Let’s face it, where the menopause and our sex lives are concerned, the future looks rather grim. Many experts would have us believe that all we have to look forward to is the inevitable decline towards a host of charming afflictions.
Yes the list includes: vaginal dryness, vaginal atrophy, (the word alone makes you want to clamp your legs shut for evermore!), frequent bouts of cystitis and the biggie – a loss of sex drive.
Well, we’re not having it. In fact we’re here to readdress the balance and tell you that not only could your sex life remain as fulfilling as ever during menopause, but that the best years may be yet to come.
What is the menopause?
Put simply, menopause is when a woman stops having periods and is unable to get pregnant naturally. Think of it as three key stages:
1. Perimenopause: the stage leading up to your final period which lasts on average four to eight years and starts in your mid to late forties.
2. Menopause: this is diagnosed when you have not had a period for 12 months or more.
3. Post-menopause: all the years beyond as a non-menstruating woman.
During this time the ovaries start producing less hormones, the main ones being oestrogen and progesterone, but also testosterone (more of this very important hormone later), causing your menstrual cycle to become irregular until finally your periods stop altogether.
It is true that this decrease in hormones can cause other symptoms which can negatively affect your sex life such as:
Loss of vaginal lubrication which can make sexual intercourse painful.
A thinning of the vaginal wall, or vaginal atrophy (that lovely word again) which can cause discomfort as well as infections and cystitis.
And yes, a loss of libido.
The testosterone effect
You may think of testosterone as a male hormone but actually, it is an important female hormone and vital when it comes to our sexual wellbeing as it contributes to libido, sexual arousal and orgasm, by increasing the levels of the pleasure hormone dopamine.
As women age, our levels of testosterone naturally decrease, along with oestrogen, which can make it more difficult to become aroused.
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However, as with everything to do with the menopause, there are exceptions to this rule, as leading menopause expert, Dr Louise Newson explains.
“Some women get a little surge of testosterone before they go through the menopause which means an increased libido… it is all how your hormones play with each other and the difference between them.”
“In other words,” adds Dr.Barb DePree, gynaecologist and founder of women’s health forum MiddlesexMD, “even though the levels are lower than they used to be, testosterone may have some ‘dominance,’ during perimenopause. So, enjoy... !”
Now we’ve got the biology out of the way, here are some surprising truths you may not have thought about.
Firstly, the word to remember in all of the above is ‘can’. All these factors can negatively affect your sex life, but equally they may not. It is definitely not a one-menopause-fits-all situation.
As Dr. Amanda Richards, a professor of obstetrics and gynaecology at the University of Miami says, “Many women breeze through perimenopause to menopause with few problems and simply don’t experience hot flushes, mood swings or low libido come to that.”
Time for sex
It’s important to remember too that libido is a unique and complex thing, affected not just by biology, but by psychological and environmental factors and crucially, circumstances, which contrary to your younger years, are often very much compatible with an upsurge in sexual appetite!
Think about it: post-menopause, there’s no fear of pregnancy leading to a feeling of sexual liberation for many women – perhaps especially single women. Also, it’s goodbye to our contraceptive pills*, which could mean good news.
“Experts will tell you that declining hormones could mean you’ll want it less but that isn’t necessarily so,” says Dr.Richards. “Desire, once quelled by birth control pills could resurge.”
(*It’s not advisable to come off contraception until your doctor can confirm you are no longer ovulating.)
Freedom at last
Also, by the time we’re in mid-life, there are less likely to be little people sneaking into your bed or interrupting a quickie on the sofa. These are the years you can have raunchy sex on your dining table, in every room in the house if you so desire. It is this new-found freedom that actually ignites desire.
Sex is no longer about reproduction, but playful production – and we know which sounds hotter!
Also, once you have got through the transition and your hormones have settled, there are no periods, no mood swings. Women often feel more levelled out mood-wise than they ever have, leading to a new level of desire they’ve never even experienced.
Add to the mix the fact that with life experience comes confidence in our own skin and the ability to ask for what we want, and you can see how menopause may well mean a total reinvigoration of your libido.
As Dr. Richards says, “Menopause is a very defining time for most women, many of whom realise they have put their sexuality on the back burner for way too long and if they don’t use it, they will lose it for good.”
Presenter and menopause campaigner Davina McCall, concurs: “I walk around like a foxy minx now because I feel like a foxy minx. I don’t look as good naked as I did in my 20s, but I feel better and that’s the difference.”
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Ways to boost libido
Perhaps the best news is that if your desire for sex is low and you’d like to change it, there are so many effective treatments that can restore your vaginal health, improve arousal and increase sexual pleasure.
To treat dropping hormone levels and all the side effects that come with that, including low libido, the obvious one is Oestrogen and Progesterone replacement (HRT). There are two main types of HRT:
Combined HRT (oestrogen and progestogen) – for women who still have their womb
Oestrogen-only HRT – for women who have had their womb removed in a hysterectomy
It comes in many forms including gels, patches and tablets and can be started in a low dose and increased if necessary. Talk to your doctor about what’s right for you.
Supplementary Testosterone treatment can be a game-changer for improving your sex drive – particularly for women who have had a surgical or premature menopause (for example, after having their ovaries removed). Get a blood test to determine if you are testosterone-deficient.
Declining oestrogen sometimes means less blood flow to the clitoris and vagina, which means lowered arousal. A sexual aid available by prescription called Eros is a small device that uses gentle vacuum to stimulate blood flow to the clitoris.
With all this information at your fingertips, there really is no reason why menopausal sex couldn’t be the hottest sex you’ve ever had. Nature’s best kept secret.