Ask the Doctors: Getting Back in the Saddle

A relative of mine in CA turned me on to your store and I love it. Though I am writing about a problem I have. I have had cancer and became menopausal way too early (37 yrs.) and abruptly. Today, I am now 48, there is a new friend and I think he is interested. But you see, it has been a long time for me, and I do not know what to do. I think I should break it to him and tell the truth. That I have low libido, too many hemorrhoids, and too scared to take hormones for another cancer relapse. It seems to me that I am out of luck. Any suggestions….???! I do appreciate any support that you may have and thank you.
–Out of the Saddle

Congratulations on beating the cancer. No, I don’t think you’re out of luck, so let me make some suggestions to maybe get you back in a more erotic zone. I mean this literally — it’s very common for women who stop having sex and erotic stimulation to lose their libido and basically just do without it, which makes it a hurdle to get back into a sexual frame of mind. Your mental state means a lot as far as sex is concerned, so add it to your life now in any way you like: fantasy, reading, watching sexy movies, even talking about sex with friends (or the new maybe-beau, when you’re ready).

Exercise: Many menopausal women believe their libido has been kayoed by hormonal changes when the overarching culprit has more to do with the fact that they have grown sedentary. Regular exercise is vital to ongoing sexual health. If you don’t at least take a 20-minute walk a few times a week, please start doing so — it will improve your all-over health as well as your erotic response.

PC Muscles: The pubococcygeal (or PC, sometimes also known as Kegel) muscles form a figure-eight-shaped sling at the bottom of the pelvis, and it is these muscles that are associated with the pleasurable pulsing feeling of orgasm. When they have grown weak, they can not only adversely affect the way orgasm feels — less good — but the lack of blood flow to the genitals associated with too little exercise and slack muscles means it’s harder to get turned on in the first place. Like full-body fitness, this is one set of muscles that will pay you back if you take the time to exercise them.

Diet: Soy products (and in particular, associated isoflavones) are often cited as natural, diet-based alternatives to hormone replacement therapy. Reports and studies mostly seem to give cautious support to the notion that soy-based foods not only may alleviate menopausal symptoms somewhat, but also (unlike HRT) may lower breast cancer risk. However, there are stronger voices of caution too, which suggest that soy phytoestrogens are potentially dangerous re: cancer. (Some also think it’s protective, so the jury really does still seem to be out.) Add to this that not all women metabolize soy and isoflavones the same way, and in fact that soy is an allergen or irritant to many, and you have a substantial dose of confusion with your soymilk or tofu. Please check with your doctor about this question and whether soy foods (or other phytoestrogen-derived supplements) might be wise for you (or should be avoided).

Masturbation and self-pleasuring: There’s no downside to this tactic — whether or not you find yourself getting cozy with the new fellow, you can add erotic touch and stimulation back into your life all by yourself. And it’s wise to begin now, because revisiting arousal and orgasm while alone will begin to put your body back in the mood for love (or at least lust), and it will also allow you to explore the ways your response may have changed between your pre-menopausal self and the way you are today. Whether you use a vibrator or other toy or just hands, becoming solo-sexual has health benefits and definitely is one of the biggest factors under your control as far as exploring and growing your own sexual feelings are concerned. Plus self-pleasuring allows you to try out lubes and, if you wish, a dildo or insertive vibrator, which will give you an idea about how intercourse might go with your friend, should you two decide to get to that point.

Readings: Sex for One is Betty Dodson’s groundbreaking book about masturbation. I Love Female Orgasm is all about female sexual response and orgasm — and you may be interested to know that one of its authors is a cancer survivor.  The Ultimate Guide to Sex & Disability addresses sexuality and cancer issues among many other things, so you might find it useful. Menopause guidebooks often don’t say a whole lot about sexuality, but here are two that do: The group of women who publish Our Bodies, Ourselves have done a special volume on menopause, and holistic doctor Christiane Northrup has a book called The Wisdom of Menopause. I’d recommend either of those.

By the way, about hemorrhoids: They’re varicose veins (yep, of the anus–how’s that for a fun fact?), and if they bother you, your doctor should be able to help you with them. But there’s one thing we’ve already discussed that might make a substantial difference if you have them — Kegels. The rhythmic contractions of PC exercises serve to move the blood along that has pooled in the rectal veins and arteries. Exercise will help, too, and orgasm may help as well. If your bowel habits are irregular, resolve them through a fiber-rich diet; straining is especially problematic. Stay well-hydrated.

Remember, too, that you can still enjoy plenty of erotic fun with your new friend even if you don’t have intercourse. In fact, starting a sexual relationship with playful, sensual, non-intercourse activities allows you to warm back up sexually after your years of abstaining, and builds your sexual and intimate connection with the new boyfriend (or whatever he turns out to be). Don’t push yourself, but know that many women in your situation/s have found their way back to good sex. Best of luck!

We’re dedicated to getting you the information you need about sex, pleasure and your health. If you have any questions, please email our staff experts, Dr. Carol Queen and Dr. Charlie Glickman, at! For product-related questions, please email or call our customer service staff at

Dr. Carol Queen

Carol Queen has a PhD in sexology; she calls herself a "cultural sexologist" because her earlier academic degree is in sociology: while she addresses individual issues and couple's sexual concerns, her overarching interest is in cultural issues (gender, shame, access to education, etc.). Queen has worked at Good Vibrations, the woman-founded sexuality company based in San Francisco that turned 35 years old in 2012, since 1990. Her current position is Staff Sexologist and Good Vibrations Historian; her roles include representing the company to the press and the public; overseeing educational programming for staff and others; and scripting/hosting a line of sex education videos, the Pleasure-Ed series, for GV’s sister company Good Releasing. She also curates the company's Antique Vibrator Museum. She is also the founding director of the Center for Sex & Culture, a non-profit sex ed and arts center San Francisco, and is a frequent lecturer at colleges, universities, and community-based organizations. Her dozen books include a Lambda Literary Award winner, PoMoSexuals, and Real Live Nude Girl: Chronicles of Sex-Positive Culture, which are used as texts in some college classes. She blogs at the Good Vibes Magazine and at SFGate's City Brights bloggers page and contributes to the Boston Dig. For more about her at

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