What Are Hot Flashes
Hot flashes can be a pretty unpleasant symptom of perimenopause and menopause. We dont totally understand the cause of hot flashes.
Most people describe a hot flash as a sudden hot feeling that spreads all over your body but mostly the upper body, like your arms, chest, and face. You may also get sweaty, and your fingers may tingle and your heart may beat faster. A typical hot flash usually lasts anywhere from 1 to 5 minutes.
Hot flashes at night are called night sweats. Sometimes they can get so severe that you soak your sheets with sweat.
Hot flashes are super common. More than 3 out of 4 people have them while going through perimenopause and menopause.
Nothing will make hot flashes stop completely, but there are some things you can do to help get some relief. Wearing light, loose clothes, keeping your room cool, drinking cold liquids, and avoiding alcohol and caffeine can help you stay cool.
Prescription hot flash treatments can be helpful, too. Hormone therapy works best to treat hot flashes, but other medicines like SSRIs and SNRIs and clonidine may also help. Research shows that herbs, vitamins, acupuncture, and reflexology dont help with hot flashes.
Find Other Ways To Connect
Do things together to help build your intimacy. It doesnt have to be fancy, but a regular date night or time for just the two of you can help keep a relationship strong and can help you form a deeper connection once youre ready for sex.
Finally, we cant stress enough the importance of good communication. Learn what works for you and communicate that to your partner. Its easy to fall into the trap of thinking you need to be having sex to be happy, but the truth is that whatever works for you is completely fine. That may be moving to more clitoral stimulation or snuggling – whatever makes you feel good. Focus on what makes you and your partner happy and dont worry about what you think others are doing or what you think you should be doing.
Do I Still Have To Worry About Sexually Transmitted Diseases
Yes. Menopause and postmenopause don’t protect you against STDs. You can get an STD at any point in your life during which you’re sexually active. This risk doesn’t go down with age or with changes in your reproductive system.
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The Sex Surge Is Personal
Over the last eight years I have researched the Sex Surge and listened to many women and their stories of increased sex drive in perimenopause.
What I know is that each woman has to walk the path of the Sex Surge in her own way. For some this means big changes in their lives getting divorced, trying an open marriage, performing in burlesque shows, living on their own for a while. For others, it has meant small changes increasing the frequency of sex in their already happy relationship, wearing sexier clothes on a daily basis, flirting with the local barista a bit more.
Exploring the energy and finding ways to express it are key to handling the Sex Surge well, but what that looks like is unique to each woman, her life, and her needs.
Like any hormonal phase, the Sex Surge does come to an end. For most women it ends with small hormonal shifts that are steps on the path to perimenopause: the circuitry quietly returns to its normal supply.
In rare cases, the end of the Sex Surge is as if someone shut off the power entirely confidence, libido, and a sense of self crash into the dark. Most women report relief when the Sex Surge ends, even if it was great fun or allowed them to choose an amazing new life for themselves. They are glad to not think about or desire sex all the time.
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Pregnancy Giving Birth And Breastfeeding
Loss of interest in sex is common during pregnancy, after giving birth and while breastfeeding.
This can be because of:
- changes to your hormone levels
- changes to your body and issues with your body image
- painful sex caused by an injury, such as a cut or tear, during childbirth
- changed priorities, such as focusing on looking after your baby
These issues may improve over time. Speak to a GP if your sex drive does not return and it’s a problem for you.
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Ask Your Doctor About Testosterone
Testosterone replacement has long been used as a solution for men with a waning libidoand it can help rev up your own sex drive as well. Still, not all doctors are OK with prescribing synthetic versions of this main male hormone . Testosterone is by no means a cure-all and can come with side effects like acne and thinning hair. Luckily, newer remedies to enhance libido are being worked on even as we speak, Dr. Minkin says.
Menopause: Moist In All The Wrong Places
Women will inevitably experience menopause between the ages of 45 and 50, with the average onset at age 51, according to the Mayo Clinic. This normal part of aging means the ovaries have stopped releasing eggs and making most of their estrogen. Symptoms of menopause include hot flashes, mood swings, and the dreaded vaginal dryness.
This is a different kind of dry spell, which close to one out of every three women experiences. The drop in estrogen levels reduces the amount of moisture available, making the vagina thinner and less elastic, which is known as vaginal atrophy. Although this dryness may seem like a small health issue, it severely impacts a womans sex life.
When women go through menopause where vaginal dryness occurs, men can experience decreased sexual desire and some women can have a lower sense of themselves as sexual beings, Walfish said.
Recently, though, Sprout Pharmaceuticals resubmitted the drug flibanserin to the Food and Drug Administration for approval for a third time. Flibanserin aims to treat hypoactive sexual desire disorder in women, defined as the persistent or recurrent deficiency or absence of sexual fantasies and a desire for sexual activity that causes distress or interpersonal difficulty, according to the press release. This drug is believed to help women, especially postmenopausal women who struggle to boost their sex drive.
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Pain Nausea And Libido
Painful intercourse can destroy your interest in sex faster than anything else. Vaginal ulcers that arise during certain chemotherapies are a major source of such pain. The ulcers may be particularly severe in women who have had bone marrow transplantation, but they do go away when treatment ends. Women with genital herpes may have an outbreak of the disease brought on by stress and a weakened immune system. Steroids and antibiotics can cause yeast infections in the mouth and vagina. Pain medications, narcotics in particular, can also reduce libido.
Menopause, whether natural or treatment-induced, can cause thinning and shortening of the vaginal walls. Vaginal dryness is another menopausal side effect. These conditions can contribute to pain during sex.
Nausea, a side effect of chemotherapy, can kill your interest in anything, particularly sex. And some anti-nausea medications depress libido.
Libido And The Psyche
Physiologic problems must always be treated despite presence of psychiatric illness, because these two factors can have an indistinguishably intertwined impact on libido and coital activity. Dyspareunia-related decrease in frequency of coitus can be the primary cause of marital problems and can present as a marital problem when in fact physiologic problems of menopause are the cause of the change in libido. Lack of libido due to low testosterone levels can induce the same type of marital conflict, a circumstance that can in turn mislead physicians into diagnosing a psychological problem as the cause of the lack of libido.
For depression or anxiety disorders to be the cause of decrease in libido, onset of the psychiatric illness must be established and correlated with the onset of sexual symptoms. Depression and anxiety in women may directly affect libido and sexual response through loss of desire and also may affect the womans sexual partner in that he stops initiating sexual relations. Libido can be affected by marital stress as well as by accumulated anger between the couple. Both these factors should be taken into account when evaluating decrease in libido. However, the chronicity of the coital problem and of the libidinal problem is a critical aspect of determining the cause of decreasing libido and frequency of coitus.
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What About Conventional Medicine
If you have tried home and herbal remedies, but feel little improvement in your libido, then it may be worth seeking medical advice for your symptom. Your doctor may be able to prescribe treatment to boost libido. Many of these will be hormone-based treatments such as HRT, as it is a hormone imbalance at the root of the problem.
If your loss of libido is a side-effect of some other medication you are taking, your doctor may be able to work with you to find an alternative. If you are worried about your condition, it is also important to seek medical advice.
Facts And Myths About Sex After Menopause
Its not something most women look forward to, but menopause is not a disease without a cure or an illness youre forced to suffer through. Its a transition thats essentially unstoppable, as your body moves from one phase of life to another. In the simplest of terms, menopause is the ceasing of menstruation. For many women, its also the beginning of a whole new adventure — life without monthly hormonal swings and messy periods.
When not surgically induced, menopause is a natural process that starts, on average, in your 40s and ends by about age 51. Youve reached the official menopause mile-marker once youve gone 12 months without experiencing a period.
Menopause, along with the natural aging process accompanying it, does create physical and sometimes emotional changes that can alter your sex life. We can help uncover the truths about these changes and explain what you can do to overcome challenges you might face during this newest phase in your journey.
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Body Image And Menopause
Some of the things that may contribute to your body image around menopause include:
- social attitudes Western culture rarely portrays older women as sexual or desirable. These ingrained social attitudes may make you feel less attractive. Some women wrongly believe that sex is only for young people. If you feel this way, it may cause your sexual interest and activity to wane
- possible weight gain you may find your body fat increases at this time, especially around your abdomen. This is due to hormonal changes and other age-related factors
- changes to body hair growth.
What Is Low Sex Drive
To begin, it is important to clarify what wemean by sex drive. There are infinite valid reasons for a woman to not want tohave sex, either in specific instances or more generally. But when we aretalking about a woman with low sex drive, we mean someone who would like tofeel sexual desire, but just doesnt. In severe cases that result insignificant distress, you may be diagnosed with hypoactive sexual desiredisorder. However, lack of sex drive doesnt have to reach the point of adiagnosable condition to be troubling and warrant attention.
What Can I Do About Changes To My Libido In Menopause
If you notice changes in your libido as you go through menopause, you should discuss them with your provider. Dr. Mohsin can work with you to determine the root cause of your changing libido and recommend treatments customized for your unique needs.
Depending on why and how your libido is changing, some of the treatments may include:
- Using water-soluble lubricants for dryness
- Making lifestyle changes, such as a healthier diet and regular exercise
- Hormone replacement therapy for all menopause symptoms
- Low-dose hormonal contraceptives to help alleviate menopause symptoms
- Topical estrogen for vaginal dryness and itching
- Estrogen transdermal patches to help with all menopause symptoms
- Brisdelle® for hot flashes
- OSPHENA for painful sex during menopause
- Intrarosa® for painful sex caused by vaginal dryness
Do you have more questions about menopause and your sex life? Dr. Mohsin and the team at Progressive Womens Health have answers. To learn more, book an appointment online or over the phone. We also offer convenient messaging and telemedicine appointments.
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Mental And Emotional Causes
No matter what stage of life youre in, your emotional and mental state contributes a great deal to your sex drive. Some women are more susceptible to depression during menopause. Since the body changes during perimenopause and menopause, some women have body image issues or lose confidence. Other psychological causes of decreased libido include stress and relationship issues. As mentioned above, some women struggle with connection during menopause because they are going through a major physical and emotional change. This can lead to a lack of connection with their partner. There may also be a breakdown in communication about needs and preferences that may have changed.
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How Can A Woman Heighten And Improve Her Sexual Function And Desire During And After Menopause
As discussed above, the use of systemic hormone therapy or vaginal estrogen therapy can diminish vaginal dryness and decrease any discomfort associated with sexual intercourse. Water-soluble lubricants can also help overcome vaginal discomfort. Some women find that relaxation techniques, sensual massage, masturbation, or changing positions during coitus can heighten their sexual experiences. For women or couples who are struggling to understand and accept the changes in sexual function that may accompany menopause, counseling can be an option. Talk with your partner about the changes that are happening to your body. Some couples try counseling on an individual basis or as a couple.
Why Does Menopause Affect Libido
Fluctuating hormone levels during perimenopause and menopause can also affect a womans mental health, which in turn, may cause a decrease in her libido.
Stress can also impact a womans libido, as she may be juggling a job, parenting, and be caring for aging parents. The changes in hormone levels a woman may experience during menopause may make her irritable or depressed, so dealing with everyday stress may feel more difficult.
According to an article published in the , women who have more significant side effects associated with menopause are more likely to report lower libido levels.
Examples of these side effects include hot flashes, depression, anxiety, trouble sleeping, and fatigue.
Other factors that make a woman going through menopause more likely to experience a reduced libido include:
- history of chronic health conditions, such as heart disease, diabetes, or depression
- history of smoking
- engaging in low levels of physical activity
A woman should talk to her doctor about how these conditions could affect her sex drive.
There are several steps a woman can take to increase her libido. These include medical treatments, lifestyle changes, and home remedies.
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The Emotional Aspects Of This Journey
For me thereâs also another less physical, more emotional aspect to this perimenopause journey. For many years in my late 30s and early 40s I tried to get pregnant. My long-time partner, like me, was a cis-woman, and we were helped by several different sperm donors. I got pregnant just once over the course of five to six years, and I miscarried soon after.
These years we spent were some of the hardest and saddest Iâve ever had. Every month, getting my period felt like the death of someone very dear to me, someone I loved immensely, inexplicably, despite never having met them in the physical world. Like menopause, miscarriage is an aspect of life which is still not discussed or shared as much as many others.
During this time of Trying to Conceive I monitored my cycle with military precision. Unfortunately Clue wasnât available at the time, but using more analog methods I tracked every possible fertility sign: my cervical fluid, the position and texture of my cervix, my dreams and moods. I even used a microscope to observe and analyze the structure of my saliva. It felt at times like a kind of madness or obsession. The drive to have a child was all-consuming.
For all of these reasons, itâs particularly poignant for me that I find myself once more tracking my cycle very closely, but for entirely different reasons.
I feel lucky to be able to make the most of this unexpected gift from the hormonal universe that my surprising human body is, and always has been.
Increased Sex Drive In Perimenopause
I understand that the desire for a lot of sex sounds like something crazy when were talking about perimenopause, but it does happen.
For some women, there is a slight shift upwards in testosterone, to the point that they want sex much more frequently than they have in the past. For me, this first started around ovulation. I wanted sex 10 times more than I ever had before, but only around ovulation.
Over time though, my libido grew to be a constant factor in my life. At the most intense point, I would wake up, have about three minutes of peace, and then begin thinking about and desiring sex until I went to sleep at the end of the day. It was exciting in many ways I really enjoyed thinking and feeling sexy things all day long but it was also exhausting.
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As I began to write on my blog, about this new level of libido at midlife, 100s of women emailed me with similar stories. So many were afraid something was wrong with them, or that they had a brain tumour .
Most of all, women described not having safe places to talk about these symptoms and be believed, a frustration shared by so many midlife women.
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