Help! Sex isn’t as satisfying anymore Q A friend said she gets fewer UTIs since starting hormone therapy. I’m prone to these infections. Should I consider it?

Private health

Q:

Recently, it’s been harder for me to have an orgasm and even when I do, it’s weak. Why might this be and what can I do? I’m 53.

A:

Many factors can cause this problem, including a drop in hormone levels, changes in blood flow, medications (antidepressants, pain medications and hypertension drugs top the list of possible culprits) or medical conditions like diabetes, hypertension or heart disease, so I suggest talking to your doctor if you suspect any of these is to blame. Otherwise, normal aging of your genital tissues can slow response rate, so it may take more stimulation or time to climax.

Using a warming oil (such as Sliquid Organics Stimulating O Gel, which has peppermint oil, sweet almond oil and menthol) or a vaginal estrogen cream, tablet or other insert can promote greater arousal by increasing blood flow to the genitals, which may in turn improve orgasm. Finally, research shows doing Kegel exercises for 12 weeks improves orgasm and sexual satisfaction in postmenopausal women.

A

A new study found that taking hormone therapy (HT) during the menopausal transition increases the lactobacillus-type bacteria in urine, which may discourage development of urinary tract infections (UTIs); this was especially true of women who took HT via a pill or patch. But since these forms deliver hormones throughout your body, I wouldn’t advise them unless you’re also experiencing other disruptive menopausal symptoms (like hot flashes, joint pain or mood issues).

If UTIs are your only symptom, ask your doctor if localized estrogen can help. Also, consider taking a cranberry supplement like Utiva UTI Control (utivahealth.com) daily. It contains 36 mg. of proanthocyanidins, compounds shown to keep bacteria from sticking to the bladder wall, reducing UTI risk.