Intimacy about menopause

Finally! Menopause brings many freedoms. No periods! No birth control worries! With the life changes that usually accompany menopause, such as the empty nest, one would think that this would be the ideal time to reconnect with your partner and re-establish that intimacy you both crave.  However, menopause also brings new challenges to this intimacy.

The first challenge is the vanishing libido. As annoying as periods were, the hormones that caused them also helped you to feel “in the mood” – at least for a few days each month. With those gone, libido no longer naturally happens, you actually have to actively think about it. A woman experiences significant changes both physically and emotionally during menopause and this causes stress – something else that drives down libido. Because of this, it is extremely important to talk with your partner about these changes.

Although there is no medical treatment that can restore libido, there are some things that can help. You should see a medical professional to make sure that you are healthy, and it’s reassuring to talk with an objective person about what you’re feeling and what it is normal. Find something that helps you feel better about yourself and the wonderful things that your body can do. Start an exercise program, consider yoga and/or meditation, take a class in something you’ve always been interested in but never had the time for, learn how to cook healthier food.  Things like this will reduce the stress on your body that menopause causes and can help you to find more balance.

The other challenge that many women face is the change in gynecologic health that a declining estrogen level brings. For many women, sex becomes painful – so painful that they stop having it. Obviously, this is a major issue if one wishes to remain intimate.  More than 50 percent of post-menopausal women experience painful intercourse. Fortunately, there are ways to help with this problem. The first sign that women experience is vaginal dryness, which can be helped with lubricants. I recommend that women use the most gentle and simple product possible, such as coconut oil, olive oil and silicone-based, over-the-counter products. Many options are available and your health care provider can help you with additional recommendations.

For many women, however, those simple remedies are not enough. For them, another option is a topical vaginal estrogen therapy. This is thought to be much safer than systemic hormonal replacement therapy and can be helpful in restoring the ability to have intercourse without significant pain. Other new medical options include a laser procedure and a new, daily non-estrogen pill that acts like estrogen to the vaginal tissues, but the latter can be quite expensive.

The challenges of menopause in maintaining intimacy can be overcome so that you and your partner can nurture and strengthen your relationship for many more years.  Menopause is just the beginning of the second part of your life.

Dr. Anne Rainville is a board-certified OB/GYN specializing in women’s health. She has been practicing in the Portland area for some 22 years and has special interests in fertility evaluation and treatment, minimally invasive surgery, urinary disorders, ultrasound services, adolescent gynecology and menopause. Her office, Women’s Wellness Comprehensive Care, can be reached at 518-6000.

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