It’s a Women’s World
It’s a Women’s World | Dr. Rachael Ross, Sexologist, Menopause, Meharry Medical College, Vaginal Dryness, Testosterone, Center for Women’s Health Research

Dr. Rachael Ross practices medicine with Primary Care Consultants in her native Gary, Ind. After earning her undergraduate degree from Vanderbilt University, she followed a family tradition of attending Meharry Medical College. Four of the five physicians
Noted Sexologist Returns to Meharry for Panel Discussion on Women’s Health

Despite her curiosity about the intersection of medicine and sexuality … particularly for women … Rachael Ross, MD, PhD, found there just wasn’t much offered in the medical school curriculum when she was a student at Meharry Medical College. Now a nationally renowned clinical sexologist, Ross was thrilled to be invited back to her alma mater last month to participate in the panel discussion “Not the End of the Road: Menopause in Women over 50” as part of the Center for Women’s Health Research Community Forum.

During residency, Ross began doctoral coursework with the American Academy of Clinical Sexologists and is board certified in the subspecialty, as well as in family medicine. A contributor to the popular television program, “The Doctors,” Ross has also been an oft-quoted expert in consumer magazines and is the author of numerous articles and a book on the topic of sexuality and sexual health.

“For so long, the menopause discussion just glossed over sexuality,” Ross said, adding the focus was always on hot flashes, mood swings, weight gain and wrinkles. “It’s nice to see sexuality becoming part of the discussion. Women deserve answers and solutions just like the guys do.”

Of the media messages bombarding women, she said, “Every magazine you read … every news story … is telling you when you hit 50 it’s all over.” On the other side of the equation, Ross noted, it’s very interesting to see how drugs targeting erectile dysfunction have impacted and changed long-term relationships. Now one partner is ready, willing and able, but the other is struggling with physical and emotional issues that also must be addressed.

Certainly, she said, vaginal dryness and hormonal changes impact desire, but a woman’s sex drive is much more complicated. “It’s ‘did you take out the trash, am I mad, am I feeling OK, am I stressed out?” she noted. “It’s very hard to come up with a magic solution to all of that.”

In addition to vaginal dryness, Ross said menopausal women often find they have are losing muscle mass, have a lower sex drive, feel fatigued, lose skin elasticity, have weight gain that is difficult to combat, are subject to irritability and mood swings, and experience atrophy of the clitoris and vagina. “Orgasm takes longer and takes a little more energy to get there. Coupled with a partner who might not have as much stamina, you end up with more sexual frustration than you used to,” she said.

Although there might not be one ‘magic pill’ to address all those issues, Ross said physicians could certainly help their female patients find strategies and solutions to improve their sex lives. One of the first items to check is a woman’s testosterone level to see if it has decreased too much. “The number one hormone responsible for the desire component of the sexual response cycle in both men and women is testosterone.”

She also suggested physicians go over medications with patients — particularly antidepressants, blood pressure prescriptions and allergy medications. Antidepressants can suppress the ability to experience passion, and some allergy drugs contribute to vaginal dryness.

“Oftentimes, it requires a late-in-life switch around your mindset about sex and sexuality,” Ross said, noting that might include the use of sexual aids or thinking about ‘sex’ in new or different ways. “It then becomes helping a patient break down their cultural attitudes and barriers and beliefs around this issue,” she said of the challenge.

“Open communication with your primary care doctor is very important,” Ross stressed, adding it is quite likely the physician would have to address the subject. “Studies show patients are very embarrassed to bring this up to their physicians.” Yet, she continued, “One in three women will complain of some sex drive issue during their life.” The time to start those discussions, Ross added, is well before menopause so that sexual desire and health become a part of the ongoing dialogue in a patient’s larger, global health picture.

“Healthy sex lives help keep couples engaged with each other,” Ross said. Besides, she added, “Sex is one of the few pleasures in life that’s not going to get you fat, raise your cholesterol or increase your risk of heart disease.”