How Will Menopause Impact Intimacy?
Menopause and Intimacy
All women experience menopause differently, and many women experience changes in their sex life during this time. You may have heard about menopause impacting a woman’s ‘libido’ or sexual desire.
Some women may enjoy sex more because they no longer worry about what other people think and feel a sense of freedom as they age, or there is no longer a concern or need for birth control. While others may find they no longer feel sexual desire or no longer want to have sex, and that can be really upsetting. What causes a woman to change the way she once thought about sex?
Well, hormones play a big role in a woman’s life, and for many, menopause (often described as not having had a menstrual cycle in 12 months or more) may be the most difficult time.
Estrogen levels fall dramatically as a woman approaches and passes menopause; this can result in a wide array of symptoms. But most concerning are those women who suffer from Genitourinary Syndrome of Menopause (GSM). A newer, more inclusive term that describes various menopausal symptoms and signs such as these is listed here.
Genitourinary Syndrome of Menopause
Genitourinary syndrome of menopause is a chronic, progressive condition of the vulva, vagina, and lower urinary tract, which is characterized by the following signs/symptoms:
Vaginal Symptoms
Vaginal dryness
Vaginal irritation/burning/itching
Thinning/graying pubic hair
Vaginal pelvic pain/pressure
Shortened narrowed vagina
Loss of stretchiness
Minor cuts (lacerations) near the opening
Whitish discoloration to the vagina
Decrease in size of the labia
Sexual Symptoms
Painful sexual intercourse
Decreased lubrication during sexual activity
Bleeding after sexual activity
Decreased arousal/loss of libido
Inability to orgasm or painful orgasm
Urinary Symptoms
Painful urination
Urinary urgency
Urinary incontinence (stress and urge)
Recurrent urinary infections
Urethral caruncle (red vascular growth on the urethra)
How do you treat GSM?
Well, initially, one could try topical lubricants and moisturizers. Topical lubricants and moisturizers can help improve symptoms of GSM by increasing hydration and lubrication of the vulvovaginal area. Lubricants and moisturizers are an important treatment option for those who may not be able to take estrogen to otherwise improve dryness and reduce pain.
But more severe cases may need Hormone therapy. What are the hormonal treatment options for vaginal atrophy (GSM)?
These may include:
-Estrogen therapy and dehydroepiandrosterone (DHEA) are more commonly used
-but other options can include testosterone and oxytocin therapy (BHRT- Bioidentical Hormone therapy) can also be very beneficial.
Treatment options can be taken by
topical route (patches, creams, and gels absorbed through the skin)
vaginal route (cream, gels, tablets, or ring, placed in the vagina)
oral route (tablet, troches, swallowed or dissolved in the mouth)
And finally, always talking with your partner about your concerns can strengthen your relationship. Getting older and chronic health problems like heart disease or diabetes can affect your sexual health and how you feel about sex.
Some possible topics to discuss include:
What feels good and what doesn’t
Times that you may feel more relaxed
Which positions are more comfortable
Whether you need more time to get aroused than before
Concerns you have about the way your appearance may be changing
Ways to enjoy physical connection other than vaginal intercourse, such as oral sex
Feeling good about your body and sexuality is critical as you go through menopause. We would love to guide you through this season of life and help you be at your very best. To get started, you can schedule your free appointment today to keep your intimacy through menopause.
