SEX AFTER MENOPAUSE
women find that going through menopause does not impact their sex life. Some
even find it even more exciting than ever because they are no longer concerned
about becoming pregnant. For many women, though, some of the physiological
effects of menopause does impact their enjoyment of sex. It is important to
understand that these effects can be treated, and sex after menopause can be
very fulfilling and enjoyable.
of Menopause that Affect Sexual Enjoyment
menopause, there are certain physiological changes that can interfere with the
enjoyment of sex. Due to loss of estrogen, these symptoms include:
flashes that can occur at any time, causing discomfort and irritability
Night sweats that interfere with a woman's sleep, thereby decreasing her desire
Loss of androgens (including testosterone) that can lower a woman's sex drive or
is likewise important to note that a woman's desire for sex can be affected by
other physical changes related more to aging than to menopause. These changes
* Decreased blood flow to the pelvis - ovaries no
longer need as much nourishment, and the reduced blood flow causes the vagina to
become smaller and less elastic
Walls of the vagina may become thin and tender, causing intercourse to be very
Problems with urine leakage or increased urinary frequency due to weakening of
pelvic muscle support
both menopause-related symptoms, as well as symptoms of aging, there are steps
you can take to ensure an enjoyable sex life beyond menopause.
living - exercise and a healthy diet can make a difference in your overall sense
of well-being and dealing with some symptoms, like hot flashes
Hormone Replacement Therapy - can reduce the incidences of hot flashes and night
sweats, as well as treating vaginal dryness
Various over-the-counter and prescription medications and sex techniques (be
sure to discuss with your health care provider)
Compensate for vaginal dryness through the use of over-the-counter water-based
gel lubricants (such as K-Y Jelly, Replens, or Astroglide) during intercourse
Continued sexual activity can also help to prolong and maintain vaginal health
sexual problems that are easily treatable are dismissed by many women as just a
part of aging. If continued sexual fulfillment is important to you, be sure to
discuss any problems you are experiencing with your partner and your health care
women find that sex after menopause can actually be more enjoyable and
fulfilling than in younger years. Find out what to expect and how to easily plan
for some of the inevitable changes.
does not signal the end of female sexuality. In fact, many women find that
intimacy is enhanced in midlife.
years ago Judy Grant, a 52-year-old lawyer, realized she was no longer getting
her period, her vagina was drier than usual, and sexual arousal was taking
longer. She began to worry that her sex life would soon disappear.
had heard that at menopause, women lose their interest in and ability to have
sex. But since she started using a little KY jelly to add lubrication and
adjusted her expectations, she's found she enjoys sex more than ever. She
especially likes the extra time she and her husband spend stroking and cuddling
before they try to reach orgasm.
Judy, many women fear that menopause signals the end of their sexual
desirability and pleasure. This fear comes from stereotypes of the midlife and
older woman as unattractive and asexual. In addition, loss of the ability to
bear children may become confused with loss of sexual desirability.
reality is that the need for and capacity to have satisfying sexual
relationships does not disappear as a natural or irreversible part of aging in
women or men. According to Paula Doress-Worters, co-author of The New Ourselves,
Growing Older and The New Our Bodies, Ourselves, "there is no reason to
think that women in midlife should necessarily have problems with
menopause does bring physiologic changes that may slow down response time and
affect sexual activity in a variety of ways, 70%-80% of women do not experience
a reduction in sexual activity or satisfaction. And for those who do, there are
safe, effective solutions.
you perceive and deal with the changes can have a significant impact on your
sexual health and pleasure. Some women have a reawakening of sexual interest
when they are no longer concerned about getting pregnant and adult or older
children require less time and attention. However, there is tremendous
individual variation in women's experiences.
at Menopause That May Affect Sexuality
changes at menopause can sometimes affect sexual activity and desire in some
women. Changes may occur in lubrication, the vaginal walls, arousal, orgasm, and
sex drive that make sex less comfortable and enjoyable.
Dryness and Pain During Intercourse
most common problem is vaginal dryness, although only about 20% of women
experience it. The vaginal walls may also become thinner and less flexible.
Itching, burning, and occasional pain and bleeding may occur during intercourse.
water-based lubricants, such as Astroglide and KY jelly, can help with vaginal
dryness. Do not use petroleum-based lubricants such as Vaseline. They weaken the
latex in condoms and can cause vaginal infections. Vitamin E or moisturizers
such as Replens can also help if used regularly.
lubricants and moisturizers are not sufficient, vaginal estrogen cream, rings,
or tablets are generally helpful.
women have fewer and less intense orgasms when they reach menopause. It may take
more time and stimulation to become aroused. For all women, having intercourse
or masturbating regularly can help increase sexual responsiveness and pleasure.
They keep the muscles supporting the uterus, vagina, and bladder in shape and
increase lubrication. Kegel exercises, contractions of the pelvic muscle near
the vagina, can also help strengthen the vaginal muscles.
of interest in sex, temporary or long-term, occurs in some women during and
after menopause. Possible causes include the following:
* Relationship problems
* Psychological issues
* Medication side effects
* Hormonal changes
* Discomfort from the physical changes of
problems tend to be the cause of decreased sexual desire only when there have
been ongoing difficulties in the relationship. These difficulties may be
exacerbated by changes at menopause. If this is the case, consider seeing a
therapist who specializes in sexuality.
the problem is hormonal, estrogen may help. However, its effect is generally on
the physical changes, such as vaginal dryness and pain during intercourse. No
direct relationship has yet been found between estrogen levels and desire to
study in particular published in the journal Menopause in September/October
2000, found no direct relationship between declining estrogen levels and desire
to have sex. Rather, the researchers found that hormonal levels, health, and
social changes associated with aging, and the mental and emotional effects of
being recently menopausal probably work together to create changes in a woman's
sexual desire. Longer-term studies are needed to determine whether reduced
estrogen production affects a woman's sexual functioning as she gets farther
natural decrease in testosterone at menopause might play a role in sexual
desire, although this remains unproven. Testosterone is available in pills,
injections, and creams, but side effects are a major concern.
changes that take place in midlife can provide an opportunity to explore new and
different sexual experiences. Men also go through changes, such as needing more
time and stimulation to become aroused. The slower, more sensuous foreplay that
often results is a welcome change for some women.
focus on sensuality, intimacy, and communication can help a sexual relationship
become more rewarding than ever. There are many ways of expressing your love
* Hugging, cuddling, kissing
* Touching, stroking, massage, sensual baths
* Manual stimulation
* Oral sex
relationships after menopause can indeed be satisfying if you are able to adapt
to the changes that occur.
Note About Birth Control and Safe Sex
you are having intercourse you need to continue using birth control until you
have not had a period for 12 months in a row. However, protection against
sexually transmitted diseases, including HIV/AIDS, remains a concern. Unless you
are in a long-standing monogamous relationship, be sure to use a male latex
condom or female condom, and preferably with the spermicide nonoxynol-9.
Institute on Aging
North American Menopause Society (NAMS)
possible to restore post-menopausal sex drive, but do women want to?
Orange County Register
9, 2004 08:00 PM
treat it like a dirty little secret. A "condition" they whisper to
their physician, convinced they are unusual, strange, dysfunctional.
say they don't like sex anymore. They say they've lost interest since menopause.
maybe their husbands or partners can't perform because of prostate surgery or
blood pressure medication, and (is it possible?) they're relieved. Glad to have
sex out of their lives.
much for post-menopausal zest.
desire is the most common complaint older women present at our clinic,"
says Dr. Jennifer Berman, co-director of the Female Sexual Medicine Center at
says the doctor, is a problem that can be solved. Women willing to talk about it
can find a solution, she believes.
not alone in assuming the embers are there, ready to flame if they're fanned.
pharmaceutical companies and mainstream media are discovering that women's
sexual dysfunction at midlife is a hot topic. Drugstore shelves are filling up
with herbal remedies designed to spark love interest. A "female Viagra"
is being developed. Clinics, such as the one at UCLA and another planned at the
University of California, Irvine, cater to the sexual changes of
problem is obvious. The solutions, if there are any, are not.
are physical causes, such as hormonal imbalances and medications affecting sex
drive and stifling sexual urges, Berman says. Appropriate treatments, such as
hormone replacements and other medications, can make a difference, she says.
are psychological causes such as cellulite-dimpled derrieres, age spots and
wrinkles creating self-image concerns, counselors say. Women who don't feel sexy
don't act sexy or respond to sexual overtures, they say. Therapists stress
counseling to help women focus on their attractions, including the experience
that comes with age.
are natural reasons, such as evolution to grandmotherhood, researchers say.
Viagra-emboldened senior studs are not "natural," they point out.
truth is, no one has a magic pill for any of the causes.
health professionals are trying to make sense of how and why sexual dysfunction
occurs in midlife, they're proposing some solutions.
down to the basics If sexual desire lessens, a good physical examination is the
first step, according to Dr. Robert Butler, 76, and his wife, Myrna Lewis, 64,
who co-authored the classic study "Love and Sex After 60" in 1976. The
book was updated last year. Butler is founder of the International Longevity
Center in New York.
and a healthy lifestyle are two ways to prolong sexual activity, Butler says.
women on relationships also is primary, Lewis says. She finds that many women
who complain of lack of arousal are locked in a sexual relationship that isn't
working for a number of reasons, from boredom to physical disabilities such as
says many couples she counsels benefit from a growing maturity in their
relationships. There is a familiarity, an understanding of arousal techniques
that come with time.
women at any age, sex is all in the mind, says Newport Beach, Va.-based
psychologist Pat Allen.
got to feel good about it, got to have the right attitude," she says.
sex with a longtime partner can get boring, she says, if he stops paying
attention to her turn-ons.
she suggests it's up to the women to change the atmosphere. Use your
imagination, from sexy underwear to stimulating videos. Whatever works.
got to remember that we're the magnets, and you've got to think like a
magnet," she says. "What we forget is sex is an art form."
aging and menopause, estrogen decreases, and some women experience a change in
sexual function. Estrogen decline may cause hot flashes and vaginal dryness that
makes intercourse painful, Berman says.
testosterone also can alter women's sexual response, she says. A drop in the
male sex hormone, which women also produce, is thought to diminish sexual
interest. At this time, there are no approved testosterone preparations for
women, although clinical studies are under way, Berman says.
will not say hormone replacement cures low desire, insisting there is no blanket
solution for everyone, but she adds, "There is a role for testosterone in
is no good data showing testosterone really affects libido, says Dr. Vivian
Dickerson, a UCI Medical Center gynecologist and president-elect of the American
College of Obstetricians and Gynecologists.
says there seems to be a short-term benefit for women whose testosterone drops
as a result of menopause, but no data indicating a long-term benefit.
are studying the role of testosterone in women's sex drive, but it may be
causing nothing more than the placebo effect, she says.
sex drive is complex. It's tied to mood, body image, age, weight, "even how
tired you are," Dickerson says. "All these things have tremendous
impact on our sex drive at any age.
come to me and say, I don't want my husband to feel rejected, I don't want him
to worry, but he's not doing anything for me sexually," she says.
women want from sex varies but is usually more snuggling, kissing,
should go away for two weeks to a place where there are no children or
need plenty of time to be together," she says.
have to talk to each other. You have to create levels."
level one, the couple can touch and kiss but no more.
you do that, spend a day touching and kissing, you know the ground rules about
what pleases the other person. There's a freedom and communication," she
usually don't have to tell them when to go to level two."
Butlers point out there is more to an intimate relationship than sexual
is the new psychological buzzword for intimacy without actual penetration.
Touching, holding hands, cuddling can be satisfying sexual activity for seniors
when the man cannot achieve an erection, they say.
designed women to be more "forceful on the world stage" after
menopause and naturally less inclined to think about sex, says Dr. Leonard
Shlain, author of "Sex, Time and Power: How Women's Sexuality Shaped Human
Evolution" (Viking, 2003).
society short-circuits nature's plan with medicinal enhancements for sexual
desire after menopause, he says.
controversial theory says women invented time when they recognized their natural
also equated menstruation with fertility, and a lack of menstruation with a
natural shift away from sexual interest.
various enhancements to tinker with nature "upsets the hormonal clocks
originally instilled in us," Shlain says. "This alters the course of
is a reason women stop menstruating, he says.
cutting off her ability to have children, nature lets women have the time and
energy to help their daughters raise children. This is a clever strategy on the
part of nature," he says.
shuts us down as an act of mercy," psychologist Allen says.
Because there's no point in feeling sexual when the guys your age don't have
much push. Why do you suppose Demi Moore is with what's-his-face?" (That's
Ashton Kutcher, for those who care.)
women outnumber men 15 to 1, she says. "The men don't hold up, and those
that do hold up don't want a 50-year-old woman anyway, so too many women feel
they have to give up sex."
shutdown is natural, she says. "We're not supposed to be available to men
because all the men are supposed to be dead," she says.
Medical Center's Dickerson points out that bodies change with menopause and that
most people are in denial about the effect of age on their sex drive. "We
have to come to grips with aging," she says.
think we expect things to be the same with us always, but there are natural
modulations of things when time goes on.
can't see as well at 50 as we did at 20, yet we expect to have the same sex
Sex After Menopause: Expert Advice
to enjoy sex after menopause
article in the February 2004 issue of the Journal of the American Medical
Association (JAMA) contained a research study on sexual dysfunction that
garnered extensive media coverage. The findings may surprise you: 43% of women
and 31% of men in the US suffer from sexual dysfunction. Pretty large numbers.
Significantly more people have sexual issues than Hollywood, fashion magazines,
and even many doctors lead us to believe.
stated, sexual dysfunction is a common problem. Almost half of all American
women struggle with it. Viagra has come to the rescue of many aging men, but
what about women? So far women been left out in the cold.
there are some new herbal formulations that hold out the promise of improved
sexual stimulation and response for females. Many women have reported
significant improvements in sexual pleasure, both before and after menopause,
with the use of these products. You could consider trying one of these female
sex stimulants to help improve your sex life.
truth is that as women age and reach menopause, many women lose interest in sex.
Their bodies simply stop producing the same levels of sex hormones as they did
when they were younger. As sex hormone levels decline, so does desire. To make
matters worse, many women develop vaginal dryness, which can make sex painful.
the same time, some men are losing their drive and ability to perform, so their
female partners may not even notice the drop in their own libido. But now that
we know better -- and men are finding help -- women should make an effort to get
a piece of the action!
listed below four suggestions for increasing your sex drive, enhancing arousal,
and combating sexual problems after menopause. Give them a try and see if you
notice a change for the better.
Hormones: Why worry about hormones? Because scientists have begun to
realize that menopause devastates us hormonally. Women produce less and less
testosterone, the "male" sex hormone, as they age. By the age of 40,
they have half as much testosterone as they did when they were 20. Research has
shown that a low testosterone level means lack of sexual desire. As if that
weren't enough, estrogen levels also decline by 80-90% during menopause. Low
estrogen levels cause vaginal dryness, which leads to painful intercourse, and
diminished blood flow to the vagina, which interferes with arousal and pleasure
This may be devastating to some women. Many doctors recommend hormone
replacement therapy (HRT) as a solution.
Taking estrogen can help rid you of all symptoms of menopause including
moodiness, vaginal dryness, and hot flashes. In addition, it may reduce the risk
of cardiovascular disease, osteoporosis, and some cancers. Testosterone therapy
has been shown to enhance desire, induce feelings of well being, and combat
However, testosterone may produce unwanted side effects such as acne,
increased risk of heart disease and breast cancer. HRT is a serious treatment
with many important factors figuring in. It should be carefully considered with
Supplements: For many women, the real problem is not lack of sexual
interest but a generally low energy level. They work, manage the household, take
care of the kids, husbands and parents, and at the end of the day simply don't
have the energy to engage in sexual activity. To give yourself an added boost,
try taking a nutritional supplement with ginseng or ginkgo. Both herbs have been
taken for hundreds of years as natural energy enhancers.
Supplements can also provide our bodies with the raw materials they need
to perform better, naturally.
For example Arginine, an amino acid that is found in nuts, meat, and
dairy, enhances blood flow. Taking a supplement with Arginine, ginseng, and
ginkgo biloba can improve arousal by increasing the flow of blood to the
clitoris-vagina area during sexual activity, together with boosting energy
Provestra is a herbal supplement that has proven to be specifically
useful for enhancing sex drive, libido and sexual response in women after
menopause. You should consider trying this out for yourself.
Diet: I have a friend who had a terrible time with menopause. She
experienced huge emotional swings, gained weight, and suffered debilitating hot
flashes. After consulting an alternative medicine doctor who advised her to eat
lots of soy, she completely changed her diet. She became a vegetarian, replaced
meat with tofu and milk with soymilk, and added more fresh vegetables to her
meals. Within a few months she had lost weight, all her symptoms had
disappeared, and her sex drive had improved tremendously.
Studies show that one valuable resource for women is soy. Soybeans
contain phytoestrogens, or plant estrogens, that may help replace the estrogen
that your body is naturally producing less of over time. Japanese women, who eat
a diet heavy in soy, have far lower levels of breast cancer and less trouble
with menopausal symptoms. A suggestion is to inject more soy into your diet and
see what it does for you.
In general, remember that you should eat a diet that is low in fat and
high in fresh fruits and vegetables.
Physical problems: Vaginal dryness, a common problem after menopause, can
be easily treated with lubricants available
at most drugstores and supermarkets. You'll need to apply the lubricant every
time you have sex. If you use condoms, avoid Vaseline or other oil-based
lubricants as they destroy the condom material. While there is a vast variety
available, we specifically recommend these special sex enhancement lubricants:
Water-based sexual lubricants
Silicone-based sexual lubricants
If you find that your vaginal walls have relaxed over time, as do many
older women, there is hope. A simple exercise, known as the Kegel exercise, can
improve your muscle tone and help you to enjoy sex more. Simply squeeze the
muscles around your vagina as if you were trying to stop yourself from urinating
midstream. Contract these muscles for one minute, then release. Repeat at least
10 times, and increase the number of repetitions over time. You can do these
exercises any time – while you're working at a desk, while driving, or even
when you're watching TV.
A FREE HANDBOOK ON MENOPAUSE VISIT: http://www.menopause.org/edumaterials/guidebook/mgtoc.htm