Managing your sexual health during menopause

Managing your sexual health during menopause

Menopause symptoms do not mean you need to put your sex life on hold

Many women going through the menopause report that they find their sex drive becomes a thing of the past.  Certainly, it’s not surprising that women find that their libido takes a dive during the menopause when they are dealing with a host of changes in their body, emotions and mental state.

The good news is that there are effective treatments that bring positive benefits to overall wellbeing, sexual health and relationships.

Sleep can be disturbed by night sweats and hot flushes

Lack of sleep caused by night sweats and hot flushes is probably the most common complaint that I hear from women.  Women can find themselves waking up drenched in sweat and having to change their night clothes or sheets.  When this becomes a nightly occurrence, it’s easy to see why some couples sleep separately.

Menopause symptoms are caused by the fluctuation in hormones, particularly the drop in oestrogen production.

There are various methods to manage menopause symptoms

There are various methods that women use to manage symptoms.  Some women find it useful to keep diaries to see what triggers the hot flushes or night sweats.  Alcohol, caffeine, smoking and spicy food are commonly reported as triggers.  Others find that deep breathing can help to calm the sweats and flushes and help them get back to sleep.  Regular daily exercise is also said to reduce the incidence of night sweats.

And of course, hormone replacement therapy (HRT) can be used to get hormones back in balance.  It is essential to have a detailed discussion with your GP to ensure you get the right dosage and it is worth remembering that it can take some time to arrive at the right combination for you.  You should have regular follow ups with your GP to check how the treatment is working and to adjust the dosage if necessary.

Vaginal dryness can make intercourse painful

Vaginal dryness is another very common symptom that affects libido.  Literature suggests that it may affect 60% of postmenopausal women. However, it is recognised that women do not usually talk about or present this symptom to their doctor, so it might be more common than we think. In my clinic, where I encourage women to complete a menopause symptom chart, almost 90% of women report vaginal dryness of some degree.  Vaginal dryness can cause soreness and itchiness and can lead to discomfort or pain with intercourse and sexual dysfunction.  Because intercourse can become so uncomfortable, even painful, sexual desire is affected and can lead to a vicious circle.

On a positive note some women tell me how supportive their partners are when they are aware of the problem, so an early discussion is highly advisable to prevent relationship resentments.

Menopause is the end of having the ‘time of the month’ and the start of having ‘the time of your life’

And it is heartening to note that it is not all doom and gloom.  Some women report that they have the best sex of their lives as they no longer have to worry about pregnancy or deal with the monthly hormonal fluctuations that come with periods.  I like to think of  the menopause as the end of having the ‘time of the month’ and the start of having ‘the time of your life’.

Using moisturisers and lubricants during intercourse can help but this is a short-term solution and it does not suit everyone.  It is important to choose the right products for the female physiology as not every lubricant or moisturiser is vagina friendly and may cause local irritation or infection.  If a woman experiences local irritation, with or without discharge, pain and/or bleeding during intercourse she should see a doctor and in the case of bleeding this should be urgent.

Changes in the vagina and the urethra can cause symptoms like a urinary infection such as frequency, urgency and bladder pain and sometimes these may lead to actual infections.  There can also be urinary incontinence, which can be very distressing.

It is equally important to mention that as effective as lubricants and moisturisers can be with relief during intercourse, neither provide a long-term solution nor do they restore the vaginal physiology.

Oestrogen replacement is a long-term solution for vaginal dryness

Oestrogen replacement is an established effective long-term solution for vaginal dryness  and there are three ways it can be given as systemic HRT, as a low oestrogen dose through the vagina or as a combination of systemic HRT and local oestrogen.

Newer treatments with promising results and safety are currently becoming available although their evaluation is still in its infancy.  They include an oral treatment called Ospemifene and laser therapy, and they could be an option for women who either do not want to or should not use hormones.

My advice to women is not to accept vaginal dryness as part of getting older. Although not life threatening it can affect quality of their life and potentially relationships.  It tends to get worse over time, and with life expectancy taking us into our 80s  there is even more need to start treatment sooner rather than later.

About Dr Theodora Kalentzi
Dr Theodora Kalentzi is a General Practitioner (GP) who is passionate about quality care and helping people consider a holistic approach to their health and wellness.  Over her 25 year career, she has gained experience in various clinical specialties, education, mentoring and management.

Theodora qualified as a doctor in Greece in 1992, where she worked in the community and hospital care before coming to the UK in 1996.  She was trained in a variety of specialties including general medicine, gynaecology, chest medicine, care of the elderly and accident & emergency before she became a GP and member of the Royal College of GPs in 2001.  She subsequently undertook a Masters Degree in Health Management at Imperial College London.

For more information about Dr Kalentzi and her menopause clinic visit Medical Prime