Q: My problem is lack of libido. I am 54yrs, have been married 30yrs and love my husband. I am fit and active and not stressed. However, when it comes to love making I find my mind is willing but my body isn’t, in that I don’t seem to have any natural physical desires or sensations (without a lot of stimulation). My husband complains that he always has to initiate our love making sessions and this is true.

I enjoy the closeness of love making and I enjoy the actual sex once I get going, but I know my husband is disappointed that I can’t approach him. I am also worried that this imbalance will eventually cause problems in our relationship.

I’ve read that Testosterone Cream is very helpful in my predicament and wondered if you would recommend this and also where I could purchase this from. I’ve looked on the Internet but can only find suppliers in the USA.

Any advice or information would be greatly appreciated and I think your response will be of interest to many other women.

A: This is a very common problem for women after the menopause. Some women have gone on HRT to try and solve this problem and it has not made any difference. A study in the New England Journal of Medicine showed that there was no difference in women taking HRT compared to a placebo in terms of sex drive and factors effecting quality of life such energy, depression, sleep etc. I would not recommend the use of testosterone. It is not available to purchase in the UK for a very good reason, because it is a drug, a hormone, and should only be used if given on prescription.

Even when prescribed, it can give unwanted and unpleasant side effects including deepening voice (as one woman who came to the clinic had experienced), loss of head hair (male pattern baldness) and increase in body hair.

Make sure you eating a good diet and that your blood sugar is balanced. Although you mention that you are not stressed, the adrenal glands will be overworking if your blood sugar is fluctuating. The adrenal glands produced androgens, male hormones, so you want them to be working effectively.

Take a good multivitamin and mineral designed for the menopause, containing good levels of zinc and boron (e.g. MenoPlus) which are important for the production of sex hormones. Studies have shown that the amino acid L-arginine can be helpful in increasing libido because of its ability to enhance nitric oxide (do not arginine if you suffer from herpes as it can trigger the virus).

Herbs, such as American ginseng and damiana, can also be helpful for increasing sex drive, together with ginkgo biloba which improves circulation an blood supply to the sex organs. If you feel dry during intercourse, which can put some women off sex, then use a natural lubricant like Sylk (see Resources Page).

Q: A few months ago I was going through a stressful time and I found a small lump under my armpit. It has since disappeared, but should I be worried?

A: Lumps in the armpit can have various causes so should always be checked out with your doctor. If the lump re-appears then it is important to see your GP.

It is interesting that you associated the lump with going through a stressful time as these two can be connected. So the main aim now is to prevent a recurrence by controlling the stress hormones. Make sure that you are eating little and often, no longer than three hours without eating and avoid caffeine and sugar. If your blood sugar is fluctuating then adrenaline (one of the stress hormones) will be released.

Add in a good multivitamin and mineral supplement for three months (like the BioCare One a Day or MenoPlus if you are over 45) and extra B vitamins as a B complex as these vitamins are known as the ‘stress’ vitamins. Also include extra magnesium as this is Nature’s ‘tranquiliser’ and will help to cushion your body if you go through another stressful period.

The herb Siberian ginseng (Eleutherococcus senticosus) could also be very helpful. This herb is classed as an adaptogen, which means that it works according to your body’s need – providing energy when required, and helping to combat stress and fatigue when you are under pressure. It helps the adrenal glands which will have been under extreme pressure if you were stressed. Siberian ginseng is extremely useful when you have been under mental or physical stress and should be taken for around three months.

Aromatherapy oils, such as bergamot, lavender and camomile, can be added to a relaxing warm bath just before going to bed and some women have said that sprinkling the essential of lavender onto the pillow is restful. Oils that support the action of the adrenal glands are geranium and rosemary. Rosemary is also a gentle stimulant, which can help to increase energy levels when you are experiencing stress. Sedative and antidepressant oils that are noted for initiating the relaxation response include bergamot, clary sage, jasmine, marjoram and rose.

Q: I am now 50 years old and my periods stopped in July of last year. I wondered how I would know if I had brittle bones, which I hear mentioned in the newspapers quite a lot nowadays. I smoke about 15 cigarettes a day and wondered whether this could have an effect on my bones and I know I am not exercising as much as I should.

A: Osteoporosis affects 1 in 2 women over the age of 50 in the UK. And osteoporosis isn’t just a matter of brittle bones. It can kill. In fact it is a bigger female killer than ovarian, cervical and uterine cancers combined.

But the biggest problem is that osteoporosis is so often a ‘silent disease’, bone loss happens gradually over time, without any symptoms. Osteoporosis, at the moment, remains woefully unrecognised and yet it is preventable and treatable.

There are a number of risk factors for osteoporosis and these include: family history of osteoporosis, yo-yo dieting or an eating disorder such as anorexia or bulimia, irregular menstrual cycles or long gaps between periods when younger, certain medications – steroids, heparin, anticonvulsants, diuretics, long-term laxatives or antacids, low level of physical activity and smoking. Smoking not only reduces bone density (by up to 25%) but also increases the risk of hip fractures so you need to think about stopping.

The gold standard for testing for osteoporosis is a DEXA scan but unfortunately is hard to get on the NHS nowadays. In the clinic in Tunbridge Wells I use an ultrasound machine which passes sound through the heel bone. Recent research has shown that ultrasound scans can predict those patients who subsequently go on to have a fracture as well as DEXA scans.

Another way of assessing bone health is to do a Bone Turnover test which measures biochemical markers in urine that show the rate of bone breakdown. Higher levels of these bone resorption markers, indicating higher bone turnover and higher bone loss, have been found to be associated with a two fold increased risk of osteoporotic fracture. This is an easy test to do and can be done by post.

Once you have found out the condition of your bones there is a lot you can do nutritionally and with your lifestyle to improve your bone density. I have discussed the natural approach to osteoporosis in my book ‘Osteoporosis – the Silent Epidemic’).

As well as getting your nutrition right it is also important to take a good ‘bone’ supplement. The first nutrient that comes to mind is calcium. But many other nutrients are equally crucial for healthy bones, and these include magnesium, vitamin C, vitamin D, zinc and boron.

Magnesium helps to metabolise calcium and vitamin C and converts vitamin D to the active form necessary to ensure that calcium is efficiently absorbed. Vitamin C is vitally important in the manufacture of collagen, which is a sort of ‘cement’ that holds the bone matrix together (use an alkaline form of vitamin C like magnesium ascorbate not ascorbic acid).

Boron is an important mineral in relation to osteoporosis as it plays a crucial part in the conversion of vitamin D into its active form, which, in turn, is necessary for calcium absorption, and zinc is needed for the proper formation of bone cells. There are many good ‘bone’ supplements, the one I use in the clinic is called OsteoPlus and also contains digestive enzymes.