Menopause is a natural phase that every person with a uterus goes through, marking the end of their reproductive years. During this period certain physical and emotional changes occur that can affect sexual health and well-being. One of the most significant changes is the decrease in hormone levels such as estrogen and progesterone. We sat down with a menopause specialist and board-certified OB/GYN, Dr. Kirstie Cunningham explore the role that the hormones that change during menopause can have on your sex life and what you can do about it.
The impact of hormonal changes
Estrogen and progesterone are hormones that play a critical role in the reproductive cycle. As you approach menopause, levels of these hormones begin to decline, leading to a range of physical and emotional symptoms, including vaginal dryness, reduced blood flow to the vagina, decreased libido, hot flashes and mood swings.
Dr. Cunningham explains that the most common concerns patients come to her about are “libido, hot flashes, brain fog, and low energy.” Because at this stage of life many women are at the top of their careers, they have to be on their mind all day every day. They can feel perimenopausal brain fog as they process things more slowly and their memory becomes less reliable. It often goes so far as to interfere with their work.
Libido is a big thing because it affects relationships. I have come to women who are on the verge of divorce because the libido combined with mood swings has negatively affected their relationship. Estrogen levels also change. When estrogen drops, the vaginal lining dries out and sex can be painful. So some women get stuck in this loop where they worry that sex will be painful. The fear of pain becomes so distracting that sex is hard to enjoy.
All of these are related to hormonal changes. After caregiving, their relationships improve.
When to start asking questions
We often hear mixed messages about the difference between perimenopause and postmenopause. The average age for menopause in the US is 51. By that time the average person has already had symptoms for 10 years. In order to prepare for perimenopause, or the late reproductive phase of life, Dr. Cunningham believes women should start asking about menopause in their 30s or earlier. About 1% of women have very early menopause. Dr. Cunningham herself experienced menopausal symptoms in her 20s.
Dr. Cunningham explained that during perimenopause as testosterone decreases libido often begins to decline. But this does not affect everyone. For those affected, treatment is available. Some have found bioidentical hormone therapy helpful, along with newer treatments like the O-shot. Dr. Cunningham explains that the O-shot is a treatment for both stress incontinence and orgasmic disorder (this ranges from delayed orgasm, muted orgasm, to none at all), whether it’s occasional or general. For example, some women can have an orgasm with masturbation but not vaginal intercourse, which is occasional.
The O-shot consists of plasma and platelets. Blood is drawn, spun and injected into the inner vaginal wall and clitoris. It is given with a numbing cream to make it relatively painless. Even if these treatments don’t call to you, there are some great tips that everyone should keep in mind.
Tips for maintaining sexual health during menopause
- Remember that lube is your friend: Lubricants it can help with vaginal dryness, making sex more comfortable and enjoyable.
- Communication: Be open with your partner about any changes you’re experiencing and explore new ways to be intimate.
- Practice self-care: Prioritizing self-care is essential for optimal health during menopause, including maintaining a healthy diet and exercise routine and finding ways to manage stress.
- Educate yourself: Turn to specialized sources such as NIH the CDC for accurate information about menopause. Follow qualified doctors like Dr. Cunningham social media to start expanding your knowledge.
- Seek expert support: Remember you are not alone. Talk to a health care provider about any problems you are experiencing, as there could be alternative treatments and solutions to help you with your problem. Not all doctors are equally trained in menopause. NAMS (North American Menopause Society) offers certification for physicians. I’m going to you here to find a menopause specialist in your area.
The hormonal changes that occur during menopause can undoubtedly have an impact on sexual health and well-being. However, there are many interventions available to help women maintain their sexual health as they navigate this life stage. With the right mindset and proactive approach, it is possible to maintain a fulfilling and enjoyable sex life during and after menopause.
