Menopause can affect sexual health:Menopause can cause changes in a woman's sexual health, including a decrease in sex drive, vaginal dryness, and painful intercourse. Men need to be understanding and patient with their partners during this time.
Women commonly report low sexual desire (40-55%), insufficient lubrication (25-30%), and painful intercourse (12-45%), which is a complication of genitourinary syndrome of menopause (GSM) reported by 50% of middle-aged and elderly women.
The decline in sexual response can be attributed to a decrease in sex hormones like estrogens and androgens. However, it is important to recognize that psychological and relational changes associated with ageing, as well as an increase in metabolic and cardiovascular health problems, also affect sexual function.
Predisposing factors: Besides biological factors (gynecological or surgical interventions, Premature Ovarian Insufficiency, endometriosis, iatrogenic menopause- bilateral oophorectomy, chemotherapy, radiotherapy- and endocrine factors) affecting sexual function in menopause, there are many other factors like psychosexual (like previous sex life, body image, personality traits, history of sexual abuse/violence, affective disorders, coping strategies) and contextual (ethnic/cultural/religious expectations and constraints, support, and network).
Precipitating factors: Apart from biological factors (age at menopause, biological vs. iatrogenic menopause, Iatrogenic menopause, extent and severity of menopausal symptoms, current disorders, substance abuse) factors precipitating the issue can be psychosexual (relationship, sexual experience, affective disorders, loss of partner) and contextual like life stressors (divorce, separation, partner infidelity), loss or death of close kin, lack of access to medical treatment, economic difficulties.
Maintaining factors: Factors maintaining the issue may be due to biologicalreasons (changes secondary to menopause i.e. hormonal, vascular, muscular, neurological, immunological changes, contraindications to hormone therapy, inadequacy of hormone therapy, pharmacological treatments, substance abuse); due to psychosexual factors (perception of menopause changes, loss of sexual confidence, affective disorder, distress (i.e. personal, emotional, occupational, partner), partner’s general health or sexual problems) and due to contextual4.factors of lack of access to care and interpersonal conflicts
Not all women experience a decline in sexual functioning as they age or go through menopause. The psychosocial aspects and the hormonal environment contributing to the maintenance of a healthy sexual life in menopause are important.
Declining androgens also contribute beyond estrogen deficiency
GSM often leads to vaginal dryness, decreased lubrication, discomfort or pain with sexual activity, post-coital bleeding, irritation/burning/itching of the vulva and/or vagina and pelvic pain. Sex steroids play a crucial role in developing and maintaining healthy genital tissues. Their deficiency also contributes beyond low estrogen levels.
Sexual Dysfunction impacts not only the symptom bearer, but also her partner, on a sexual, emotional, and interpersonal level. A couple-oriented approach is important that addresses the sexual health needs of the ageing couple as a whole, rather than treating the woman alone.
Vascular insufficiency in female genital tissues can be one of the contributing factors in women caused by cardiometabolic insults. Hormone levels and vascular health work together to maintain the integrity of female genital tissues.
Sexual issues in menopause are underdiagnosed and undertreated. Educating the women is crucial, as there is a general lack of awareness that many options are available to maintain and improve genitourinary and general sexual health.
Discuss with your doctor who can help you with treatment options for menopause-related sexual dysfunctions. Your doctor may suggest hormonal treatment or non-hormonal treatment options for you based on your severity of symptoms, effect on quality of life, potential adverse effects, and personal preferences.
Menopause, the natural end of menstruation, can bring about physical and emotional changes that impact your sex life. While some women experience a decrease in libido (sex drive), others find their sexuality remains strong or even improves. The key is understanding the changes, open communication with your partner, and exploring ways to maintain a fulfilling and healthy sexual experience.
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Decreased estrogen levels can lead to vaginal dryness, making sex uncomfortable. Lubricants can help ease discomfort.
Decreased blood flow to the genital area can affect arousal and orgasm.
Weight gain or body image concerns can affect self-confidence and sexual desire.
Stress, anxiety, or mood swings related to menopause can impact your interest in sex.
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Libido can fluctuate throughout life, not just during menopause.
The way you experience orgasms might change due to hormonal shifts, but they can still be very pleasurable.
Sex therapy can address emotional or psychological factors that might be impacting your sexual desire or satisfaction.
Menopause can be a time of self-discovery and new beginnings, including a fulfilling and evolving sexual life.
Menopause is a natural transition for women, but it can bring about changes that impact not just the individual experiencing them, but also their relationships. Here's a guide to help couples navigate these changes and strengthen their bond:
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