WASHINGTON -- The Food and Drug Administration on Tuesday approved the first pill-based drug for women who experience pain during sex because of menopause.
The daily pill is called Osphena, and it is designed to treat menopausal symptoms that make the vaginal tissue thinner and more fragile, causing pain during sexual intercourse. The condition, known as dyspareunia, is one of the most commonly reported health ailments among postmenopausal women, according to the FDA. Menopause occurs when the ovaries stop producing the hormone estrogen, usually around age 45 or 50.
Osphena acts like replacement estrogen and makes vaginal tissue thicker and less fragile.
The drug carries a black box warning alerting doctors and patients that Osphena can increase the risk of endometrial cancer, stroke and blood clots. The drug's prescribing guidelines recommend that it be used for the shortest amount of time possible to achieve patients' treatment goals.
Common side effects of the drug include hot flashes, vaginal discharge, muscle spasms and excessive sweating.
The FDA approved the drug based on studies involving 1,889 postmenopausal women who were randomly assigned to receive Osphena or placebo. After 12 weeks, women taking the drug had a statistically significant improvement in their symptoms.
Osphena is made by Japanese pharmaceutical company Shionogi, which has U.S. operations in Florham Park, N.J.
"Medications that are prescribed for stroke issues and heart issues can have devastating effects on sexual functioning," explains Dr. Janice Epp of the Institute of Advanced Study of Human Sexuality. In addition, researchers have found that a family of <a href="http://www.springerlink.com/content/0483x4276q80417q/" target="_hplink">antidepressants known as selective serotonin reuptake inhibitors (SSRI) can take the winds right out of your sails</a>. These drugs include brand names such as Prozac, Zoloft and Paxil.
Fix: Talk To Your Doctor
Don't be shy -- talk to your doctor about how your prescriptions are affecting your sex drive. "There are a whole lot of new drugs that don't necessarily have those side effects, but it takes a lot of experimenting," says Dr. Epp. "Sometimes it takes three to four different tries to find the one that's best for you."
Culprit: Pain Or Discomfort
"People of both sexes can develop pain disorders as they get older, and that can have a big effect on sexuality," notes Patty Brisben, founder and chairwoman of Pure Romance, a company that specializes in selling sex toys and providing information on women's sexual health issues.
Fix: Mix It Up
Brisben suggests re-evaluating your definition of sex. "Being intimate does not necessarily mean having sex in the traditional sense," she says. Some solutions sensual touching and massages and mutual masturbation. Dr. Epp suggests looking into new positions. "Sit on a chair, try being in different positions," she says. "Side by side actually puts the least amount of stress on your joints."
Culprit: Lack Of Sleep
The <a href="http://www.sleepfoundation.org/article/how-sleep-works/how-much-sleep-do-we-really-need" target="_hplink">National Sleep Foundation</a> recommends getting seven to eight hours of shut eye a night. But with the stress of work, kids, bills and, oh yeah, your marriage, who can think about fitting in time to have sex, much less sleep?
Fix: Plan Sex Dates
For some couples the days of random romps may be behind them, and that's alright, says Dr. Epp. "Plan some sex dates around times that you know you feel more energetic -- it lets you look forward to it," she says. "Some people say, 'Sex should be spontaneous!' to which I say bullsh*t," she says, laughing. "You plan other things in your life and you don't complain about it. You can do the same with sex."
Waning libido and vaginal dryness are two unpleasant side effects of menopause. With increased longevity, "women can now expect to spend a third of their lives in post-menopausal years," Brisben said. "So understanding how you're being affected by those changing hormones is essential."
Fix: Creams And Lubricants
A dip in estrogen may lead to thinning vaginal walls and itchiness in the area. According to the Mayo Clinic, <a href="http://www.mayoclinic.com/health/vaginal-dryness/DS00550/DSECTION=treatments-and-drugs" target="_hplink">treatments can include </a>vaginal estrogen creams such as Estrace and Premarin; a flexible estrogen ring that is inserted; or estrogen pills, patches or gels.
Culprit: Avoiding Frank Conversations About Sex
"I think if you're just now embracing this subject at or around age 50, you've got some catching up to do!" Brisben tells <em>Huff/Post50</em>. But it's never too late to start having a frank and honest conversation with your partner about what you want in bed.
Fixes: Accessories, Letters, Books, Therapy
"I recommend having these conversations out of the bedroom and when you have some alone time," Brisben says. "Be open, be receptive and be ready to listen." Don't be afraid to bring some playfulness to the discussion. "Shop online for intimacy products together," Brisben suggests. Or write your partner a letter: "Tell them what you'd like to introduce into your intimate relationship." Another tact: Read sexy books together and share what interests you and what doesn't. "If you find these conversations are still hard to have ... a sex therapist or counselor is trained to help," Brisben adds.
Culprit: Not Addressing Problems Down There
It's the one part of aging and sexuality that gets the most attention: erectile dysfunction, which is <a href="http://www.mayoclinic.com/health/erectile-dysfunction/DS00162/DSECTION=causes" target="_hplink">often rooted in some larger physical problem, including heart disease, high blood pressure, diabetes and obesity</a>, according to the Mayo Clinic. Medications and drug and alcohol use can also play a role.
Fix: Prescriptions, Pumps And More
Ubiquitous ads promote the popular little blue pill to cure impotence, but there are <a href="http://www.mayoclinic.com/health/erectile-dysfunction/DS00162/DSECTION=treatments-and-drugs" target="_hplink">other treatments as well, including vacuum pumps, implants and surgery</a>, according to the Mayo Clinic.
Culprit: Thinking You Have To Be 'In The Mood'
According to the movies or steamy prime time television shows, passion goes from 0 to 69 with a mere glance, a bitten lip or a bad pun. But "as we age, our bodies slow down and we have less energy," Dr. Epp tells <em>Huff/Post50</em>. "That's naturally occurring, but it can have an affect on our sexuality."
Fix: Learn The Difference Between Arousal And Desire
Rethink the connection between arousal and desire. Tell your partner if you need more than the <a href="http://www.womansday.com/sex-relationships/sex-tips/sex-by-the-numbers-103274" target="_hplink">average 20 minutes spent on foreplay</a>.