By Deanna E. Guthrie, MD, FACOG
The kids have graduated high school, and the house is empty. It’s just the two of you, and the private times you wished for without interruption are now available. So why isn’t intimacy happening on the regular?
You love your partner, and when things get going, you still enjoy it. However, if they didn’t ask, you wouldn’t care. You acknowledge this, but you don’t like the reality of the situation. Your partner doesn’t understand, and you struggle to explain how you feel. Sound familiar? Menopause is the likely culprit.
What is Menopause?
Menopause is the natural biological change that occurs in every woman. As females age, their ovaries slow the production of hormones. Throughout a woman’s younger years, the regular cyclic production of estrogen, progesterone, and testosterone is responsible for the reproductive process in the form of monthly menstrual periods or attaining pregnancy. In their early to mid-40s, a woman’s hormone levels decrease, and a variety of symptoms may begin that can significantly affect daily life. Some women are lucky enough to have little to no symptoms, while other women can be severely affected, making life miserable.
How Does Menopause Affect Your Libido?
Menopause can have a noticeable effect on a female’s libido, the medical term for sex drive, a person’s desire and energy for sex. This can change and fluctuate during menopause due to several factors:
Hormones: A woman’s sexual desire can decrease when estrogen and testosterone decrease around menopause. You think about sex less often. Unless your partner initiates, sex likely does not happen.
Mood: Depression and low desire for pleasure can affect a woman’s desire to participate in sexual activities. Also, irritability and mood changes can lead to arguments and turmoil, causing problems in your relationship and your sex life.
Weight Gain/Body Image: There is a recognized change in metabolism and fat storage during menopause, which can impact a woman’s body image. Not being happy with weight gain can affect self-esteem, leading to less desire to be seen by your partner, not feeling sexy, and a decreased desire to have sex.
Vaginal Atrophy: With a decrease in estrogen, there are changes in the pelvic region. The vagina thins and can narrow and shorten. Your natural lubrication lessens, necessitating vaginal lubricants. Due to these changes, sex is painful. Spontaneous activities now become more timed and regimented, requiring aids. Today, when you think about having sex, it does not initiate good feelings. It becomes something you do out of obligation, which makes you feel worse. Other changes can include delayed arousal response and less intense orgasms, which often lead to further frustration.
Sleep: Sleep disturbance occurs during menopause, leading to changes in cortisol levels. This adds to weight gain, changes in metabolism, and mood changes. Lack of sleep also causes fatigue and low energy levels, compounding a lack of sexual desire or the ability to make the effort to have sex.
Treatment for the Sexual Symptoms of Menopause
What kind of treatments are available for the sexual side effects of menopause? The good news is you have plenty of options:
Behavioral Changes: Small changes in a couple’s sexual routine can liven up and increase the pleasure in your relationship. Strengthening romance by finding new common interests and scheduling date nights can help enhance the experience.
Sexual Counseling: The sexual side effects of menopause can certainly play a role in relationship issues. If challenges and the inability to connect prove serious, sexual counseling is available for both partners.
Exercise: Regular exercise and activities you find fun and energizing decrease stress. Weight loss can also occur if you are more active, providing a better self-image and boosting energy levels. Sleep can get better with regular physical activity. All of these can lead to a better outlook toward sex.
Lubricants: Again, low estrogen can decrease natural vaginal lubrication. The use of vaginal lubricants during intercourse reduces the painful friction that can occur. With sex being less painful, you will likely look forward to more encounters.
Vaginal Dilators: For those who experience the shortening and decrease in width of the vagina due to the changes from menopause, regular sex helps increase the length and caliber. If sex is not possible, the use of vaginal dilators that graduate in size can help get things back on track.
Natural/Herbal Products: Natural herbs and supplements are available, which act in lieu of hormones and can help control symptoms of menopause.
Sleep Aids: Natural and prescription sleep aids help you attain restorative sleep that battles fatigue, low energy, and stress. Improvement in this area can help bolster sexual health.
Hormone Replacement: Replacing lower levels of estrogen, progesterone, and testosterone can correct the changes of menopause. Estrogen brings a better mood with increased lubrication and restoration of the vagina. Progesterone helps with mood and sleep. Testosterone changes energy levels and increases the desire for sex.
Some women believe it is inevitable that as they get older, they will experience less or no sex, alongside the changes of menopause. They resign themselves to the new normal, which can affect relationships.
Don’t worry. Satisfying sexual health with your partner can still be available to you in this season of life.
Reach Out to Rosa Gynecology for Sexual Challenges Related to Menopause
First, pay a visit to your gynecologist to help rule out abnormal medical findings. This can lead to a discussion on choosing the right course of treatment for your personal and unique situation.
To discuss sexual challenges caused by menopause, call 770-487-9604 or schedule an appointment online with myself or another Rosa Gynecology provider.
