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Sex After Menopause

Menopause is a time when women experience considerable hormonal changes which result in symptoms such as hot flushes, mood swings, and sexual issues. While all of these symptoms are natural, they can cause significant distress for menopausal women and their partners – which can become disruptive to their relationship.  

With menopause, the ovaries stop making estrogen (a vital sex hormone), which causes the vagina to become dry and less elastic. Decreased estrogen also produces changes in the blood vessels and tissues of the vagina and vulva, making it more difficult to become sexually aroused.

Increased lubrication and regular use are also great ways to keep vaginal health at its peak. Daily vaginal activity is important during and after menopause because it stimulates blood flow and helps to keep your vaginal muscles toned and elastic.

Emotional Effects

Changing hormone levels not only have a physical effect on the female body, but they also provoke an emotional response. Fluctuating hormones can interfere with sleeping patterns and mood, causing:

  • Tiredness
  • Anxiety
  • Irritability
  • Depression/sadness
  • Fatigue
  • Lack of concentration and motivation
  • Sense of loss
  • Loss in self-confidence
  • Loss of intimacy

A decreased sex drive or inability to enjoy sex can also lead to a loss of self-esteem and intimacy between partners. What menopause represents (loss of fertility) is also a cause for emotional problems. These side effects can be just as debilitating as the physical effects, especially when it comes to sex.

Many of the physical changes that occur with aging can also intensify the emotional symptoms of menopause.

Not all women experience negative emotional-symptoms linked to menopause. Some women gain additional wisdom and confidence. Those who do experience negative symptoms should see a doctor if they interfere with healthy sexual activity or everyday life.

Reducing Sexual Complications

Staying sexually active is one of the easiest ways to lessen the sexual complications of menopause. The physical and emotional side effects of menopause cause many women to reduce or refrain from sexual activity. However, the vagina needs consistent use to remain healthy – especially after menopause.

Regular sexual stimulation helps promote blood flow to the vagina. It also helps maintain the vagina’s elasticity, depth, and overall shape.

Click here for a list of different lubrication to help with vaginal dryness during intercourse.

Around 55% of women do not seek medical treatment for menopausal symptoms.

Most side effects lessen over time and eventually go away. However, for some women, the symptoms are intense and persistent, so medical treatment is advised. Doctors may prescribe medications or creams that are composed of estrogen, progesterone, or both.

Over-the-counter products (like lubricants) are often the first line of recommended treatments. In worse cases, a doctor may prescribe hormone therapies to help reduce vaginal dryness.

Medical treatment options for managing the side effects of menopause include:

  • Topical estrogen or progesterone medications: Prescribed rings, tablets, creams, or suppositories put directly on vaginal tissues to help reduce dryness.
  • Low-dose oral contraceptives: Mainly prescribed to reduce vaginal dryness and hot flashes. These may also come in transdermal patches.
  • Menopausal hormone replacement (MHRT): Prescribed to help reduce vaginal dryness, discomfort, and associated pain during sex. MHRT may also help reduce hot flashes, mood swings, and mild depressive symptoms.
  • Medications meant to treat other conditions: Some management medications used to treat depression, anxiety, epilepsy, and high blood pressure may help reduce hot flashes and moodiness.

Men and Menopause

One survey found that 70% of menopausal women who experienced pain during sex said the problem also caused tension with their partner.

In terms of sexual activity, having a supportive and understanding partner makes it easier for women to cope with menopause and its symptoms. On the other hand, being dissatisfied with a partner can exacerbate the sexual and psychological symptoms of menopause. A woman's relationship with her partner exerts a significant influence on her menopausal symptoms – in particular, the sexual symptoms which she’ll experience.

Many men probably have little knowledge about menopause and what they can do to help their partner overcome these new difficulties.

There is considerable evidence that couples can continue to have a great sex life after menopause. Men may be unaware of the important role they play in keeping up a great sex life during and after their partner hits menopause.

While health professionals are a good source of advice, men are often too embarrassed to discuss their sex life with a doctor. This is understandable as it can be seen as an awkward topic. However, doctors will treat a sexual problem (like menopause) the same way they would any other health problem. They’ll probably even provide more detailed advice in regard to your specific circumstance as they have a better understanding of the human body. It’s important to speak openly and honestly with them.

Sexual symptoms are typically a problem for women because they cause a mismatch between their partner’s sexual needs and their own. For example, a woman who takes longer to orgasm after menopause may only bother if her partner experiences quicker orgasms.

Menopausal sex problems are joint problems, most effectively treated by involving both partners. It helps when the partners of menopausal women are educated about why the sexual symptoms of menopause arise and what might exacerbate them. Educated partners are in a better position to help menopausal women treat the symptoms and have a great sex life after menopause.

Women experience significant changes at menopause, and it’s difficult for those who are close to them not to notice. As her partner, you likely know her well and spend significant time with her – and are thus likely to notice mood changes more than others (and perhaps find yourself in the middle of menopausal mood swings once in a while). Unlike her friends and family, you will also notice any changes in her libido or sexual response. All these changes can cause concern and anxiety, and you may wonder what you are doing wrong.

Don’t worry, nothing is wrong. All of these changes are normal. The main thing that most women require during this time is understanding and support. Education about the physical changes that occur at menopause and the symptoms they create can help reassure you that it’s natural.


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