Sex and the Menopause
The menopause is part of every woman’s life, just like menstruation (periods). Roughly between the ages of 45 and 55 the ovaries run out of eggs and the hormonal changes that result lead to the end of periods. During the menopause, women experience a range of symptoms that vary in severity from person to person. Some women can go through the menopause without noticing while others suffer greatly and have to resort to medication to relieve their symptoms. One set of symptoms that can be both upsetting and stressful are those that affect a woman’s sex life. There are many ways to relieve these symptoms and regain confidence and control. Given information and advice, many women are able to return to an active and healthy sex life long after the menopause.
I Just Don’t Feel Like Having SexAccording to surveys carried out by Menopause Matters, 78% of women between the ages of 50 and 60 have an active sex life. 58% of these women suffer discomfort during intercourse, 26% of those experiencing discomfort admit to making excuses to avoid sex because of it and 43% of women experiencing these symptoms said that their relationship with their partner was being affected. A massive 71.5% of women with discomfort during sex were not using treatment despite the fact that many over the counter products can give significant relief. Excuses to avoid sex include ‘not in the mood’, ‘too tired’ or ‘I’ve got a headache’.
Why Does the Menopause Affect Your Sex Life?The range of symptoms that result from the drop in oestrogen levels and other hormone changes during the menopause include vaginal dryness, itching, painful sex (dyspareunia), loss of libido (reduced interest in sex), irritability, lack of energy, heavy and irregular periods, weight gain and depression. If these aren’t enough to put a woman out of the mood for love-making, then the tiredness from poor sleep due to night sweats, the loss of confidence often brought on by these changes and the embarrassment felt when discussing sexual issues would be good enough reasons on their own.
So What Can Be Done?For vaginal dryness, itching and pain there are numerous over-the-counter products that can be used without visiting the GP. These come under two headings: vaginal lubricants and vaginal moisturisers.
Vaginal lubricants are applied just before or during sex and reduce friction. If you feel confident enough to ask your partner to apply the lubricant they can become an integral part of love-making. Water-based lubricants wash off easily and do not mark sheets and clothing. Silicone-based lubricants are smooth and warmer to the touch than water-based products. A smaller quantity of silicone lubricant is needed to be effective and so the containers are often more discreet, easily fitting into a handbag or hiding behind a book on a bedside table.
Vaginal moisturisers also reduce friction. Unlike lubricants, though, they are absorbed into and cling to the skin, behaving more like natural vaginal secretions. Moisturisers are applied on a daily basis and are particularly useful for coping with constant dryness and itching.
Loss of libido, either because of hormonal changes or because of tiredness and irritability, can be trickier to deal with. For many women, acceptance can go some way towards developing new strategies for a healthy sex life. A low interest in sex does not necessarily mean that sex is less enjoyable – according to the Sexual Advice Association, post-menopausal women may have quicker arousal – but it may be that more attention needs to be given to when and where love making takes place and more time may be needed for foreplay.
Talking to a partner is an essential part of coping with loss of libido. Helping a partner to understand what is happening may make them more sensitive to the need to adapt the love-making process. They may even have some good ideas about how to help. If broaching the subject is too difficult or embarrassing, and for many women this is the case, it may be worth talking to a counsellor. Because weight gain is a common symptom of the menopause it is worth considering some general lifestyle changes that may help to improve confidence during this time. Eating a healthy diet with plenty of fresh fruit and vegetables will help with weight and energy levels. Regular weight-bearing exercise – walking is great – will help to control weight, improve circulation and help your bones to stay strong. Exercise can also improve quality of sleep. For night sweats, consider separate duvets. Invest in a lightweight duvet with pure cotton bed linen and light cotton nightclothes to prevent overheating.
When to Go to the GPIf self-help measures do not bring relief from troubling symptoms then it is worth making an appointment with a GP. There are also specialist clinics run by the National Health Service around the United Kingdom now where you can talk about your concerns to a trained nurse and get excellent advice on the many different ways of controlling your symptoms.
Prescription-only treatments may include vaginal oestrogen gels that help to ease pain during sex by thickening the walls of the vagina and increasing natural lubrication. Long-acting contraceptive injections such as Depo-Provera or the Mirena coil (a t-shaped intrauterine coil containing a contraceptive agent) stop menstrual bleeding and so are useful for treating heavy and irregular periods. Contraceptives have the added benefit of taking away any fear of pregnancy while the body is changing. It is important to remember that pregnancy is a risk until periods have been absent for one year. The GP or menopause nurse may also be up-to-date with new treatments and interventions that could be helpful. For example, research into testosterone treatments to increase libido in women over 50 are currently underway in some countries but have not yet been approved for use.
If depression is an issue it is important to remember that many commonly-prescribed antidepressants have loss of libido as a side effect.Hormone Replacement therapy (HRT) can help with many symptoms of the menopause, but it also has some significant side-effects and needs careful consideration and discussion with a GP.