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    Older Women Say They Want More Sex, Not Less

    Study Flouts Conventional Wisdom About Low Libido in Older Women

    The Role of Hormone Replacement Therapy

    Women who were on HRT at the beginning of the study reported higher levels of sexual activity than those who were not.

    But in a finding that was puzzling to researchers, women who were assigned to take hormones as part of the study weren’t significantly more likely than those taking placebo pills to continue to have sex over time.

    "I was very surprised that we didn’t see greater effect of hormone therapy in these women," says study researcher Margery Gass, MD, executive director of the North American Menopause Society in Mayfield Heights, Ohio.

    Gass explains that since the findings of the Women’s Health Initiative were announced, namely that combined estrogen and progestin therapy increased a woman’s risk of heart attacks, strokes, and breast cancer, prescriptions for hormone pills and patches have declined.

    But prescriptions for vaginal estrogen treatments, like creams and tablets, have increased as women look for ways to relieve vaginal dryness and loss of vaginal tissue and muscle tone, called vaginal atrophy.

    "As gynecologists, we see the women who are having problems, and we are totally convinced that hormones do help women a great deal if they are experiencing dryness and discomfort with intercourse," Gass tells WebMD.

    She says she thinks the finding that hormones didn’t appear to have any influence in sexual function may be due to the fact that the study wasn’t really designed to test hormones for that reason. And she says because most of the women in the study were married, they may have had long-established patterns of sexual activity and continued to stick to the habits despite having some discomfort.

    Use It or Lose It?

    Indeed, physical symptoms that could make sex uncomfortable didn’t appear to slow women down. Women who reported having moderate to severe vaginal dryness were more like to report being sexually active.

    Overall, 70% of women had vaginal atrophy in the study were more likely to report being sexually inactive. But Gass says it is tough to tell which problem came first.

    In this case, the "use it or lose it" principle may be the key to maintaining good sexual function.

    "In that regard, it’s just like every other part of our body,” she says. “If we want to stay in shape, playing tennis, golf, running, whatever we like to do, it’s vital that we keep doing it, and this is perfectly true for intercourse as well,” Gass says. “If you want to be able to be comfortable and enjoy intercourse, the best thing you can do is to maintain that activity and be consistent and regular with it."

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