Part 1, 2 and 3

PART 1

 

PART 2

 PART 3

Part 3 of 3: Slide show and Dr. Bartlik's narration

 

INTELLIGENT (AND CLINICALLY-BACKED) SOLUTIONS TO SEXUAL DOWNTURN

By: Barbara Bartlik, MD 

We need more solutions for the sexual problems of men and women. Viagra-like medications are not always the answer. Half of the prescriptions written are not refilled. Pre-menopausal women now have two prescription medication therapies for low sexual desire: bremelanotide and flibanserin. But they are not gaining acceptance and are not covered by insurance for post-menopausal women. Evidence-based integrative medicine solutions are available as stand-alone or adjunctive therapies. Due to time limitations, I will briefly run through some of these. 

Most sexual problems are caused by a combination of psychological and physical issues. So, treating one without the other is not as effective as it could be. Nutritional deficiencies, inflammation, medication side effects, toxicity, and an unhealthy diet and lifestyle could contribute to or even cause sexual problems. Clients could be seen as treatment-resistant and unresponsive to sex therapy and mental health treatment when an undetected physiological problem is the primary cause. Clients feel cared for when you help them find new ways to improve their health. Integrative medicine counselling is perceived as psychologically supportive and may improve anxiety and mood. When clients improve their lifestyles, they lose weight and need less medication for psychiatric and medical conditions. These medications often harm sexual functioning, so it is essential to reduce them when possible. We need to think outside the box.  

Adequate sleep is essential to sex hormone production and sexual function. It also improves energy and mood and helps prevent weight gain. 

Ancient traditional therapies such as Ayurveda, acupuncture, aromatherapy, botanical medicine, European hydrotherapy, Traditional Chinese medicine, and others can help sexual problems. There is some scientific evidence that these can be beneficial.  

Exercise benefits mood, fitness, weight control, well-being, and sexuality. Anaerobic exercise of large muscle groups, such as doing squats, increases testosterone in men and possibly in women, which can improve desire and arousal. Yoga can increase flexibility and sexual performance. Other exercises can enhance the strength of the pelvic floor. 

Micronutrients are necessary for hormone production and metabolism, and for endothelial and neurotransmitter function. Many common medications deplete micronutrients, which can cause sexual dysfunction. Supplementing with the following micronutrients when they are deficient can improve sexual functioning: Vitamins C, D, B6, B12, Boron, Folate, Iron, Magnesium, Sodium, Zinc.  

Amino acids L-arginine and L-citrulline, precursors to nitric oxide, support vasodilatation and sexual function.  

    Omega-3 fatty acids support hormone metabolism, cardiovascular health, and neurological function. 

    Botanical medicines can benefit sexual function; Ashwagandha, damiana, horny goat weed, maca, ginseng, shilajit, and Tribulus are used traditionally for sexuality and most are backed up byresearch. 

    Off-label compounded penile and vulvar creams are mostly not evidence-based but are available through compounding pharmacies. They contain combinations of ingredients such as alprostadil, DHEA, L-arginine, PDE-5 inhibitors, pentoxifylline, phentolamine, testosterone, and theophylline. To learn more about these, ask a compounding pharmacist which preparations are most popular.  

    Oral troches and nasal sprays contain Oxytocin. 

    CBD is available over-the-counter, orally and in lotions and lubricants 

    DHEA may be taken orally or vaginally. 

    Vaginal moisturizers contain hyaluronic acid, vitamin E, and coconut oil  

Case: Vaginismus successfully treated with Viagra  

A 38-year-old married mother was the victim of sexual abuse by an older sibling when she was a child. She struggled with vaginismus from the time she was sexually active in her late teens until she was in her early thirties. After several years with her husband and treatment with vaginal dilators, she could finally have sexual intercourse comfortably. However, after the birth of her child, the vaginismus returned. She could not have intercourse for two years, but she and her husband engaged in other forms of sexual activity once or twice a week. She started on sildenafil 50 mg of sildenafil, which was very effective. She noted that her vagina felt more open, relaxed, and lubricated, and, after a few times, she had no pain on penetration.  

The research on PDE-5 inhibitors, the Viagra-like medications, in women is mixed, with some studies reporting that they are effective and others finding no efficacy. There is a study showing that sildenafil is helpful for unconsumated marriage. 

Strengthening the pelvic floor muscles improves bladder control and sexual function in men and women. Women who do Kegel exercises experience enhanced sexual desire, arousal, lubrication, and orgasm. Men experience improved erections, ejaculatory control, and orgasm. However, people find doing Kegel exercises tedious and challenging to do consistently. 70% of women have some degree of incontinence at some point in their lives. The solutions for female incontinence include medications with unwanted side effects and surgeries that can have serious consequences. Both can interfere with sexual life. Several new electrical or energy devices can help strengthen the pelvic floor and provide sexual benefits. I mention them briefly here because you might be able to help your clients by recommending them. 

Why are these devices considered integrative? For several reasons: (1) primarily, practitioners with an integrative orientation are using them; (2) they are not yet standard of care; they may have been FDA-approved for other indications but are considered experimental for sexual problems and are used off-label for sexual dysfunction. The devices may be safe, but questions of efficacy and safety remain about many of them, and most are expensive and not covered by insurance. 

    Emsella Pelvic Floor Treatment uses high-intensity focused electromagnetic technology to strengthen and tone the pelvic floor muscles. It is designed to improve urinary incontinence, pelvic organ prolapse, and vaginal laxity. It also improves sexual function in men and women. The client sits on a chair that emits electromagnetic pulses that stimulate the pelvic floor muscles, causing them to contract repeatedly, the equivalent of doing thousands of Kegel exercises in 30 minutes. 

     Neuromuscular Electrical Stimulation devices are similar to TENS units. They use electrodes to deliver an electrical current, which causes pelvic floor muscles to contract rhythmically. The electrodes can be applied externally to the vulva or intravaginally through a probe. 

    Pulsed Electromagnetic Frequency (PEMF) Treatment creates a magnetic field by pulsing an electric current through a coil. It increases nitric oxide production in the endothelial cells lining the blood vessels, causing them to relax. This improves circulation and oxygenation, reduces blood pressure, promotes healing, and increases genital engorgement. Studies show that nitric oxide levels in plasma increase after PEMF application (Kim, 2019). PEMF stimulates cell growth and repair and may improve vulvovaginal atrophy, erectile disorder, and orgasmic difficulties. 

    Radiofrequency Thermal Treatment is usually performed by gynecologists and involves inserting a probe in the vagina that delivers painless heat to the vaginal canal and external clitoral and labial tissues. The claim is that it improves circulation and blood flow, stimulates new collagen production, and regenerates nerves.  Women have reported improvements in their ability to orgasm, postpartum healing, sexual pleasure, vaginal intercourse satisfaction, vaginal laxity, vaginal moisture during sexual activity, mild bladder prolapse and urinary leakage.  

    Red Light Therapy uses red or near-infrared light to stimulate the mitochondria and enhance ATP production. This promotes circulation, collagen formation, and healing and reduces inflammation. The light is directed toward the genitals using a wrap, a seat, or other methods. Studies have shown that red light therapy can improve penile blood flow and erectile dysfunction and increase testosterone levels, sperm volume, and sexual satisfaction.  

    Consider including  Integrative/Functional principles to your psychotherapy practice. You will learn how to improve your health and that of your clients by helping them adopt a healthier lifestyle. They will then respond better to therapy for mental health issues and sexual problems.  

    You can obtain integrative medicine training and become an integrative health coach at the following: 

     * Institute of Integrative Nutrition (IIN), NYC, https://www.integrativenutrition.com/ 

     * Andrew Weil Center for Integrative Medicine (AWCIM), University of Arizona, https://awcim.arizona.edu 

     * Institute for Functional Medicine (IFM), https://www.ifm.org  

When Desire Fades: The Growing Need for New Approaches in Sexual Medicine

Written by: Lennard M. Goetze, Ed.D & edited by: Marilyn Abrahamson (editor of INSIGHTS Magazine)

 Foreword

In today’s rapidly evolving healthcare landscape, the intersection of mental health, hormonal wellness, and sexual health is receiving long-overdue attention. As traditional medical approaches often fall short in addressing the complex, deeply personal challenges faced by individuals experiencing sexual dysfunction, integrative medicine offers new avenues for healing.

Dr. Barbara Bartlik, a distinguished psychiatrist, sex therapist, and leader in integrative medicine, has dedicated her career to bridging these disciplines. Through decades of clinical experience, academic teaching, and active participation in leading medical symposia, Dr. Bartlik advocates for comprehensive, evidence-based approaches that treat the whole person—not just isolated symptoms.

In the following feature, Dr. Bartlik highlights emerging trends in sexual health, the alarming decline in libido and testosterone, and the growing influence of modern lifestyle factors on intimacy and relationships. Drawing upon both conventional and integrative strategies, she makes a compelling case for why new solutions are urgently needed—and how integrative, functional medicine can help fill that gap.

Integrative Solutions for Sexual Wellness  (Part 1): Beyond the Prescription Pad

Dr. Bartlik highlights the ongoing need for more effective, evidence-based solutions for sexual problems in both men and women. While two medications for low sexual desire are now approved for premenopausal women—a significant achievement—these treatments have been slow to gain widespread acceptance and are notably not covered by insurance for postmenopausal women, a demographic that urgently needs support.

She notes that while medications such as Viagra and related drugs offer benefits, they are not a universal answer. The fact that approximately half of prescriptions for these medications go unrefilled underscores the need for innovative, integrative, and personalized approaches to sexual health care.

Disconnected: Why Couples Are Having Less Sex — and What to Do About It
Before summarizing integrative therapies, Dr. Bartlik reviews prevalent sexual health concerns that demand new solutions. Chief among them is low libido, a common sexual complaint that has long been the most frequently reported issue among women. Contributing factors include relationship difficulties, busy schedules, restrictive cultural or religious backgrounds, concerns about physical appearance, menopausal symptoms, vaginal pain, and the lasting effects of cancer and its treatments.

She references Rosemary Basson’s model of the female sexual response, which suggests that many women do not typically experience spontaneous sexual desire. Instead, desire often emerges in response to a partner’s initiation. However, if male partners are experiencing their own issues, including diminished libido, this dynamic can become further complicated.

Studies show that the frequency of sexual activity among both married couples and individuals in relationships has declined to historic lows, a trend exacerbated during the COVID-19 pandemic and persisting in its aftermath.

Stress and Screens: How Modern Life Is Eroding Intimacy
Men, too, are experiencing lower libido rates than in previous generations. Dr. Bartlik attributes this trend to a combination of factors: anxiety, mood disorders, stress, shifting social roles, economic pressures, sedentary lifestyle, and the use of medication. These factors contribute to a reduction in testosterone levels and decreased interest in forming intimate relationships.

Increased access to alternative sexual outlets such as online pornography has also altered interpersonal dynamics—men don’t desire real women as much as they used to, which is very distressing to women. Excessive screen time through exposure to content that is not explicit also takes away from time that would otherwise be spent on social or sexual engagement. While younger individuals may gravitate toward video games, older adults often turn to television and streaming media, further diminishing opportunities for connection.

Testosterone in Freefall: What It Means for Men, Women, and Relationships
A particularly concerning issue Dr. Bartlik addresses is the significant decline in testosterone levels among men. She cites research indicating that a 22-year-old man today has an average testosterone level equivalent to that of a 67-year-old man in the year 2000. Overall, testosterone levels have dropped more than 20% over the past two decades—from an average of 600 ng/dL in 2000 to approximately 450 ng/dL in 2018. Currently, one in four men over the age of 30 has clinically low testosterone.

Alongside this, sperm counts have declined by 60% in the last 40 years, with male infertility on the rise. Dr. Bartlik underscores that testosterone is essential not only for sexual health but also for mental well-being, affecting mood, anxiety, sleep, self-esteem, vitality, and overall energy.

Modern Intimacy in Crisis: The Integrative Medicine Perspective
While previously mentioned factors play a role, Dr. Bartlik notes that other contributors of particular interest to the integrative medicine community merit further exploration. By considering hormonal health, nutrition, lifestyle habits, environmental exposures, and the psychosocial landscape, integrative practitioners have an opportunity to develop new, personalized, evidence-based therapies that address the complex, interconnected challenges of sexual health in the 21st century.

ABOUT DR. BARTLIK

Dr. Barbara Bartlik is an integrative psychiatrist and sex therapist known for her holistic approach to mental and sexual health. She earned her medical degree from the Albert Einstein College of Medicine and completed a residency and fellowship at NYU. Early in her career, she trained under Dr. Helen Singer Kaplan, a pioneering sex therapist, and later worked at Weill Cornell Medical College. Dr. Bartlik’s interest in integrative medicine grew from personal health challenges, leading her to adopt dietary changes, remove mercury dental fillings, and use nutritional supplements—experiences that significantly improved her well-being. These transformations inspired her to incorporate integrative practices into her psychiatric care, emphasizing nutrition and addressing deficiencies to enhance mood and health, often reducing the need for psychiatric medications.

She is particularly focused on sexual health, noting the negative impact psychiatric medications can have on sexual function. By combining psychiatric care with holistic strategies, Dr. Bartlik helps minimize medication reliance while improving mental and sexual well-being. A board-certified expert in integrative medicine, she frequently presents at prominent conferences and advocates for better solutions in sexual health, particularly for postmenopausal women.

GO SHAME-FREE! SEXUALITY IS A MAJOR INGREDIENT OF OUR HEALTH AND WELLNESS

The Women’s Professional Health Network is proud to introduce Jennifer Wiessner, LCSW, CST a Certified Sex Therapist, Sexual Wellness Consultant, Educator, and Entrepreneur dedicated to promoting healthy, shame-free conversations about sexuality. As Maine’s only female AASECT-certified Sex Therapist in 2012, she paved the way for a growing network of professionals in her state. In 2023, Jennifer was honored with the Maine Family Planning Significant Contributor to Sexuality Education award for her continued advocacy and education.

Jennifer’s mission is to reduce shame around sexual health and empower individuals, families, and providers through compassionate, accessible education. She specializes in sex therapy for all orientations, sexual medicine issues, and later adolescent care, alongside offering one-time, non-therapy consultations across the U.S.

Passionate about community impact, Jennifer created Raising Sexually Healthy Children, workshops for parents, educators, and providers, and co-founded Girls on Fire, an annual empowerment event for young women. She regularly educates medical and mental health  providers, medical students, school and camp staff on integrating sexual health into holistic care.

Jennifer offers virtual, in-home, and office-based consultations and workshops, believing that through open, informed conversations, we can replace shame with celebration — one person, one family, one community at a time.

 

FROM THE SOURCE:

Jennifer Wiessner, Sexual Wellness Consultant

From Maine Magazine/Photo: Myriam Babin

I have been called to the deeply resonant work of sexuality for 15 years as a licensed clinical social worker and an AASECT certified sex therapist and sexual health consultant. I believed many years ago when I had small children that if I could help parents of young children communicate about bodies, boundaries, healthy touch, sexuality, pleasure, consent, I could change the world because then an entire generation of children would grow up with less shame, more knowledge and pride in their bodies. I continue that work today alongside my couples and sex therapy practice, my sexual health consultations, lecturing and raising sexually healthy children workshops. Yes, I know I do many things, but it's because sexuality has an intersectional thread in every aspect of our humanity. My passion about sexuality and sexual health is like breathing for me because it's so integral to all of us and yet so suppressed and misunderstood, especially for female bodied people, causing women to relinquish precious energy and self-love.

Our sexuality intersects with every aspect of our wellbeing, and yet has been overlooked by our culture, our care professionals, and even ourselves. Most people don't know that talking about sexuality with others, particularly our friends, can help us better understand sexual norms, like even knowing if we're treated well in a relationship, how do we know if we don't talk about it? Also, talking about sexuality with close friends can create more solid relationships and allies. If we talk about sexuality, there is likely little else we can't discuss and then we know who our support network is. It can also make it easier to talk to medical providers who often don't have the comfort or skillset to do so. Sadly, most of us don't like to talk about sexuality, especially if we feel like something has changed in it. Think perimenopause or menopause. As care providers, we need to have courage to change this for ourselves, for our patients and all the young women that come after us.

The reality is we are always changing and are always in transition, and as women, it is difficult to get accurate, actionable information on what is happening to our bodies and hormones from basically age 35 plus. My work in sexual health is multidimensional and includes providing emotional and functional support to patients alongside medical providers. I help adults, particularly women, to better understand their bodies, work through oppressive early messaging, trauma, bodily dysfunction issues, pain, arousal issues, struggles with intimacy and health conditions that impact intimacy with themselves and partners. What is important is that we get informed, have resources for our patients, and collaborate with providers who are skilled in sexuality and the female experience.

The lack of sexual education and body-positive role models weighs heavily on our psyche and dampens our sexual energy. The more we talk about it, the more we bring our sexuality and sexual health out of the oppressive shadows into the light of our everyday experience where it belongs. It is our birthright and a foundational aspect of our humanity. Two quotes I enjoy are: “Your body is not your art, it's your paintbrush" By Glennon Doyle and from Gloria Steinem: “Each individual woman's body demands to be accepted on its own terms." My work is to help each person, each woman, to realize the full and expansive breath of their sexuality on their own terms without shame as a backdrop. It's important to note that sexual shame or shame of any kind, is not our natural state.

It is not in our nature to feel ashamed of who we are as human beings. We are not born ashamed of ourselves. Shame of all kinds is learned and can severely limit us. Some have even called shame our biggest cultural of fear. Shame is like pine pitch; no matter how many times you wash your hands, it's still feels sticky. Sex therapy can help with the self-discovery and healing from the negative effects of shame can lead to a more fulfilling and authentic relationship with sexuality.

Our pleasure is our gift and to be celebrated. It is a life force that is powerful, and when harnessed, we connect to a deep sense of ourselves, our personal power, and can access greater health and creativity in our lives and in our work. My work and my passion is to help all people, particularly women, awaken this energy, connect to themselves, their work, creative endeavors and relationships, all increasing wellbeing. The ultimate goal for us is to support children and young women from the schoolroom, to the boardroom, to the bedroom. Anything less is faux-powerment. As medical and mental health providers, we can dismantle sexual shame, connect to the joy of our bodies, and create a world where every woman, from the womb through menopause and beyond, has access to the resources, support, and empowerment she needs to thrive.

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Contact: https://jenniferwiessnerhealthysexuality.com/

4/2025- Sexual Health Symposium / Mt. Sinai (feat. Dr. Barbara Bartlik)

FOR IMMEDIATE RELEASE

Dr. Barbara Bartlik Illuminates Integrative Approaches to Sexual Health at Mt. Sinai 2025 Sexual Health Symposium

NYC/ April 2025 - At the forefront of a rapidly evolving conversation on sexual wellness, Dr. Barbara Bartlik, one of New York Magazine's Best Doctors in Psychiatry and a nationally recognized leader in integrative medicine, delivered a featured lecture at “Symposium 2025: On Human Sexuality,” hosted by Mt. Sinai Medical Center. Her presentation, titled “Integrative Medicine Treatment of Sexual Problems,” offered a comprehensive exploration of contemporary solutions for sexual health issues affecting both men and women. The annual symposium, organized under the direction of Dr. Ahron Friedberg and co‐directors Dr. Vladan Novakovic and Jennifer Harper, M.Div., drew clinicians, psychoanalysts, and mental health professionals from across the country. Framed within a nuanced discussion on the complexities of human sexuality, the event sought to advance open, inclusive, and evidence‐based dialogues around topics too often marginalized by politics, social norms, and traditional medical models.

A Holistic Lens on Sexual Health, Dr. Bartlik’s presentation stood out for its integrative perspective, merging conventional psychiatry with emerging technologies and natural therapies. Her review addressed a spectrum of conditions, from common sexual dysfunctions and mood disorders to menopause‐related issues, pelvic floor dysfunction, and bladder health. She highlighted the importance of tailoring treatment plans that honor both the physiological and psychological dimensions of sexual wellness.

Among the therapeutic modalities discussed were the use of Viagra in women, sexually- enhancing nutritional supplements and creams, red light therapy, Pulsed Electromagnetic Field (PEMF) therapy, healthy lifestyle interventions, alongside established psychopharmacologic and psychotherapeutic approaches. Dr. Bartlik stated that testosterone levels in men are in steep decline, along with sperm counts and fertility. Urinary leakage is a major problem affecting over 70 percent of older women. Pharmaceutical and surgical solutions are woefully inadequate. 

Numerous technological advances effectively treat this condition but are not FDA- approved or covered by insurance, so the cost is out-of-reach for most women. “This is a major women’s health issue that needs immediate attention,” according to Dr. Bartlik. She emphasized the growing body of evidence supporting these techniques as adjunctive or alternative options, particularly for patients seeking non‐pharmaceutical interventions or those with treatment‐resistant conditions, “Sexual health is inseparable from mental health,” Dr. Bartlik noted during her lecture. “Our role as clinicians is to create space for individualized care — integrating the best of conventional medicine with scientifically grounded natural therapies.”

SHOWCASING AN EDUCATIONAL RESOURCE
In addition to her presentation, Dr. Bartlik highlighted her textbook, INTEGRATIVE SEXUAL HEALTH, a landmark contribution to the (Dr. Andrew) Weil Integrative Medicine Library published by Oxford University Press (2018). The book offers in‐depth clinical guidance for practitioners and positions itself as a leading reference in the intersection of sexual health, psychiatry, and integrative medicine. 

A THOUGHTFUL SYMPOSIUM FRAMEWORK
This year’s symposium took a reflective approach to the broader landscape of human sexuality. In his opening remarks, Dr. Friedberg spoke to the evolving discourse: “Human sexuality is complex, its expressions varied and often shaped by unconscious conflicts and cultural scripts. Our task is to bring these conversations into the open — not only to treat, but to understand.” 

The event also featured a distinguished lineup of speakers including Dr. Harold Bronheim, Dr. Mark J. Blechner, Christian Churchill, PhD, Dr. Vicente Liz Defillo, Martina De Giorgis, LCSW, Dr. Jennifer Downey, Dr. Elizabeth Grill, Dr. Monique Rinere, Dr. Phillip Luloff, covering topics from psychoanalytic interpretations of sexuality to reproductive mental health and the psychodynamics of sexual identity.

About Dr. Bartlik...

DR. BARBARA BARTLIK is a Manhattan‐based psychiatrist, integrative medicine specialist, and sexual health expert with over 30 years of clinical practice. She is widely recognized for her holistic approach to patient care, combining conventional treatments with evidence‐based natural therapies. A prolific author and educator, Dr. Bartlik continues to shape contemporary conversations around sexual health, psychotherapy, and integrative medical care.

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For more information about Dr. Bartlik and Integrative Sexual Health, https://drbarbaramd.com/

Media Contact: Lennard M. Gettz, Ed.D,  InterMedia Press / AngioInstitute- Phone: 516.603.1416 /Email: LG@321image.com

SEXUAL AND PSYCHOLOGICAL ISSUES WITH MENOPAUSE: By Barbara Bartlik, MD

The onset of menopause, typically in a woman’s early 50s, is a time of major physiological transition, due mainly to plummeting estrogen levels. The hormone estrogen, primarily produced in the ovaries, controls the female reproductive cycle and sexual response and affects all of female biology. Estrogen is anti-inflammatory and protects the bones, brain, gut, heart, joints, nervous system, and skin, so when a woman enters menopause, her whole system undergoes major changes. These changes lead to unwanted sexual changes, such as vaginal dryness, reduced lubrication, painful intercourse, orgasmic difficulties, and low libido. Estrogen is to women as testosterone is to men: with low levels of estrogen, women can lose interest in sex and have difficulty performing. If they become anxious or depressed, this, too, can impact their sexuality.  

The extent and severity of menopausal changes can vary significantly from woman to woman. Some may experience no mood changes, while others may experience low mood and even depression. Unhappiness and dissatisfaction can arise from physical changes and loss of fertility that accompany aging. Weight gain, graying hair, and wrinkles can negatively affect a woman's self-esteem..

Menopause is no longer synonymous with old age, but rather a time of transition and potential growth. With women now living at least one-third of their lives past menopause, many are prompted to make positive changes - increasing exercise, improving diet, giving up unhealthy habits, and making  psychological adjustments. Many women find themselves feeling empowered and better than ever, a state that anthropologist Margaret Mead referred to as “menopausal zest.” 

However, many women do experience deep depression that may require psychiatric medication; some require hospitalization for the first time in their lives. Rates of depression increase two-fold (Freeman, 2006). The reduction in estrogen decreases the feel-good neurochemicals dopamine and serotonin. For most women, there is a period when hot flashes interfere with the workday and also with sleep, which contributes to depression. Again, duration and severity vary widely. Many women experience a reduction in sexual feeling and interest related to hormonal changes, vaginal discomfort, disturbed sleep, and low energy. For some, this persists, but not for all. At the same time, their partner may be experiencing problems related to sexual functioning or midlife issues. These experiences are normal and shared by many women going through menopause. You are not alone in this new normal.

What can a woman do to minimize the psychological and sexual changes that accompany menopause? First and foremost, maintain a healthy lifestyle. Reducing alcohol intake, quitting smoking, regular exercise, and consuming a balanced diet can all offer benefits - these changes alone can often stop hot flashes and insomnia. Secondly, engage in stress-relieving practices, such as meditation, yoga, exercise, spending time in nature, enjoying music, and engaging in pleasurable hobbies. Seek support and guidance from specialists who can provide solutions. And finally, do not neglect your sex life and go into sexual retirement. Keeping it active can improve your psychological health, relationship, vaginal health, sexual competence, and vitality.  

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AUTHOR

DR. BARBARA BARTLIK is a recognized expert clinician and author in integrative medicine, psychiatry, and sexual health. She is in private practice in Midtown Manhattan and has treated men, women, and couples with a broad range of psychiatric and sexual problems for over 30 years. She sees patients both in the office and virtually. Dr. Bartlik is an editor of the book, Integrative Sexual Health, a volume in the [Dr. Andrew] Weil Integrative Medicine Library (2018). She takes a holistic approach to treatment, emphasizing lifestyle and nutritional strategies, and seeking to responsibly minimize the use of pharmaceuticals while optimizing health and well-being. Dr. Bartlik uses sophisticated laboratory tests to seek out underlying sources of inflammation that lead to medical and emotional problems and addresses them through diet, nutritional supplementation, and the elimination of toxins and other offending factors. For more information, visit her website: https://drbarbaramd.com/

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"I am so grateful for Dr. Bartlik for this powerful and deeply resonant article! I only wish I had come across something like it when I was 45. My perimenopause crept in silently and, for nearly a decade, drained the joy from my life in ways I didn’t understand at the time. I took the changes in my relationship and the diminishing spark far too personally, which created tension and took a toll on my self-esteem. It wasn’t until I turned 55 that I realized what I had actually been navigating all those years. That’s why this article struck such a chord—and why I would love to share it widely, especially with younger women. When we’re equipped with knowledge, suffering truly becomes optional. I especially appreciated that it didn’t just focus on the physical challenges (which are of course very real and important), but also highlighted the opportunity for transformation this time in life offers. Mental and emotional well-being are key pillars in my work with women in midlife, and it’s affirming to see these aspects so thoughtfully explored." - Sabine Gee - Midlife Health & Menopause Expert

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NAVIGATING CHANGES IN MIDLIFE
As women enter menopause and even many years prior in perimenopause, sexual changes begin to surface that can feel disorienting. Our culture is sex-saturated and yet sex-silent. With many adults having received little to no functional sexuality education while growing up, adults lack the support for open and healthy discussions surrounding the physical, emotional, mental, and sexual aspects of our well-being. Most medical and behavioral health providers lack the skills to comfortably address sexuality concerns.

As a certified sex therapist, I support women and couples navigating the changes of midlife, menopause and andropause (male equivalent of menopause). Most adults present feeling alone and fearful of the changes in libido and function. With few people they can talk to, they feel further disconnected from themselves and a partner. As many as 42 percent of women and 54 percent of men are not satisfied with their sex lives. Most people will experience sexual dissatisfaction at some point in their lifetime. Knowing we are not alone can encourage people to seek supportive therapy. Sex therapy can support individuals and couples to better understand the universal changes happening in midlife and beyond and how to better communicate about them and seek the medical and psychological support they need that can improve their sexual health. 

Beginning this process can include visiting the national directory for the American Association for Sex Educators, Counselors and Therapists (AASECT) and find a qualified professional in your state. aasect.org

Jennifer Wiessner, LCSW, CST

jenniferwiessnerhealthysexuality.com