Oh, I see I got your attention. Well who doesn’t want better sex? That’s rhetorical—I know the answer. Well, when it comes to better sex at midlife, I spend all day every day talking with and caring for women wrestling with the very same issues you are struggling with. Here are the top issues I run into, on pretty much a weekly basis, that are getting in the way of great sex for women who are at middle age. Maybe some of them will resonate with you, and if so, make an appointment with your gynecologist to discuss them—you’ll be glad you did.

Body Mass Index (BMI)

Research is clear that there’s an association of obesity and altered sex hormones that can affect your sexuality. Losing even as little as 10 to 15 pounds can improve these hormonal shifts and minimize your risk for diabetes and hypertension that can further affect your libido.

Current Medical Concerns

Vaginal dryness, discharge, painful intercourse, or irregular bleeding need further assessment by a physician to evaluate infection, hormonal deficiencies, or other reasons why sex may not be desirable. The most important thing: know these things aren’t “normal” and you need to se your doctor and have these concerns addressed and treated.

Elevated Blood Pressure

Elevated bllood pressure and many medications used to treat hypertension can cause significant issues with your sex drive. Make sure your blood pressure is well controlled and that you are not experiencing any side effects from medication that might be creeping into your bedroom.

Chronic Pain

Chronic pain can be derived from many conditions, many of which are readily treatable. Pain is the body’s way of getting attention and addressing an area of concern. Pain should never be ignored or tolerated as oftentimes this can lead to a worsening health condition and decreased libido. If you have chronic pain, put it at the top of the list of things to discuss with your physician.

Menstrual Irregularity or Menopausal Symptoms

Menstrual irregularity or other menopausal symptoms (e.g. hot flashes, insomnia, irritability, forgetfulness, weight gain, etc.) are classic signs that there are hormonal shifts underway. Fluctuating and decreasing levels of estrogen can lower your sex drive. This is an opportunity to discuss with your Gynecologist whether birth control and or hormones in the form of hormone replacement therapy are appropriate. This conversation may require multiple visits and some trial and error to get you to where you need to be. And that’s why your physician, especially as you navigate midlife, should be viewed as your partner. A sign that you’ve found the right doctor is when she or he spends the time with you that you need, listens to your concerns, and is focused on developing a treatment plan that’s right for you.


You should always understand why you’re taking a particular medication, and it’s also important to understand any potential side effects. Over the counter medications and supplements should be discussed with your physician, and their side effect profiles reviewed. This is a very important part of your care when seeing a physician specializing in midlife care, so be sure and compile a complete list of medications and supplements you’re taking, and why, for your visit you’re your doctor. When it comes to an impact on your sex drive, diabetes and antihypertensive medications are commonly known to cause decreased libido.


Seasonal allergies and the medications required to treat them may be causing more than a runny nose. Allergies often affect both our sense of smell and pheromones, which are substances given off by the body to attract your partner. Decreased pheromones can decrease your sexual desire and your desire for your partner. Antihistamines commonly used to control allergy symptoms can be causing drowsiness, which can also have a negative impact on your sex life.

Alcohol, Drugs and Tobacco

Excessive alcohol, cigarette smoking, and drugs, like marijuana, can lower the libido and negatively affect sexual performance. Studies also show that nicotine levels can build and cause excessive lethargy, which also affects sexual desire and performance. Be honest with yourself. Is it possible you drink or smoke or engage in casual drugs more than might possibly be considered good for you? If so, it could absolutely be affecting your sex life and keeping you from what should be an important part of any woman’s life at midlife. If you have even the slightest concern that substance abuse is an issue, have a conversation with your healthcare provider right away—they can and will help.

Vitamin D

Seventy-seven percent of Americans have inadequate Vitamin D levels, yet this test is one of the most often overlooked. As a result, it’s no surprise that most people are unaware they have a Vitamin D deficiency. Women should know that decreased Vitamin D causes lower levels of estrogen and can affect your sex drive, so there’s every reason to want to correct this—and it’s easy. Adequate sunlight is all it takes to naturally raise Vitamin D levels, so finding more time to be outside, no matter what time of year it is, is important. You’ll find a quick thirty-minute walk will not only do you a world of good from a fitness standpoint, that Vitamin D you’ll get as a result is absolutely what the doctor—especially this doctor—ordered. Also, put your sunscreen on before that walk, and use it every day. Your Vitamin D level should be 30-35 ng/ml. Vitamin D3 supplements of 1,000-2,000 IU daily are often recommended to achieve these desired levels. Make sure to ask for your Vitamin D levels to be tested at your next checkup.

There you have it. And if you want to be having it—great sex at midlife, that is—then make sure you discuss these things that are relevant with your physician. Make time for an appointment, get the tests you need to have, and get yourself on the road to enjoying every single bit of this marvelousness that is midlife—including having amazing sex.

Photo Credit: Cüneyt Genç Flickr via Compfight cc