It's not just the physical symptoms that affect post-menopausal sexuality.
Q: What happens to your body sexually after menopause? Sex doesn't feel right. Is there shrinkage of the vagina? What can be done to correct this?
A: By definition, menopause marks the end of a woman's reproductive years—there are decreased levels of her reproductive hormones estrogen, progesterone and androgens (testosterone and others).
Sexually speaking, a lower level of the hormone estrogen during menopause has the potential to lead to:
- Lack of desire
- A decrease in pelvic blood flow
- Vaginal dryness and decreased lubrication
- Slight shrinkage of the vagina, labia and clitoris
- Changes in clitoral sensitivity (may be increased or decreased)
- Pain or burning with complete or attempted vaginal entry and/or penile-vaginal intercourse
- Thinning of the lining of the vaginal wall
- Weak or decreased orgasmic sensations
- Increased vaginal and urinary tract infections
You may be experiencing these and other changes throughout your body. But in reality, there's a lot more going on.
One of the greatest predictors for a woman's post-menopausal sex life is the quality, level of activity and satisfaction of her sex life before she reached menopause. Additionally, a woman's current relationship status (new or long-term, close and intimate, or distant and aloof), her emotional and physical health, attitude on aging, as well as self-image and esteem contribute in the expression of her sexuality. Some specific factors include but aren't limited to:
- Whether or not she is in a relationship or relationships
- The physical health, as well as interest, of her partner
- Anxiety or depression
- Decreased libido
- Perceived loss of sexual attractiveness due to body and tissue changes (dry, sagging or wrinkling of skin, changes in body contour)
- Potential medication side effects (anti-depressants, blood pressure, stomach and colon, and other medicines)
- Her health (heart disease, neurological disorders, respiratory difficulties, others)
Fortunately, there are many measures a woman can take to alleviate or minimize the physical changes taking place during menopause, as well as any loss or decrease in her sex drive.
For starters, women who increase their sexual activity often experience an increased ability to lubricate, thereby decreasing vaginal dryness. I know that sounds strange, but the more often blood flow is brought to that area through sexual activity, the better the circulation and the healthier the body tissues. It may take a while to improve, but it's certainly worth the effort. Other measures to take include:
- Visiting a family physician with knowledge and experience in women's health, or a gynecologist. This visit would include a full examination and blood tests to check your blood count, levels of hormones including thyroid and estrogens like estradiol, and others as determined by your health status.
- Quitting smoking.
- Increasing exercise and activity. If you're in better shape you will be more energized, have higher levels of the natural mood-enhancing chemicals in your body—resulting in a healthier mind and body.
- Limiting alcohol to no more than one drink per night.
- Drinking adequate amounts of water, as it keeps the body tissues lubricated.
- Improving your overall nutrition.
- Using of water-based lubricants such as Astroglide or K-Y, or one that contains polycarbophil such as Replens.
- Using a progesterone cream, which may enhance libido.
- Practicing Kegel exercises. This technique strengthens the muscles around the vagina and can enhance intercourse's physical sensations and pleasurable experience.
- Changing position to improve comfort during sexual activity.
- Making time for romance—communicate and plan a date with your partner.
Lastly, it is a complex combination of psychological, physical, cultural and personal relations that ultimately affect a woman's sexuality and desire. Although there is a wide spectrum of how these factors are balanced, many post-menopausal women enjoy new aspects of sensuality and intimacy that are both pleasurable and fulfilling.
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