Let's talk a little bit about sexual function changes that occur during the menopausal time frame. So there are two big ones that occur: one is a change in libido. Women experience this change in sexual desire that goes from being more of a spontaneous sexual desire in younger years to more willingness receptive desire in menopausal years. So women may not have that innate drive to be sexual but if the situation is right, and they are not too tired and they are not going through the grocery list in their head and there is some privacy and their relationship is in a good place then it may be okay. And the interesting thing is that women actually experience arousal before they experience desire. So they may be in a sexual situation and noticed they are sexually aroused before they go "Ok, yeah, this is a good idea. I think I'm in". Then they are into the sexual situation, and things are okay. But it is this shift in going from the spontaneous sexual desire to this more responsive sexual desire, that is surprising to women and to their partners because they have lost that spontaneous drive to be sexual. And that is disturbing to many women and to their partners. So many women will come and complain about this low sexual desire. There are many things that can play into this. In the medical aspects, it includes the hormonal shifts that go on and there is no doubt that the hormonal shifts are at least partly responsible for this change. Often what doctors do is that they reassure women that they are normal. Because the message that they are getting from the media are that they are supposed to be sexual and wear lingerie and want to go out and attack their partner. But the reality is that is not going to happen for women in mid-life. They are not going to have that spontaneous sexual desire in most cases. So in most cases this going to be the right time, right place, right situation and everything works fine.
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