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Writer's pictureJeannie Collins Beaudin

"Sorry, dear, not tonight..."


Some years ago, when my husband and I owned a pharmacy, we attended huge pharmacy buying shows in Toronto each year to find new products to sell in our pharmacy. At one of these, I saw an interesting display of “Play” brand products… essentially a line of sex toys designed to be sold in a pharmacy. I was quite surprised to see it there (aren’t these things only sold in sex shops?)

The company representative explained that sex is part of a healthy lifestyle, and some just need a little help to get things going, especially as they get older. But many people would be too embarrassed enter a sex shop, and some might hesitate to even bring up their problem with their doctor.

But everyone goes to a pharmacy and might consider a discreetly packaged aid to improving their sex life. Pharmacists have private counselling areas where women could discreetly ask a woman pharmacist about ways to address a minor problem, such as dryness or irritation.

Of course, what’s considered “normal” can very from person to person, and in the same person over time. A reduced interest in sexual activity is only a problem if you feel it is, or if it creates friction with your partner.

Sometimes the problem can be “in our head”

Problems in the bedroom, or even being interested in the first place, can originate in our mind as well as our body. It can happen at any age but becomes more common in women as we move into the mid-life years.

For example, many of us can become “sandwiched” between caring for teenagers and elderly parents while still working at full-time jobs. Being stressed and overtired is a recipe for a lack of libido, our interest in sex. “Please, not now, I just want to sleep.”

For some, just creating time and the environment for intimacy is all that is needed – booking a “date night” to spend unpressured time together. For others, it may mean addressing an underlying worry that is taking too great a toll.

Depression can be a reason for low libido but I’m sure anyone who is depressed has more worries on their mind than a lack of sex. Always best to talk to your doctor if blue feelings seem to hang on longer than they should and are affecting your quality of life.

There are psychologists who specialize in helping overcome the psychological side of low libido. Of course, I’m not a psychologist but I used to work with such a professional – we referred patients to each other when we felt the other could better address a woman’s problem. If, after her analysis she believed the source of the woman’s low libido was hormonal, she referred her to me; if I saw no signs of a hormone imbalance that would contribute to a lack of sexual interest, I would suggest the woman see my colleague.

There can be physical causes too…

Mis-matched libidos can cause difficulties in a relationship or they can be the result of a problem unrelated to sex in a relationship. Presuming that you have a good relationship with your partner that is not contributing to a disinterest in sex, and don’t have any overwhelming stresses in your life, the root of the problem might be something physical that can be quite easily solved by your pharmacist.

A common cause of sexual problems in women is lack of lubrication. As we age our production of vaginal mucous generally decreases. Taking a little time to “warm up” with extra foreplay may be all that is needed. Let your partner know this. Being a little dehydrated can also result in less lubrication and alcohol is dehydrating. Try drinking a glass of water along with that wine and avoid overdoing the alcohol to prevent dehydration.

There are also lubricants made especially for intimate use. If you are treating dryness avoid ones with ingredients added to create a “warming sensation”, flavours or scents at least initially, as these extra ingredients increase the chance the product itself will cause irritation. KY Jelly is a popular brand and there are several generic ones also available. Look for a water-based “personal lubricant” as a good choice. There are also silicone- and oil-based lubricants but there can be compatibility issues with condoms or sexual aid products. Note that silicone lubricants tend to last longer, while oil-based ones last less time. In a pinch, a kitchen oil can be tried, but regular use of these can increase risk of a vaginal infection. Many stores display lubricants next to their selection of condoms, or you may find them in the feminine hygiene product section.

Be aware that there is also a higher-level product for dryness, called Replens. This gel contains added ingredients that help the product cling to the surface of the vagina, prolonging its action. It is designed to be used less often than a personal lubricant, usually every 3 days, as the product stays effective for several days.

Vaginal atrophy

The tissues of the vagina depend on both estrogen and testosterone for growth and health. With very low levels of either of these hormones, or if sexual activity has been out of the picture for a long time, the vagina can wither or atrophy. Sex itself increases the blood circulation to the vaginal area, keeping it healthier.

Taking hormone replacement supplies the vagina with hormones along with the rest of the body but, if the only problem is vaginal atrophy, there are hormone replacement products that can be applied directly and only a low dose is needed. There are suppositories and creams available for vaginal use, and compounding pharmacists commonly make a cream or gel from a weak estrogen, called estriol, that works well on vaginal tissues. You would need to see your doctor to discuss these options.

Vaginal infections

If you experience irritation of the vulva area (the outside of the vagina), consider the possibility of a vaginal infection. Symptoms of infection vary with the type. You will note that these involve irritation but also a discharge, not actual dryness. Here are two common types of vaginal infections:

  • Yeast infection (vaginal candidiasis)—itchiness; thick, white, cottage-cheese-like discharge; soreness or burning during intercourse or while urinating; no odour

  • Bacterial vaginosis—itching; burning during urination; thin, grey, white or greenish discharge, “fishy” odour

  • If you haven’t experienced an infection before you will need to see your doctor for a diagnosis. Many women recognize the symptoms when an infection reoccurs. Yeast treatments can be purchased without a prescription but treatments for a bacterial infection usually require one. Depending on laws in your jurisdiction, a pharmacist may be able to renew a prescription based on your description of symptoms similar to a previous episode.

Back at the show…

So, when I saw this interesting line of products at the trade show designed to help with common problems with sexual function that can arise during and after the menopausal change, I decided to write an article for a pharmacy journal, where I had a monthly column, to bring these to the attention of other pharmacists. As I often did my own photography for my articles, I asked for some samples to take home. I didn’t want the boxes crushed in my suitcase, so I decided to just carry them home carefully in a plastic bag. As we approached the security check at the airport, I felt a little embarrassed that the agents would be examining the parcel I was carrying. I asked my husband if he would take the bag through the checkpoint for me.

We ended up in different security lines for some reason. And as my husband went though, the agent examining his things looked over at me, smiled and waved. How odd. Afterward, I asked my hubby what that was about… He said, “I told him these were sex toys that belonged to my wife in the next line, and I was just carrying them for her!” I thought I’d die laughing…

I shouldn’t have been so embarrassed really. But, especially in North America, sex is something that almost everyone has done but never talks about, even when problems develop that could easily be resolved. We should feel comfortable discussing low libido or physical difficulties that prevent us from enjoying a wonderful part of our relationship with our partner. And remember, if it’s a minor problem, such as mild vaginal dryness, you can ask to speak to your pharmacist about it in a private area.

Lastly, we should realize that a sexual relationship doesn’t necessarily need to include sexual intercourse. Couples can still enjoy intimacy that fosters a close relationship and displays their love, even if they are no longer capable of performing the actual act. It’s all about loving, enjoying and giving pleasure to each other, and being close, after all.

References:

Can I Speak to the Hormone Lady? J Collins Beaudin

Yeast infection (vaginal)—Mayo Clinic

Bacterial vaginosis—Mayo Clinic

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