menopause sexual healthMenopause & Sexual Health

So you are menopausal or post-menopausal? The first question is, are you or your partner bothered by a change in sexual function. If not, then it is not a problem and you don’t need our help, if yes, continue reading – we can help.

The decrease of estrogen and testosterone during menopause can lead to changes in a woman’s sexual drive and functioning. Some menopausal and postmenopausal women may notice that they have a decrease in arousal, which may be accompanied by less sensitivity to touching and stroking. Menopausal women experiencing decreasing estrogen, progesterone and testosterone levels, may have symptoms which include; irritability, depression, decreased libido, vaginal dryness, decrease in vaginal length, night sweats, hot flashes, lack of sleep, incontinence, and painful sexual intercourse may occur.

Taken individually, each of these symptoms may severely impact frequency and enjoyment of sexual activity. Many times, there are more than one symptom occurring simultaneously. Furthermore, body self-image may be negatively impacted by these changes, thereby affecting the way a woman perceives herself as a sexual person. Since menopause women generally have sexual partners in the same age range, partner-related sexual dysfunction during this period may also contribute to a woman’s sexual well-being.

While this may seem daunting, symptoms associated with menopause should not prevent a woman from enjoying a healthy and fulfilling sex life. These symptoms may be managed with hormonal therapy (oral, transdermal, or vaginal). While hormone replacement therapy is not appropriate for all women, with most, it can make a significant difference in terms of alleviating symptoms and improving sexual function.

Non-hormonal therapies such as herbal supplements, acupuncture, biofeedback, stress reduction, vaginal lubricants, vaginal dilator therapy, treatment for depression, partner sexual dysfunction treatment, and treatment for urinary incontinence may be used to treat specific symptoms that are found to be related to a woman’s menopausal and postmenopausal sexual dysfunction.

 

Certified NAMS Menopause Practitioner

Dr. McKenzie is pleased to announce she is now a certified NAMS Menopause Practitioner, which designates her as having expertise in the area of women’s health midlife and beyond. Dr McKenzie is committed to providing the highest clinical care standards for menopause practice, and providing optimal menopause-related health care.

The North American Menopause Society

 

Overview of available therapies for sexual problems*

This information is from the North American Menopause Society

ProblemPossible therapies or actions to consider
Low libido / low sexual desire• First and foremost, examine your relationship and situation:
What are the turnoffs? How can they be addressed?
• Identify medications that may curb desire (such as certain antidepressants or blood pressure drugs) and talk with your provider about lowering the dose or switching to alternatives
• Sex therapy/counseling
• Certain testosterone-containing products (not government-approved for treating low desire in women)
• Bupropion (not government-approved for treating low desire)
• Yoga
Vaginal dryness / atrophy• Regular sexual activity or stimulation (promotes vaginal health and blood flow)
• Vaginal lubricants (for temporary relief of dryness before and during sex)
• Vaginal moisturizers (for longer-term relief from dryness)
• Low-dose vaginal estrogen therapy in cream, ring, or vaginal tablet form (reverses underlying atrophy and dryness)
• Higher-dose hormone therapy throughout the body via pills, patches, and other preparations (reverses underlying atrophy and dryness, but generally reserved for women with bothersome hot flashes)
Arousal difficulties• Topical treatments for vaginal dryness/atrophy (see above)
• Vibrator or other mechanical devices (eg, clitoral therapy device)
• Sex therapy/counseling
• Bupropion (not government-approved for treating arousal difficulties)
• Viagra-like drugs (PDE-5 inhibitors) to increase blood flow to the clitoris (not government-approved for treating female arousal difficulties)
• Yoga
Orgasm difficulties• Sex therapy/counseling
• Yoga
Pain during sexA variety of therapies are available depending on the source of the pain:
• Vaginal moisturizers, lubricants. If pain doesn’t improve, see your provider.
• Vaginal estrogen
• Sex therapy/counseling
• Vaginal dilators
• Pelvic floor physical therapy
• Kegel exercises
• Symptom-specific medications (eg, steroid creams for vaginal inflammation, antibiotic creams or pills for vaginal infections)
• Yoga

*In addition to the listed therapies and actions, all sexual problems are likely to benefit from good health habits (including exercise, eating right, and adequate sleep) and open communication with your partner.