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Never before has the subject of women’s sexual health been discussed as much or as openly as it is now! Unlike many of our mothers and grandmothers, we’re not “out of business” once we’ve gone through menopause, and we want to learn all we can to help us stay physically–and sexually–healthy. Thankfully, a new kind of doctor wants to teach us just what we need to know. Dr. Alyssa Dweck, an OB/GYN practicing in Mount Kisco, New York, is one of them.

Once Dr. Dweck’s patients have stopped having babies, she doesn’t quit taking care of them. She consults with women about nutrition (she holds a Masters Degree in Human Nutrition from Columbia University), and has great expertise in female sexual health and medical sex therapy, not to mention great passion for the subjects. 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 late fifties and the sixties. You can learn about the forties here and your fifties here.

Bladder leakage is a common concern for women in their sixties and might actually be an even more uncomfortable subject for discussion than sexual problems. Women are mortified to broach this topic, but there’s a reason why the incontinence pad industry is so lucrative. Although genetic factors, such as weak pelvic tissue, play a role in leaking urine in your later years, other issues are influential, such as childbirth, diuretic medicines (water pills), heavy caffeine intake and obesity. Some problems are correctable; some not so much.

“When you leak, and your bottom is constantly exposed to caustic, acidic urine, your vulvar tissues become inflamed and irritated. Moisturizing washes and products can play a key preventative role here. Change pads often to stay dry and urinate frequently on the clock so you’re less likely to have a distended bladder and that overwhelming urge to go. Avoiding caffeine, maintaining a healthy weight, and doing kegel exercises are other important pearls to consider.

“There’s a strong population of women who remain sexually active and vibrant in their sixties. Certainly, there’s another group who have acquiesced and are acclimated to the fact that they’re less sexual, and they’re fine with that. They have a good relationship with their partners, and they are happy with alternate forms of intimacy, such as cuddling, hugging and mutual masturbation. Oral sex is especially popular since penetration can become uncomfortable and erectile dysfunction might also be an issue. Moisturizers and lubricants are all important at this age and vaginal estrogen is another option.

The pendulum regarding hormone replacement therapy has swung once again, since the Women’s Health Initiative was first reported. Systemic hormone replacement therapy is a viable option for some and each woman is individual in her needs with dosing and duration. Menopause shouldn’t be looked upon as a disease but rather as a natural rite of passage and a truly liberating time when you don’t have to worry about getting pregnant or bleeding. I say best to embrace it!

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