Menopause is something that will affect every woman during their lifetime. Yet even though that midlife change is something half the population will experience, it’s still considered one of those taboo topics that people don’t like talking about. Probably because many of the symptoms are considered a bit embarrassing, like hot flushes, heavy periods, vaginal dryness, and sexual problems. But there’s no reason to shy away from discussing something that's a perfectly normal part of life.
When it comes to sex and menopause, there are some ridiculous rumours that your sex life is over. That you’ll never experience good sex again or, heaven forbid, that you’ll never have an orgasm again. Well, we can set that one straight right now and tell you that simply isn’t true. You can still have a perfectly happy and healthy sex life for as long as you want. But yes, things just might need a helping hand.
So let's see if we can help debunk a few myths.
What age does menopause start?
Menopause is a biological process when the ovaries stop producing as much of the hormone estrogen and no longer release an egg each month, marking the end of your menstrual cycles.
Menopause is diagnosed after you’ve gone 12 months without a menstrual period, but the time before that can last several years and is known as perimenopause. During this period of time, you’ll start experiencing many of the symptoms which are all common side effects due to the change and fluctuation in your natural hormones. When menopause starts will vary from woman to woman, but can begin in your 40s or 50s. The average age of menopause is 51. Around 1 in 100 women experience menopause before 40 years of age. This is known as premature menopause.
What are the symptoms of menopause?
There are many common menopausal symptoms and all women can expect to experience at least some of them. The duration and severity of these symptoms vary widely from person to person. These symptoms include:
- Irregular periods. Probably the first thing you’ll notice is the change to your periods, both in their regularity from month to month and also the flow, which can become very heavy and painful.
- Hot flashes. Sudden, overwhelming feelings of heat, usually in the face, neck and chest which can make your skin a little blotchy, red and sweaty
- Night sweats - as above, but just in the night. (Yep, those hot flushes can come at any time, day or night!)
- Difficulty sleeping, leading to tiredness and irritability during the day
- Weight gain due to slowed metabolism
- Mood changes such as low mood or anxiety
- Problems with memory and concentration
- Recurrent urinary tract infections (UTIs)
- Vaginal dryness - during both sexual activity and other times, making it tender and painful to touch the vulva
- Sexual dysfunction. A lack of desire to have sex or inability to enjoy sexual activity
It's understandable to feel that many of these symptoms will impact your daily quality of life. But fear not, there are a number of treatment options that can help. The important thing is not to suffer in silence, so make an appointment to see your doctor and discuss your options.
The main treatment for menopausal symptoms is hormone replacement therapy (HRT).
Many of the symptoms women experience is down to the reduced hormone levels in their body, especially estrogen. By replacing it with estrogen therapy using tablets, implants, skin patches or gels, many of the symptoms can be relieved. If you still have your uterus, you will likely need progesterone to protect the lining of the womb too.
How does menopause affect your sex drive?
As you go through menopause, the reduced estrogen can lead to changes in a woman’s sex drive. Some women notice they’re not as easily aroused and may be less sensitive to touching and stroking. The lower estrogen levels also lead to reduced blood flow to the vagina, impacting vaginal lubrication. And of course, the symptoms listed earlier aren’t exactly doing their bit to make you feel sexy!
Does menopause cause a lower sex drive in all women?
No. Every body is unique and many postmenopausal women actually report having an increased sexual desire. This can be down to reduced anxiety over getting pregnant or fewer childcare responsibilities as their children grow older, allowing for more time to be intimate with their partner.
How can I treat vaginal dryness or vaginal atrophy during menopause?
Vaginal dryness is one of the most common symptoms of menopause which can also cause a knock-on effect to women's health. The reduced natural lubrication can make vaginal tissue sore and painful which not only affects your sexual health, but can make wiping after urination painful for some women too.
Vaginal atrophy is where the tissues of the vagina and vulva shrink and become less stretchy, which again can cause pain and discomfort, especially during sexual activity.
These symptoms can be relieved with the use of vaginal estrogen, administered through pessaries, cream, or a vaginal ring directly into the vagina. So speak with your doctor who can advise the best treatment for you. Alternatively, you can easily pick up some over-the-counter vaginal moisturizers from your pharmacy.
When it comes to sex, the use of a good vaginal lubricant can make all the difference to make sex comfortable and pleasurable.
A water-based lube is the closest to your own natural lubrication and is safe to use with all condoms and sex toys, making it the universal choice. Don’t be afraid to use a good amount, and keep reapplying if needed. Because it is water-based, your vulva and vagina will naturally absorb it, so just add more as needed!
A silicone or hybrid lube will last a bit longer and will give a smoother, more cushiony glide. But just remember that silicone lubes can’t be used with silicone toys as it can break down the material of the toy.
Whichever lube you choose, it's important to find one that is designed specifically for intimate use. This isn't the time to be breaking out the vaseline! An organic-based lube or one designed for sensitive skin is ideal as it won't interfere with the natural pH balance of your vagina.
If you're experiencing vaginal tightness, you can try a slim vibrator or dildo to gently stimulate the vagina too, (again, using plenty of lube!), which can help the vagina relax and make sex more pleasurable.
Minimize any pain you might have by using sexual positions that allow you to control the depth of penetration. So now's as good a time as any to get creative with your partner and enjoy some experimentation!