Q I am a married 54-year-old post-menopausal woman. My libido has diminished significantly, and it takes me much longer to climax. My husband gets tired sooner and is unable to maintain an erection as long as he used to; this makes it even more difficult for me to climax. I have taken up an activity I did in my 20s when I was single: giving myself enemas. The enema-induced orgasms are fantastic. It's not an obsessive habit. I'll sometimes do it four times in one week and then go a month without one. Am I doing any harm to my body by doing frequent quart-size soapy enemas using a retention balloon nozzle and holding it as long as possible and then masturbating as I expel? Will a doctor be able to tell what I've been up to when it's time for a colonoscopy? I would die if a doctor figured it out. --Frustrated Lady Earnestly Enquires Today
A "Women need to understand that our sexualities change throughout life," says Dr. Leah Torres, a general obstetrician/gynecologist with a special focus on family planning. "What once was will not always be. That said, menopause can be tricky, but one can adapt to changes that may occur. There are medications and lubricants and all sorts of tricks."
Yeah, yeah---but what about the freakin' enemas, doc? "The enemas are not harmful as long as they are not painful, though this practice may change the balance of bacteria that normally live in the colon and may make one more susceptible to changes in bowel movements," says Torres.
As for your fear of being discovered, FLEET, Torres says you should be able to rely on your doc's professionalism. "I have not seen many colonoscopies, so I would not know a physician's ability to determine a person's level of enema activity," says Torres. "But as a physician who prides herself in building trust with patients, I would never disclose my knowledge of sexual activities that may make my patient uncomfortable or embarrassed unless there is a concern for her health or it directly affects her care."
If it would really and truly kill you if your doc figured it out, FLEET, how about a white lie? Mention the fact that you're administering enemas to yourself, leaving the masturbate-as-you-expel bit out and ask your doc if that's a problem. "She can ask her doctor an 'innocent' question such as 'When I feel constipated, I give myself an enema. Is that dangerous?'" says Torres. "No need to mention masturbation, and the doctor's answer may allay her other concerns."
Q My mother cannot find her clit. I'm serious. She's 80 years old, quite fit and otherwise anatomically correct, but she noticed about a week back that she couldn't find her clit. She went to her gyno and told him, and he didn't seem shocked. She isn't sexually active, but she'd like to keep as many of her original parts as she can. I searched online and couldn't find much about missing clits. I've told her that no news is good news, but you try living with a clitless mother! --Help My Mother Find Her Clit
A "It is normal for the vagina, and the parts within and around the vagina, to atrophy with age," says Torres. "And women who have gone through menopause have very little estrogen. For the lady parts, estrogen is crucial in upkeeping the healthy, youthful appearance of vaginal and labial tissues as well as for the laxity of the vagina." But there's one thing that doesn't happen during menopause. "Women do not 'lose' their clitorises," says Torres. "The majority of the clitoris is located inside the body, but women recognize the 'clitoral glans' as the clitoris. This may become smaller with age, making it seem as though the clitoris has disappeared. But let me be clear: The clitoris never goes away."
Q My husband and I both hit 40 this year. We are one of those straight couples that have been together since high school. We were kinky right from the start, became involved in the BDSM community in our 20s and found ourselves in a poly relationship before we even knew that was an option. After years of struggling with polycystic ovary syndrome, I had a hysterectomy a couple of years ago, and I've had a hard time getting regulated with hormone replacement. There was a lot of extra bodily trauma with my surgery, and I've been trying to be patient in getting back into my sexual self, but it's been a struggle. I have no interest anymore in kink, and I'm having a hard time wrapping my head around how I could go from being a pain slut to not even liking to have my hair pulled. I wouldn't say that I've totally lost interest in sex, but I don't have the driving need for it that I used to. I haven't had luck talking to my OB/GYNS. If I'm not having hot flashes, in their opinion, I shouldn't mess with it. I'm having a hard time talking to my husband He sees my lack of interest in sex as a lack of interest in him. --Too Young To Be Old
A "Society makes talking about sex taboo, and that taboo can invade the clinic room and adversely affect the doctor-patient relationship," says Torres.
Dr. Torres is a professional and she's being polite. Translation: Your current OB/GYNs suck santorum-smeared donkey balls, TYTBO. If your docs are unwilling to discuss and prioritize your sex life, you need to get new OB/GYNs.
"If a patient comes to me with changes in sexual function that concern her and she wants addressed," Torres says, "it is the same as if she came to me with 'it hurts right here, doc.' It is something that needs investigating. Having a hysterectomy often includes removing the ovaries, which is equivalent to inducing menopause. No ovaries equals no estrogen equals menopause. Even if you still have your ovaries, their function may be affected by a hysterectomy. This can affect the libido or it may have no effect whatsoever. Everyone is different. Also, after major surgery, particularly after a difficult and prolonged recovery, people may not enjoy sex the same way they used to for a variety of reasons. For this woman, pain may now be associated with the struggle to recover as opposed to what it used to be associated with: orgasm."
So what does the doctor recommend? "There are options other than female hormone replacement therapy for treating hypoactive sexual desire," says Torres, "and it may be a good idea to consult a specialist in sexual health."
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