What is the menopause?
In 2004, two Scottish scientists developed an ovary-ultrasound test which predicts when you will reach your ‘change.of life’. However, it is not available on the NHS. It’s now possible to obtain this Wallace-Kelsey test privately; the current cost is about £250.
In the years leading up to the menopause, the level of oestrogen (an important female sex hormone) starts to fall.
This fall can have several effects:
- the vagina and vulva (the vaginal opening) may become a little dryer
- as a result, the woman may become slightly more vulnerable to urinary infections
- the breasts may lose some of their bulk
- the skin may become a little less elastic.
If you are unlucky, the changes in your body may possibly lead to two distressing symptoms:
- hot flushes
- sweating attacks.
However, a lot of women do actually sail through the menopause with little or nothing in the way of unpleasant symptoms.
Can I have sex after the menopause?
Yes! Even today – one sometimes reads articles in the newspapers which suggest that nearly all women lose their sexual desire at the menopause – and that most of them have little sexual activity thereafter. This is nonsense.
The truth is that there’s no reason why you can’t continue to enjoy a happy and satisfying sex life during and after the menopause, if you want to.
My colleagues and I have found that many women enjoy wonderful sex lives after they’ve passed the menopause – and continue to do so for a very long time. We have even uncovered some evidence that:
- women who are interested in sex are more likely to be orgasmic after the ‘change’ than younger females.
- they are also more likely to be multi-orgasmic!
There are three main reasons for this.
- After the ‘change’ women are glad to be able to quit worrying about contraception.
- By the time they reach 50 or so, a lot of women have gained a great deal of love-making experience and skill.
- Very often, they now have partners who actually know what they’re doing in bed! (Though of course, a few postmenopausal women – notably certain film stars – decide to take ‘toy boys’ as lovers.)
In 2009, one of us (Christine Webber) conducted a survey among women aged 45-65. The findings showed that in that age group 26 per cent of women were definitely up for sex, while 29 per cent ‘quite liked it’. Only 6 per cent were not at all keen, and 16 per cent said that they’d be more interested if they had a new partner!
How could the menopause affect my sex life adversely?
It’s fair to say that many women have a great time in bed after they pass the menopause. However, others don’t.
These are some problems that can occur.
- Night sweats and hot flushes. These can be counterproductive to relaxation and romance. At night, such symptoms produce an intolerable feeling of heat, often accompanied by profuse sweating, and even a feeling of acute claustrophobia. If the sufferer has to throw off the bed sheets and open the windows when night sweats are at their worst, she’s not going to feel like absorbing even more body heat from her sexual partner!
- Relative oestrogen deficiency can bring about vaginal dryness and thinning of the vaginal lining. The lack of lubrication and support for the vaginal walls can reduce arousal during sex and increase friction, which in turn may produce soreness, burning or irritation.
- Irregular periods can make the timing of spontaneous love-making difficult. (However, the menopause shouldn’t really cause badly irregular periods; if yours are ‘all over the place’ consult your doctor.)
- stress urinary incontinence (SUI) can occasionally arise during love-making – or during a climax.
- Some women are conscious of dry skin, changes in the shape of their breasts and of a gradual redistribution of weight away from their breasts towards their waistline.
- Loss of libido can occur; a minority of women complain that after the menopause they simply lose their desire for sex. Husbands may feel rejected because of this, and so relationship difficulties can arise.
- Psychological symptoms such as mood swings, insomnia and depression can make it difficult to enjoy sex.
The good news is that all these problems can usually be remedied - chiefly through commonsense advice from a doctor (or from a therapist who is experienced in dealing with menopause problems), together with sympathy, understanding and love from the woman’s partner.
Also, there will soon be some new treatments which will allegedly boost a woman’s libido.
Hormone replacement therapy (HRT)
‘HRT’ means giving natural or synthetic female sex hormones that replace the hormones which the woman is not producing enough of.
HRT comes in the form of tablets, patches or gels and always contains oestrogen (either in a natural or synthetic form), and often a progestogen as well. (A progestogen is similar in effect to the female hormone progesterone.)
HRT is extremely good for relieving menopausal symptoms like hot flushes, night sweats and vaginal dryness. Unfortunately, since about 2003 it has becomer increasingly clear that it is not as free from ill-effects as we had been led to believe.
However, if used sensibly, it can be a great help to many women – particularly where sex is concerned.
What does ‘used sensibly’ mean? Basically, it means following the current (2009) official UK guidelines – which are to take the lowest possible dose for the shortest period of time.
One particularly important use of a form of HRT is the application of hormone creams (or hormone-containing pessaries or rings) to the vagina to correct vaginal soreness and dryness. While ordinary sex lubricants – like K-Y Jelly, Liquid Silk and Pjur Woman – can be very helpful for making intercourse comfortable and satisfying, sometimes the prescription of a female hormone preparation is necessary.
So if your vagina and vulva have become a little dry or sore, it may well be worth asking your GP, Family Planning doctor or gynaecologist about the following preparations which are currently available:
- Estring vaginal ring.
- Ortho-Gynest cream or pessaries (estriol).
- Ovestin cream (estriol).
- Premarin vaginal cream (conjugated oestrogens).
- Vagifem (estradiol).
Please note that although these products are used for their ‘local’ (ie vaginal) effects, some of the hormone could be absorbed into your system. So there is a small possibility of side-effects elsewhere – notably in the womb.
Therefore, current (2009) advice is that these vaginal preparations shouldn’t be used for more than three months without having a check-up, and possibly a change in medication.
Note: My own (David Delvin) clinical experience is that these vaginal hormone products can sometimes improve urinary symptoms which occur round the menopause.
Making the most of the menopause
It is now known that women have much the same ability as men to enjoy sex. Indeed, many females are a good deal more highly-sexed than their partners!
Women also have the advantage of retaining their capacity to have several orgasms one after another until very late in life.
Young men are capable of frequent love-making, but as they get older they aren’t able to do it so often.
Ironically, some women discover a renewed or even redoubled libido after the menopause, and sometimes report that their husbands can no longer keep up with their sexual demands. In these cases, buying a sex aid – such as a vibrator – can be a good idea.
For many postmenopausal women, the fact that their husbands take longer to reach a climax becomes a bonus; it makes love-making far more enjoyable than when they were younger and everything seemed to be over in a matter of breathless seconds. This more prolonged love-making can provide time for both partners to explore new sensations and enjoy a variety of feelings.
Touching and intimacy
After the menopause, touching and intimacy can sometimes become more important than the physical pleasure of penetrative sex. This need to touch and be touched, physically and emotionally, is well worth nurturing. Such contact offers reassurance and comfort and the opportunity to show tenderness, companionship and love.