During perimenopause, the hormones that are responsible for fertility and pregnancy, including estrogen, decrease. This causes changes in the blood vessels and tissues of the vagina and vulva. The vulva and vaginal tissues lose elasticity and moisture, and they become thinner, become drier, and lose their folds. Thinner tissues are more easily broken, bruised, and irritated. The same tissues receive less lubrication. Now, that’s all physical. Emotionally, tiredness, anxiety, irritability, difficulty with concentration, and depression are common. The sexual experience is invariably altered, no doubts about that. This does necessitate some lifestyle adjustments in intercourse after this phase.
Does menopause lower the sex drive? Yes. Albeit, not in all cases. In fact, some women say they have an improved sex drive after. However, menopause does a number on sex drive for many women. The physical and emotional changes act in concert to reduce the drive. Sensitivity may drop, arousal dips and discomfort increases. It’s easy to understand how sex drive may drop. Now, does this mean no sex after menopause? Not necessarily. It could mean less sex for some. For others, it could even mean more. Remember, there’s no fear of an unwanted pregnancy anymore. Fewer child rearing responsibilities also mean more time for intimacy. Anyway, the good news is that most, if not all changes can be adjusted with a number of available alternatives. How do we solve the problem of vaginal dryness?
Basically, the same way as usual. Water soluble lubricants do the job quite well. Water soluble lubricants are better if a condom is being used as non-water soluble lubricants such as Vaseline may weaken latex. Why would a condom be used? STDs. In fact, due to easy bruising after menopause, risk may be slightly increased. Of course, there’d be no need if both partners are faithful. However, the end of ovulation is better confirmed by a doctor to avoid unwanted pregnancies. Other options include vaginal moisturizers, vaginal estrogen therapy on the advice of a doctor. Can something be done about sex drive anyway? Maybe.
For an improved sex drive, estrogen replacement shows some promise although more work needs to be done. If nothing, estrogen helps with lubrication and may even make vaginal walls thicker, dealing with physical effects that contribute to dip in sex drive. Another viable option is counselling. In fact, sexual counselling can be very successful especially with the emotional effects of menopause. Let’s move on to the act of sexual intimacy itself. How can that be improved?
Experimentation is required. One may need the help of books, videos, even masturbation. A wide variety of comfortable positions may be tried. Foreplay is even more important. It helps to ease anxiety. Communication is needed as both partners need to know what’s comfortable and what isn’t. Keep in mind that love and affection goes beyond sex. Try out more activities that are fun and enjoyed by both. Take a walk, have a candlelight dinner, play games or see a movie. If you think you need medical consultation, feel free to contact your doctor.