Can a woman have a satisfactory sex life after menopause?

New Delhi, Oct 21

Menopause is the natural biological process characterized by the cessation or stopping of a woman's menstrual cycle, marking the end of fertility. The general onset is observed in middle-aged women, i.e., between 40 to 50 years of age. As aging advances, the reproductive cycle slows down and prepares to stop. Ovaries begin to age and produce fewer reproductive hormones altering the menstrual cycle. The body undergoes several associated changes in response to fluctuating levels of estrogen, progesterone, testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). These hormonal disturbances stimulate several physical, psychological and emotional changes having varied outcomes as the body adapts to the changing hormonal environment.

Physical Changes:

Irregular Menstruation
Weight gain
Hot flashes and night sweats
Urinary incontinence
Drier and thinner skin and hair
Emotional Changes :

Mood swings
Anxiety and depression
Stress and tension.
Anger and irritability.
A lack of motivation and difficulty concentrating.
Other Associated Changes
Worsening of premenstrual syndrome (PMS)
Changes in libido (sex drive)
A loss of energy and insomnia.
Memory lapses
Headaches
Sexual Well-being during and after menopause

All women experience menopause differently, and many women experience changes in their sex life as they go through menopause. The loss of estrogen and testosterone following menopause induces multiple changes in a woman's body and influences sexual function. Also, lower levels of estrogen can cause a drop in blood supply to the vagina, which can affect vaginal lubrication, causing the vagina to be too dry for comfortable sex. Moreover, other menopausal symptoms like bladder control problems, sleep disturbances, depression or anxiety, stress, medications, and other health concerns also affect the sexual well-being of the women experiencing menopause.

While the hormonal alteration of menopause may modify the physical and emotional aspects of sexual well-being, specific measures can assist in overcoming adversities and improving sex life. These include:

Raising libido

Changing your attitude towards sex along with talking to your partner about the same is a good way to start. A welcoming attitude towards conversations around sex especially after a certain age is looked at as taboo. So it's important to change that mindset for yourself and well as for your partner.
Good foreplay- helps increase lubrication
Frequent vaginal intercourse- helps maintain blood supply
Find alternative methods of to increase intimacy
Besides the suggestions mentioned above below suggestions will also aid you to ensure your sexual wellness stays intact -

Manage your depression. Depression is increasingly common in midlife and may notoriously dampen desire. Seek medical help if you notice any symptoms of depression.
Opt for alternate medication. Certain drugs used for treating old-age ailments like diabetes and hypertension may also adversely affect sexual well-being. Ask your physician to help find an alternative medicine if your medication lowers your libido.
Stay healthy. It is essential to stay fit and healthy through regular exercise and healthy eating as it improves your overall health, which boosts your sexual well-being.
Relieve your stress and anxiety. Job pressures, family responsibilities, lack of privacy, and worries about children or aging parents build stress, negatively affecting overall well-being.
Limit Alcohol. Although a glass of wine might enhance your libido, heavy drinking may act reversely on your sexual health.
Keep a check on your health conditions. Diseases affecting blood flow and nerve function, like diabetes, kidney disease, heart disease, and multiple sclerosis, may reduce sexual responsiveness. Thus it is important to seek timely medical assistance.
Quit smoking

Dealing with pain

Treat vaginal atrophy. Your physician may advise water-based and longer-lasting silicone-based lubricants to make penetration less painful. Topical estrogen in the form of a cream, a suppository, or a ring can be used to treat vaginal atrophy as it releases the hormone to help plump vaginal tissues and aid lubrication.
Get physical therapy. Physical therapy in the form of exercises and massage may help relax and stretch tissues in the pelvic area and reduce the pain.
Orthopedic problems may cause pain and limit your sexual activities- changes in positions may help.
Although sexual problems can be hard to discuss, it is always good to to consult your doctor. Your doctor may refer you and your partner to a health professional specializing in sexual dysfunction. The therapist may advise sexual counselling individually, with your partner, Collaborative measures involving medical aids, professional guidance, and counseling can help deal with these biological changes and enhance the quality of life. So, even though there may be some physical and mental hardships during menopause, a woman can still enjoy satisfactory sex life.

(Dr. Ameya Kanakiya Kulkarni, Co-Founder & Gyneacologist, Elda Health)

(IANSlife can be contacted at ianslife@ians.in)

--IANS
Dr. Ameya Kanakiya Kulkarni/tb