ONIKA HENRY

In my last two articles I shared with you the importance of the mind and its capacity to house a vast reservoir of erotic imagery and thoughts, and it's role as the storehouse for attitudes, beliefs and knowledge which means that it can always be accessed for sexual pleasure. I also shared the need to focus on diet and nutrition, and that the focus should be on the basics of a healthy diet and eating foods that enhance or support healthy sexual function - foods that help with vaginal lubrication and help treat hormonal imbalances. We looked at the critical role exercise plays in helping you to reduce pain and increase comfort during sexual activity, including exercises for your pelvic floor which many consider to be the seat of your life force and sexual energy. The pelvis has a great deal of erectile erogenous tissue within it, so I encouraged you to do your pelvic strengthening exercises in ways that make the experience as fun as possible.

Today we will focus on the last two of the 'pillars' - hormonal treatments and my secret ingredient.

Hormonal treatments

In the medical world, the word therapy is used when there is disease, dysfunction or condition that requires therapy. Menopause is a normal physiological process and so I prefer to use the more neutral terms of 'treatment' or 'management'. We have to remember that menopause is not a disease - it is a stage of life. And post menopausal symptoms do eventually go away. If the symptoms are really severe, then hormones might be appropriate, but in my view it should be at the lowest dose and for the shortest period of time.

When we speak about hormonal treatments or management, we must consider:

• Who should not use hormone supplements

• Why hormone supplements are used

• What treatments are available

• How hormone treatments are done

• The pros and cons of hormone treatment

Dr Christiane Northrup wrote in her book The Wisdom of Menopause, 'There is no magic bullet, one-size-fits-all hormone prescription or drug regimen of any kind that is right and healthy for all or even most women to take indefinitely. And because each of us is an individual with differing needs, constitution, beliefs, and environment, there never will be - no matter how many studies are done.'

There are three sex hormones that can drop to low levels or become out of balance during perimenopause: oestrogen, progesterone and androgens (such as testosterone). As you transition from perimenopause to post menopause, you might need to adjust which hormones you are taking. This can mean adding or subtracting a specific hormone, increasing or decreasing an amount, and even eliminating them altogether. Also, ask your health care provider about bioidentical hormones which are identical in their molecular shape, make-up, and structure to hormones made in the human body. Make sure that you ask many questions and have enough information to make a decision that is tailored speci