm is an important part of good sex. When sex starts to become not so good, sex drive decreases too. In order to want to have sex, it has to be sex worth wanting.
We just don’t learn about this stuff!!
Did anyone tell you this was going to happen during menopause? Heck, no!! Women’s sexual pleasure is a bit hush in our culture. Well, it shouldn’t be. All women should know that there is treatment for difficulty with orgasm due to lack of necessary hormones. Low dose vaginal hormones can be used and these do NOT increase your risk of breast cancer, stroke, heart attack or blood clot. I repeat, no increased risk when used vaginally. Low dose vaginal hormones bring the healthy blood flow back to the vagina. They allow the vagina to make the cells that make moisture and they allow the vagina to be stretchy again, so sex is much less likely to hurt- another menopausal trouble, to be discussed in another blog.
I have to mention that there are a variety of other things that can affect a woman’s ability to orgasm and the list is long. If you are having trouble, see your doctor. No let me change that, see your sexual medicine doctor!
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed in Missouri, Tennessee and Illinois. Call today to schedule your appointment. (314) 934-0551 or Click here to schedule an appointment.. If you are not located in Missouri, Tennessee or Illinois, Dr. Lynn offers an E Health. Click here to learn more about E Health and meet with Dr. Lynn today!
Check out our website today for more information.
Imagine Concierge Care from Your Gynecologist
Concierge care is better quality care. Dr. Becky Lynn explains how she improves the patient physician relationship leading to better care leading to better outcomes and a happier you.
How to stop the long waits in the doctors office
Have you ever waited hours in the doctor’s office to see your doctor for all of 5 minutes? Has it taken a month to get your test results back? Or no one would call you back for days and when someone did, it wasn’t the doctor. All of these things will drive a patient crazy. Concierge care came out of frustration with the current system, where doctors carry a load of about 4000 patients and on average spend about 7 minutes with you. After a hello and how is the family, that is really only 5 minutes of medical care!
As a physician, this system really weighed on me. I realized that I didn’t really know my patients like I used to. I didn’t have time to call people back when they needed information and I didn’t have time to follow up on the tests I had run in a timely manner. Not good for patients! It wasn’t so great for doctors either. After a day of seeing as many patients as my hospital system could put on my schedule, I would go home and do charting all night.
I care deeply about my patients
I care deeply about my patients. So I am making the jump into concierge medicine. This means I limit the number of patients in my practice and charge a fee, either a membership fee or a fee for service. I don’t accept insurance. I can then spend time with my patients, taking care of all their needs in one visit. I can spend up to an hour or more with a patient. Unheard of! I can really get to know people, so I can take care of the whole person. I am so excited to go back to the patient physician relationship like it should be!
Can I afford Concierge Care?
If you think not everyone can afford concierge care, well, think again. I offer an affordable, monthly plan. Also, health savings accounts and flexible spending accounts can be used to pay for care. Or you can submit your visit to your insurance company for reimbursement unless you have medicaid or medicare.
Giving Back to the Community
On the second Tuesday of every month, I provide concierge care to anyone and everyone who needs me, free of charge. Or they can contribute whatever they can afford, because everyone deserves quality care. And 7 minutes with your doctor is, plain and simple, not quality.
Dr. Becky Lynn is a gynecologist, menopause and sexual health specialist in St. Louis, MO. She is licensed to practice medicine in Missouri, Tennessee and Illinois. She she sees patients in her St. Louis office and offers telehealth consults to Illinois and Tennessee. Call today to schedule your appointment. (314) 934-0551 or click here to schedule.
Check out my website today for more information.
Or call 314 934 0551 to make your appointment today!
Listen to my radio show
I talked about the benefits of concierge care with Michael Kelley and John Hancock on KMOX on December 27th. You can listen to it here: