I wish I could tell you that sex gets better as we get older, l really do. But as you probably know if you're already there, the postmenopausal orgasm can be a very elusive character, ducking in and out of dark corners, impolitely and suspensefully keeping you waiting and hoping and predicting it will show up—in great frustration and sometimes, sadly, to no avail. Especially if you've treasured the straightforward, no- nonsense slam-bam-thank-you-ma'am kind of pleasure often available when you've got surging sex hormones (or even moderate levels of them), this experience can be, to say the least, deflating.

So: Better, no. Different, yes. More loving, if less urgent, yes. More complex and compassionate, yes. Why? For one thing, as we age, our ratio of sex hormones changes, and women and men become ever more similar biologically, says Helen Fisher, PhD, visiting research professor at Rutgers University and author of Why We Love: The Nature and Chemistry of Romantic Love. In women, circulating estrogen levels drop, unmasking the effects—assertiveness, for instance—of testosterone, in men, just the opposite happens; testosterone levels drop around age 45, as estrogen levels increase. So older men, like women, usually take longer to warm up and are likely to enjoy more foreplay. And people tend to become more relaxed about sex as they age, says Fisher. She believes women hit a plateau in middle age, enjoying their sexuality without having to worry about birth control. (Fisher points out that a person who is interested in sex in her 20s and 30s is likely to continue that interest into her 40s, 50s, and beyond. At 54, I wouldn't disagree.)

But what about that elusive orgasm? what if, in spite of increased assertiveness and a positive outlook, you find your libido waning? Faint orgasms may be the result of tired, weakening muscles; Kegel exercises can help rouse that sleepy response. If you've lost interest because sex feels uncomfortable or painful, there is an excellent solution: Estrogen applied locally relieves two of the most common sore points among older women—vaginal dryness and thinning tissue. An estrogen pill inserted vaginally is very effective in restoring moisture and building tissue, says Monica Peacocke, MD, a vulvar and vaginal disease specialist. (Estrogen is also available in a vaginal ring and a cream, but Peacocke believes the pill works best because it is least systemic and least messy.) Some women have worsening vaginal pain even after they start on a local estrogen. She thinks that's due to a vitamin D deficiency, which may also have an effect on the vagina's ability to make moisture. Peacocke believes that certain medications containing alendronate sodium (for osteoporosis) or pantoprazole sodium (for treating reflux) cause a decrease in the vitamin. She runs blood tests on her patients to determine the vaginal level of vitamin D, and prescribes 2,000 to 4,000 units a day (double the Institute of Medicine's upper intake level). She warns that you should never increase your intake of the vitamin without seeing a physician; vitamin D toxicity can cause a bevy of health problems. Though Peacocke has not yet submitted her research for publication, she has seen dramatic improvement in many of her patients.

After my first exam with a new gynecologist recently, the doctor sat down with me for a chat in her office. I don't remember whether she steered the conversation toward sex or whether l did, but there it was: Sometimes it hurts. She nodded sympathetically.

"Do you moisturize your face every day?" she said.

"Of course," l said.

"That's right," she said genially, "and you should be moisturizing your vagina, too."

Her tone was so casual and matter-of-fact, she might have been talking about my hands. She prescribed an estrogen cream (Estrace), which can be used internally several times a week, and an over-the-counter vaginal moisturizer (Silk-E by K-Y) with aloe and vitamin E for every day. I've been using both religiously. You will forgive me if in my excited state I've become hyperbolic, but together, they seem to work like a fountain of youth; I'm looking forward to becoming one heck of a sexagenarian.