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Know that old song, "Where Did Our Love Go?" Many women in their 40s, 50s, and 60s are asking, "Where did our sex go?" Loss of desire is common among women in the years before and after menopause. Desire problems peak between ages 35 to 64.

Hormones don't deserve all the blame, though. The causes of lost sex drive are complex. Here are some of the top factors behind "hypoactive sexual desire disorder," and what can be done.

Sex Drive Zapper: Estrogen Changes

Before menopause, your sex drive peaked just before and after you ovulated. But when your periods stop, estrogen dips, and those revved-up days in your cycle are gone.

Menopausal women may respond less to touch, too, and find it harder to get aroused. Less estrogen also means less blood flow to the vagina, and more dryness. So when you do have sex, it can hurt. Who wants sex that feels bad?

What helps:  First, stop the pain. Try over-the-counter water-based lubricants. Ask your doctor about prescription medications to fight dryness: There are oral drugs available, as well as vaginal creams, which have fewer side effects than oral hormones.

Traditional hormone replacement therapy doesn't seem to kindle desire for most women. What it can do is ease hot flashes and other symptoms that leave you feeling not-so-sexy. 

Sex Drive Zapper: Life Stress

At midlife, many women are deep into a marriage, a job, raising teens, and caregiving. Any of these can amp up stress, and stress puts your sex drive in park. Avoiding sex can, in turn, cause tension with your partner. Low desire is more common in long-term relationships. Because all this happens at once, it may seem like menopause is the cause, but there are many factors.

What helps: Take the focus off intercourse. Spend more time on foreplay and try other kinds of sex play, such as massage and oral sex. Seek out short-term couples counseling when your sex life hits a rough patch.

Sex Drive Zapper: Androgen Changes

In both sexes, desire tends to fall as we get older. Women are two to three times more prone to a drop in desire. In part, blame dropping androgens -- male hormones that are also found in women.

What helps: There's no FDA-approved male hormone therapy for women with sexual problems, but some doctors prescribe creams off-label for some women. The major problem with this type of treatment in women is the side effects, which include acne and excess body and facial hair. Being mindful of diet, sleep, and exercise can help restore libido.

There's good news about aging and sex, too: Time. Many women report feeling an uptick in desire after menopause.

experiencing moderate to severe painful intercourse

Moderate to Severe Painful Sex Due to Menopause?

Many women experiencing very painful sex after menopause never initiate a conversation with their healthcare providers. But providers can help. Open up and start talking.

find the words to get help

Find the Words to Get Help

Don't live in silence about the changes you face in your menopausal years. Moderate to severe painful intercourse after menopause can often be treated. You are not alone.

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Important Safety Information for Osphena

Most Important Information you should know about Osphena (ospemifene)

Osphena works like estrogen in the lining of the uterus, but can work differently in other parts of the body.

Taking estrogen alone or Osphena may increase your chance for getting cancer of the lining of the uterus, strokes, and blood clots. Vaginal bleeding after menopause may be a warning sign of cancer of the lining of the uterus. Your healthcare provider should check any unusual vaginal bleeding to find out the cause, so tell them right away if this happens while you are using Osphena.

You and your healthcare provider should talk regularly about whether you still need treatment with Osphena.

Call your healthcare provider right away if you get changes in vision or speech, sudden new severe headaches, and severe pains in your chest or legs with or without shortness of breath, weakness and fatigue.

Osphena should not be used if you have unusual vaginal bleeding; have or have had certain types of cancers (including cancer of the breast or uterus); have or had blood clots; had a stroke or heart attack; have severe liver problems; or think you may be pregnant. Tell your healthcare provider if you are going to have surgery or will be on bed rest.

Possible side effects of Osphena

Serious but less common side effects can include stroke, blood clots, and cancer of the lining of the uterus.

Common side effects can include hot flashes, vaginal discharge, muscle spasms and increased sweating.

Tell your healthcare provider about all of the medicines you take as some medicines may affect how Osphena works. Osphena may also affect how other medicines work.

What is Osphena (ospemifene) tablets?

Osphena is a prescription oral pill that treats painful intercourse, a symptom of changes in and around your vagina, due to menopause.

Please read the Patient Information for Osphena (ospemifene) tablets, including Boxed WARNING in the Full Prescribing Information.

OSP13-WWW-038-00 11/13

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