Suzi Godson

Australian study follows group of women for ten years and discovers that post-menopausal women lose sexual function”; “UK study reinforces finding that four in ten women are affected by sexual problems”. Yada, yada, yada.

It's depressing, isn't it? Women of a certain age are so used to being told they should expect their libido to fail, that they approach menopause fully expecting to swap their G-strings for fleecy dressing gowns. Nearly 80 per cent of women attending sex therapy clinics suffer from low sexual desire, a condition with symptoms that include: loss of sexual “spark”; little desire to initiate sex; aversion to sexual overtures; and pain on intercourse. The causes? Extreme tiredness, stress, depression, use of antidepressants (bit of a catch-22 that one) and general unhappiness in a relationship.

Female sexual arousal disorder or hypoactive sexual desire disorder may be related to ailments that affect blood flow. For example, a 1987 study showed that 78 per cent of women being treated for raised blood pressure had difficulty in becoming sexually aroused, but it could also occur as a result of heart disease, diabetes, thyroid problems, surgery, multiple sclerosis, obesity, taking antihistamines, narcotics, the list goes on.

It's a well-known fact that expectation influences outcome. Actually it's a scientifically proven theory. In 1963 the Harvard psychologist, Robert Rosenthal, and Lenore Jacobson, the principal of an elementary school in San Francisco, collaborated on a study which demonstrated that if teachers are led to expect enhanced performance from some children, then the children do indeed perform better. Known as the Pygmalion effect, the theory could just as easily be applied to assumptions about female sexual function in later life.

So, although it is my duty to point out that your inability to respond to your “someone special” could be an indication that you are suffering from a “condition”, I also suspect that older women who are primed to believe that their libidos will fail them are simply living up to expectations. Before you pursue some kind of diagnosis I would urge you to consider whether you are expecting your “special someone” to crank up a rusty libido that you have failed to keep oiled.

If you haven't been masturbating, you need to. Invest in a good vibrator such as the Hitachi Magic Wand (www.loveshackuk .com) and use it with a good lubricant. Astroglide is great or you could try the Yes (www.yesyesyes.org ) organic range. You might also want to get some erotic reading from www.lovehoney.co.uk/eroticbookclub . In your own time, reacquaint yourself with the sensations of arousal, penetration and orgasm until you become more confident about your sexual response.

With your partner, focus on intimacy and sensuality initi-ally. Get used to seeing and feeling each other naked. Take lots of exercise for strength and stamina and swap your dressing gown for a lace and freshwater pearl G-string (£63; www.myla.com ). Good luck.

Suzi Godson is the author of The Sex Book (Cassell, £16.99) and The Body Bible (Penguin, £16.99)

Dr Thomas Stuttaford

To answer your question in depth we would need to know more about your age than that you are post-menopausal. It would also have been helpful to have been given some account of your previous sex life.

The age of the menopause varies enormously from person to person but the average age remains remarkably constant. Despite a better diet and a less arduous life it has only crept up over the last generation and is now described as being aged 52 rather than 51. I assume that you are in your late fifties or early sixties.

The physical sexual response in women changes throughout their lives and the men involved are responsible for only a relatively small part of this. Although the more open approach to sex of the past 50 years has had its effect on female libido it hasn't ironed out the age-related differences. It is still true that most women are not easily turned on physically until their early to mid-twenties when they become increas-ingly sexually aware, responsive and in an appreciable percentage of cases multi-orgasmic. Childbirth almost invariably decreases libido for a time. In the immediate period before the menopause and thereafter, women's physical sexual needs may decrease, increase or, as happens ideally, remain the same.

Whether 17, 37, or 67 a woman's sexual drive is influenced strongly by mood. Any hint of depression, perhaps so ill-defined that it hasn't been diagnosed, can be death to libido. Conversely, a patient who is hypomanic - over-exuberant and outwardly constantly jovial - may make greater sexual demands on her partner than he can satisfy. A woman in whom a fragile self- esteem is part of her pattern of depressive symptoms may find that the boost in her morale afforded by being sexually desired can lead to almost avaricious sexual needs, despite an underlying depressive mood.

It is now realised that physical problems could also be the underlying cause of female sexual dysfunction. If it is some years since you have had a good relationship, and you have been suffering some degree of sexual famine, you will need a thorough physical assessment and a retuning of your system. The physical basis of the sexual response in men and women is largely achieved by testosterone levels and in women by the oestrogen/testosterone balance.

Now that you want a reactivated sex life you may well need a short course of hormone replacement treatment (HRT) followed by hormonal creams. The addition of small doses of testosterone to the initial cocktail can be helpful.

I would also recommend that you discuss with your doctor the possibility that you may be minimally depressed. Depression with a loss of libido, despite a good emotional and intellectual attachment to a partner, is so common during the menopause that some specialists assume that it is a factor.

Older women understandably often experience reluctance at the start of an affair to expose a body ravaged by time, childbirth and the redistribution of fat from limbs to abdomen. It may help your self-esteem to dim the lights, but be reassured that most older men, who have their own inadequacies, are not critical but grateful.

Dr Thomas Stuttaford, the Times doctor, spent many years working in a genitourinary clinic

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