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When it comes to the changes you experience around menopause, there’s usually one factor at play: your hormones. And there’s no greater ‘fluctuator’ and cause of symptoms quite like those brought on by fluctuating hormone levels.
Estrogen is one of the female sex hormones that make us, well, women! As we leave our childbearing and menstruating years behind, our estrogen levels and testosterone also begin to take a back seat, causing us many of the uncomfortable and often taboo symptoms of menopause. Like painful sex, vaginal dryness and diminished libido.
You may have simply lost the desire or are struggling with specific physical changes in the genital area, like thinning, dryness and irritation of the vagina walls, which are making sex unpleasurable. not to mention unpleasant urinary symptoms that can occur.
Sexual health can change as menopause progresses; the most common issues reported are a decrease in sexual desire (40–55%), difficulty with lubrication (25–30%), and painful intercourse (12–45%), so if you're suffering from these symptoms, you're really not alone.
Below, we explore some sex-related conditions brought on by perimenopause, menopause, and postmenopause and treatments you may wish to investigate to alleviate them.
GMS is a relatively new and blanket term used to describe the changes in the vagina and vulva, bladder, urethra and pelvic floor tissues due to a decline in estrogen. Historically, it has been known as vulvovaginal atrophy (VVA).
A loss of elastin, hyaluronic acid and collagen due to decreased estrogen production causes tissues to become dry, thin and fragile. This dryness can lead to vaginal dryness, burning, itching, and sometimes, bleeding. This can make for an awfully uncomfortable, often distressing, and at times embarrassing experience, most often for women in the post-menopausal phase.
Like a domino effect, reduced estrogen then leads to changes of the vaginal pH and microbiome, where recurrent thrush, UTIs, frequent urination and vaginal discharge can become more common. It may at times be painful to have sex, understandably leaving you feeling less enthusiastic about sex than before.
Whether your suffering from some of the GMS symptoms, or you’re feeling like you’re simply stuck in an intimacy rut based on how you’re feeling, there are ways you can help regain your desire and drive and the pleasurable aspects of sexual intercourse. Let’s discover how.
Estrogen makes us feel sensual and sexual. In our menstruating years, it peaks at ovulation, making us feel more sexually attractive. When it fluctuates, so does a drop in blood supply to our genitals and, thus, our desire to be intimate with our partners and enjoy sex. Coupled with the changes we are going through, it’s common for our body image and mindset to dive.
This is especially evident if we are experiencing frequent hot flushes, night sweats, mood changes, insomnia, fatigue and brain fog – all symptoms brought on by fluctuating hormones. These experiences can affect our quality of life and ‘feeling ourselves’, leaving sex far from our minds.
Vaginal dryness and atrophy can also occur due to decreased estrogen production, meaning sex we once enjoyed may become painful and sometimes even dreaded when we reach post-menopause.
Combined, these physiological and emotional aspects can make for a wholly upsetting and frustrating experience. The good news is that there are ways to bring back some of the magic.
Doctor prescribed menopause medications have been shown to improve many menopausal symptoms, but there are also other options you may want to consider. Try one or try them all; it's often a combination of several that sees the best results.
Chat with your doctor or menopause sepecialist if your sex life is getting you down and affecting your relationship with your partner. Your GP can work with you to achieve the right balance and appropriate therapies to allow you to start feeling like yourself again.
Remember, there's still a lot of living to do. Bringing the joy and excitement back to your life is vital to living well through this age with greater awareness and acceptance.
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This article has been reviewed by our expert advisory team.