Though it can be uncomfortable to talk about, menopause negatively affecting women’s sex life is incredibly common. A British Menopause Society survey found 51% of women say menopause affected their sex life. Today we will demystify some of the menopause symptoms that can lead to sex-related issues. We will cover loss of libido, vaginal dryness and vaginal atrophy.
Libido is a term for ‘your desire to have sex’ or ‘sex drive’. During menopause, changes to sex drive can be very distressing and disruptive. As is often the case with menopause symptoms, your hormones have a role to play here. Female sex hormones include oestrogen, progesterone and testosterone. Though testosterone is commonly associated with men, it also plays an essential role in women. (You can read more about testosterone here).
During perimenopause testosterone production declines and existing testosterone may be turned into oestrogen, leading to testosterone deficiency. One of the many roles of testosterone is to regulate sex drive. Testosterone is very effective at increasing energy levels and sex drive. The International Menopause Society has a helpful factsheet on testosterone that can be found here.
Of course, hormones may not be the only thing affecting your sex drive. Arousal is as much a psychological phenomenon as a physical one, and it can be hard to get in the mood when you have been suffering from other symptoms, such as anxiety or low mood. You can read more about anxiety and menopause here. Bodily changes and weight gain can also affect your confidence and desire for sex. As a woman, your brain is your most important sex organ, which is why how you think about sex affects how much you enjoy it - no matter what age. Finding time to relax and focus on emotional fitness- whether it is exercise or a bubble bath, may improve your confidence and as a result increase your libido, too!
Unfortunately for some women, even when the desire for sex is there, it can be an uncomfortable, or even painful experience due to vaginal symptoms. This is usually because of vaginal dryness, which can lead to painful sex. Common symptoms of menopause include vaginal dryness, itchiness, burning or incontinence during sex.
Collectively, symptoms affecting the vagina or urinary systems are known as Genitourinary Symptoms of Menopause (GSUM). We have written other articles on incontinence that you can read about here.
What causes these symptoms? The vagina, urethra, bladder and pelvic floor muscles are all very sensitive to oestrogen. They rely on hormones to stay healthy and nourished. Loss of oestrogen around menopause causes the vaginal environment to change. Collagen production and secretions both reduce affecting the vagina’s elasticity and lubrication. This can make sex more painful or less satisfying, and increase the chances of developing infections.
Vaginal symptoms, difficulty with bladder and bowel control, and sexual problems are common issues that we don't feel are talked about enough, but please don't think of these symptoms as irreversible. There is no need to be embarrassed as it's more than likely half of your friends are also experiencing the same thing!
These symptoms are easily treated with vaginal oestrogens, the correct exercise regime, or lubricants and moisturisers. In fact, many women say sex gets better in the years following the menopause. Just remember, while you may no longer worry about getting pregnant, it is still advisable to use contraception for two years after your final menstrual period if you are under 50, and one year if you are over 50. It is also important to use protection to prevent risks of contracting STDs.