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Not long ago, my friend Jean and I were talking, when the conversation turned to sex. She had just finished reading a book in which one of the characters was an adolescent girl in hormonal overdrive. "I used to feel that way, too, and, wow, have things changed," said Jean, a 37-year-old mother of two in Connecticut. "I thought women were supposed to reach their sexual peak in their mid-thirties. What happened?"
In an age that celebrates women who enjoy a very healthy libido (consider the popularity of the HBO series Sex and the City), the ups and downs of female desire still remain something of a mystery. But that's changing. With pharmaceutical companies in hot pursuit of a pill that could do for women's sexual fulfillment what Viagra has done for men's, experts are busy investigating what's responsible for female passion.
Researchers are finding that the sex experts Masters and Johnson were wrong when they claimed that female and male desire were alike. New studies suggest that women need to be aroused physically or psychologically to get in the mood for sex. Unlike men, who can get aroused by the sight of a buxom babe in a beer commercial, women rely on different--and subtler--cues. A woman may be responsive to intimate conversation--or a caring gesture by her husband.
Of course, you can't have a healthy sexual appetite without the hormones estrogen and testosterone. Genetics may also play a role. "The characteristics of sex drive appear to be innate early on," says Steven Petak, M.D., J.D., an endocrinologist in Houston. "But psychological factors are probably more important [than genetics]."
That helps explain why women's libidos vary. This diversity is evident not only among women, but within individuals. Like my friend Jean, you may have a strong sex drive during one stage of your life only to have your interest flag during another. Here, experts explain the hormonal, psychological and social factors that affect a woman's libido from her 20s through her 50s.
By the time women enter their 20s, the majority have regular menstrual periods--and a sex drive that ebbs and flows with their cycle. "Around ovulation"--not coincidentally, the time of peak fertility--"women have more interest in sex and are better able to have an orgasm than women who are just about to get their period," says Anita H. Clayton, M.D., associate professor and vice chair of the department of psychiatric medicine at the University of Virginia Health System, in Charlottesville.Finding their way
Contrary to popular belief, the 20s are not necessarily a time of sexual voraciousness. Many young women are grappling with identity and body-image problems at the same time that they're trying to establish themselves professionally and find a mate. According to the National Health and Social Life Survey (NHSLS), conducted at the University of Chicago, unmarried women are nearly twice as likely as married women to have anxiety about their sexual performance and have difficulty climaxing. "A woman's sexual interest is greatest when she's in a stable relationship," says Sheryl Kingsberg, Ph.D., assistant professor of reproductive biology and psychiatry at Case Western Reserve University, in Cleveland.Use it or lose it
If a woman in her 20s doesn't have frequent sex, her desire may wane, according to Clayton. Studies have shown that women who engage in sexual activity less than once a week are more likely to have irregular menstrual cycles and ovulation problems than those who do so weekly.The fear of disease
Two thirds of sexually transmitted diseases (STDs) occur in people 25 and younger, and women are more likely to be infected than men, according to the National Institute of Allergy and Infectious Diseases. Those who have contracted an STD may experience shame and be less interested in sex. And women who want to protect themselves must negotiate condom use with their partner, which may dampen desire.Birth control and the blues
The most popular form of contraception for twentysomething women is the birth control pill. But because it suppresses testosterone production, some women find that the Pill actually undercuts desire. Others, however, find the Pill's convenience--and its reassuringly high success rate--helps promote passion. Another factor influencing sex drive: Up to 20 percent of women in their 20s struggle with clinical depression, a condition that diminishes desire. While antidepressants may boost a woman's mood, some may lower her libido.
By the time women have hit their 30s, most have acquired some level of self-understanding. They're also likely to have established a stable relationship. Having a husband can be an aphrodisiac for women; the libido flourishes in the security of a committed relationship. But the stresses of child rearing and a career can diminish desire.
Practice makes perfect. Women get better at achieving orgasm in their 30s, which may stimulate desire--hence the popular notion that women reach their sexual peak in their 30s. "During the first few years of marriage, before children, women have, on average, the fewest sexual complaints of their lives," says Louann Brizendine, M.D., co-director of the program in sexual health at the University of California, San Francisco. That testosterone levels begin to decline at around 35 is not necessarily meaningful.The power of pregnancy
For many women, the 30s are the reproductive years. During the second trimester of pregnancy, when you are no longer struggling with nausea but are not yet so big that sex feels like an elaborate game of Twister, many women find they have a surge in desire. This can be attributed, in part, to a sense of connection to your partner, but hormones also play a role. During pregnancy, there is a thousandfold increase in progesterone and a hundredfold increase in estrogen, which causes the vaginal lips to engorge and become more lubricated. The pressure of the growing baby on the genitals may also be a turn-on. In their book, For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life (Henry Holt, 2001), sex therapist Laura Berman and her sister, Jennifer Berman, M.D., a urologist, say that during the second trimester, "Some women feel they are constantly in a state of mild sexual arousal." Being pregnant with a boy can further heighten desire; during the second trimester, the male fetus starts producing testosterone, which may boost Mom's libido.Post-baby burnout
Many women find that after the baby comes, sex has all the appeal of a root canal. This falloff in desire can be attributed, in part, to exhaustion, but hormones are also implicated. Testosterone levels drop by about half after childbirth, though they quickly return to normal. "It's common for couples to have only one or two sexual encounters up to four months after the baby is born," says Brizendine. For Margo, a 33-year-old mother of one, those few encounters were memorable if only because of the pain, a problem that affects 70 percent of women in the first six months postpartum. "We kept trying, but it took a few months--and a bottle of Astroglide," she recalls.
Nursing mothers may be particularly uninterested in sex. Breastfeeding causes the release of the hormone prolactin, which can suppress ovulation and estrogen production, as well as testosterone. "Nursing mothers are experiencing the equivalent of menopause," says Mary Lake Polan, M.D., Ph.D., professor and chair of the department of gynecology and obstetrics at Stanford University School of Medicine, in Palo Alto, California.
But you don't have to be nursing to find your interest in sex waning. The Berman sisters observe that about 60 percent of the women in their practice have low levels of testosterone--a key to desire--after the birth of their second or third child. While the reason is unclear, Jennifer Berman believes this may be due to decreased production of testosterone by the ovaries or an acquired enzyme deficiency that hinders testosterone production.Stressed to the max
Even if your hormone levels are normal, the advent of parenthood can throw a bucket of ice water on desire. Between the demands of work, young children and housekeeping, women in their 30s are under tremendous pressure. Often, they're angry at their husbands, who don't seem to take on an equal share of the new demands. "Women hit their stress peak in their thirties," says Peter Kanaris, Ph.D., a psychologist and sex therapist in Smithtown, New York. "And stress is a killer of desire."
Hormone levels are starting to decline, but midlife can be a time of sexual reawakening. Many women find that they're less burdened by the stressors -- children, financial uncertainty -- that can undermine desire in the 30s.The new sexual peak?
According to the NHSLS, the prevalence of sexual problems in women tends to decrease with advancing age. Like women in their 30s, fortysomethings are at ease with their sexual selves, but now they have the time and energy to enjoy this aspect of their life. Even if you experience a decline in interest, you may find that you can achieve new heights of sexual satisfaction. "Women [at this age] know what they want sexually and are not afraid to ask for it," says Sheryl Kingsberg. (The sad irony is that, with the passage of time, sexual problems become more prevalent in men; see "The Keys to His Desire,")Hormones gone haywire
This is also the decade when women enter perimenopause, the period preceding menopause, when production of estrogen and testosterone begins dropping off. Perimenopause typically kicks in at age 46. About half of all women over 45 experience some symptoms, including irregular periods, lower libido and vaginal dryness. But a decline in sex drive doesn't mean sex can't be great. "You might not have the spontaneous interest, but your ability to achieve orgasm doesn't change in your forties," says Kingsberg.The Pill for perimenopause
Many perimenopausal women are prescribed birth control pills to help stabilize hormonal fluctuations and ease symptoms. Of course, the Pill also protects against unwanted pregnancy, which can occur during this transition. Although the Pill may interfere with desire, it may also help a perimenopausal woman feel like herself again--and perhaps more in the mood for sex.Thyroid trouble
Disorders of the thyroid gland, which produces hormones that stimulate body functions, are common in women over 40. By age 40, 1 in 15 women have thyroid problems; by age 50, 1 in 10 women do. Hypothyroidism, in which the gland secretes too little hormones, is a major cause of low libido. Women with the condition also experience fatigue, weight gain and depression. Fortunately, treatment with synthetic thyroid hormone helps relieve symptoms.
Although the 50s heralds menopause--and a dramatic change in sexual desire--many women discover that this decade offers some libido-boosting benefits.Good-bye hormones
When women enter menopause, typically at age 51, about 40 percent begin to experience an even more significant drop-off in sexual interest or report some kind of dysfunction, says Mary Lake Polan. Small wonder: With menopause, there's a dramatic decrease in the ovaries' production of estrogen, the hormone that helps lubricate the vagina and increases blood flow to the genitals. Testosterone also declines.The bright side of menopause
Many women are thrilled to put the hassles of menstruation and contraception behind them. And even though you can't count on your hormones to rev up your libido, you don't have to kiss your sex life good-bye. New medications, including Viagra, are currently being tested.Getting a handle on HRT
Many postmenopausal women take hormone replacement therapy (HRT), which usually involves a combination of estrogen and a synthetic version of progesterone. While HRT is effective in treating symptoms of menopause, such as vaginal dryness and hot flashes, it can lower testosterone levels, dampening libido, according to Laura and Jennifer Berman. As a result, some physicians are starting to prescribe testosterone in addition to HRT.