By Lead writer: Louise Sloan
April 02, 2008

sue-goldsteinLow testosterone was part of Sue's sex drive problem.(SUE GOLDSTEIN)

Sue W. Goldstein always enjoyed sex until perimenopause came along. "Around the time I was 50, sex was pretty lousy," says the 58-year-old coauthor of When Sex Isn't Good.

At first, Goldstein thought the problem lay with her husband, but her own dropping hormone levels were muting her desire and her ability to have an orgasm. Blood tests showed "unrecordable androgens"—i.e., zilch testosterone, the hormone that affects sex drive in both men and women. "I wanted it fixed," she says. "I wanted to have an enjoyable sex life."

Hormones did the trick
The treatment Goldstein settled on involved bioidentical hormones, which are hormones manufactured to be chemically identical to the ones in your body (some doctors believe these are safer; others disagree). Bioidentical testosterone gel was prescribed to bring her levels up.

(Note: Testosterone is not an FDA-approved treatment for women.)
 More about women's sexual desire and dysfunction

The results came quickly: Goldstein's night sweats disappeared, her energy came back, and bone density tests showed good results. A few months later, her libido returned.

When sex problems are medical
Her success inspired the book, which includes the stories of 16 women with sexual dysfunction as well as medical facts and a listing of relevant studies—to educate women that their sexual problems may sometimes be biologically based.

"All the sex therapy in the world isn't going to fix a sex problem if the biology is bad," she says. She also urges women to treat sexual health like any other health issue. "Nobody's embarrassed if you have a broken arm," she points out. "So why should you be embarrassed if you have broken sexual function?"