For many women the no. 1 reason to take estrogen after menopause is to improve their sex lives. "Without it, you may soon have no sex life at all," contends Dr. Lila Nachtigall, co-author of the popular handbook Estrogen: The Facts Can Change Your Life! (HarperCollins; $11). The natural waning of estrogen in the middle years often brings physical changes that can ruin a woman's pleasure in sex. The vagina basically reverts to its prepubescent shape: narrower, shorter, dryer, less elastic, with thin walls that tear easily and are prone to infection. The libido may also dry up, if only because...

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