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Once Dr. Alyssa Dweck’s patients have stopped having babies, she doesn’t stop caring about and for them. An OB/GYN practicing in Mount Kisco, NY, Dr. Dweck advises them about nutrition (she holds a Masters Degree in Human Nutrition from Columbia University), and has a special interest and expertise in female sexual health and medical sex therapy. A powerful proponent of the “use it or lose it” credo when it comes to our vaginas, Dr. Dweck offers exceptional advice to women of all ages. I sat down with the great doctor to learn what she has to say about the sexual health issues women face in their forties, fifties, sixties, and beyond. Here’s the low-down on the fifties. You can learn about the forties here.

“Although the average age of menopause is 52, there are still women who are menstruating well into their fifties, albeit more erratically. Estrogen levels are variable through the transition. While the need for contraception is not as great, it can’t be ignored. My routine discussions with patients in their fifties focus on menopausal complaints, including hot flashes, night sweats, vaginal dryness, and the menopausal syndrome in general. Some women experience absolutely no symptoms; others get everything. You name it, they have it: joint pain, mental fogginess, changes in vaginal secretions or odor, loss of libido and trouble with their weight In fact, a majority of women in their fifties seem to struggle with their weight.

“Some women find themselves more prone to vaginal dryness or even infection as they age, and they might need to revisit their hygiene regimen. Long standing habits might suddenly cause irritation or sensitivity and moisture becomes a priority.”

“Women in their fifties often admit to sexual concerns, most commonly, loss of libido. This is a complex issue with many possible causes including, hormonal changes, relationship issues, body image issues, financial strains and other general life stresses that arise midlife. Orgasms might get weaker and vaginal dryness might be an issue; a result of tissue becoming more delicate. The “use It or lose It” phenomenon surely comes into play here.

“If you have a new partner, no matter how old you are, STD prevention must be considered. Truth be told, I see plenty of women from nearby retirement communities who are unknowingly exposed to STDs, such as herpes. Some women who are newly divorced or widowed, and new to the dating scene, might not accustomed to using condoms, but they must!

“Finally, there is massive confusion about the difference between vaginal moisturizers and vaginal lubricants. Whereas moisturizers are used all the time to keep the skin supple and soft; lubricants are used, on demand, during sexual relations for comfort and pleasure. Hyaluronic acid is a welcome ingredient in vaginal moisturizers. In fact, I highly recommend hygiene products without heavy fragrances and free of harsh chemicals for women of any age. Moisturizing properties are especially important when you’re in your fifties.”

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