If Sustaining Intimacy Is Becoming More Difficult There Are Many Approaches That Can Help
Even if, as the saying goes, the brain is a woman’s most important sex organ, we can’t deny the role our bodies playespecially as we get older. Satisfying sex depends on several things: presence of desire, arousal, absence of pain, and an ability to reach orgasm. After menopause, libido declines, and changes in our bodies can make it difficult to get aroused, painful to have intercourse, and impossible to climax. It’s little wonder that many women become dissatisfied with sex, and some avoid intimacy entirely.
Several years ago, a large national survey found that sexual activity fell precipitously with age. Fewer than half of women ages 57 to 73 said they were sexually active, and those who were had sex less than twice a month, on average.
Nature didn’t intend for women to be sexually active after menopause, so women have to work at it and be creative. To do so, women need to explore the emotional, physical, and medical factors that may sabotage sexual response and take advantage of a wide variety of therapies to address them.
Sex Is ‘highly Important’ Say More Than 25 Percent Of Postmenopausal Women Surveyed
Rather than look at averages of the women over time, investigators looked at trajectories within the cohort. This analysis technique allowed us to see if there are unique pathways that women can follow, explains Thomas.
If you just looked at averages of the group as a whole, it would look like how important sex is to women would go down for everyone, but what we actually found three distinct pathways women commonly follow when it comes to how much they value sex as they get older, she says.
Where To Get Help And Advice
- a GP they may be able to offer some helpful advice, or refer you to a specialist for an assessment and treatment
- a psychosexual therapist a GP may be able to refer you an NHS therapist, or you could pay to see a therapist privately find out more about what sex therapists do and how to find one
Try to not feel embarrassed about getting help. Lots of people experience problems with their sex drive and seeking advice can be the first step towards resolving the issue.
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Estrogen And Sex Drive
In more recent years, some studies have been published suggesting that estrogen may also play a role in stimulating libido. It has long been known that the surgical removal of the ovaries results in a significant drop in libido, but since both estrogen and testosterone are produced by the ovaries, it is difficult to isolate either hormone as the cause of the resulting drop in sexual desire.
In one study published in 2013, estradiol levels in the saliva were positively correlated with sexual desire in premenopausal women, peaking each month around ovulation. And in a meta-analysis published in 2015 the authors analysis showed that estrogen therapy does increase libido. However, another study published in 2017 showed that women on standard doses of estrogen therapy reported a modest 10% improvement in subjective domains on the standard FSFI rating scale, a questionnaire measuring sexual function in women.
While the effects of estrogen on womens sex drive remain disputed and inconsistent, and the dosages needed to achieve an impact unclear, it is nevertheless important to recognize that estrogen may indeed play a role in regulating libido.
So given what we know and what the data shows, what can be done?
Ways To Increase Your Sex Drive:
- Reduce dryness with moisturizers and lubricants
- Talk with your partner about what you like
- Rest up. A recent study found that women who get enough sleep are much more likely to experience sexual interest or pleasure
- Schedule time for sex. Making a plan for sex gives you time to get in the mood
- Spend more time on foreplay
Also Check: Menopause And Dizzy Spells
The Top 6 Ways To Increase Sex Drive In Women
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Many women today feel like they are pulled in so many directions that they forget how to enjoy themselves or their relationship. They put their work or families first and feel so tired at the end of a long day that sex is the last thing on their mind. In fact, one-third of adult women claim that low sexual desire is a constant problem that affects their quality of life.
Having a low sex drive can make you feel guilty, especially if your partner wants it more than you. It might even start to affect your relationship. But sex isnt something that should feel like work. There are many things you can do to take care of yourself and naturally improve your libido without much effort. Here are the top six ways to increase sex drive in women.
How Hormones Affect Sex Drive
The main causes in the menopausal and the postmenopausal women is the loss of estrogen and testosterone that leads to changes in a womans body and sexual drive. Therefore, menopausal and postmenopausal women may notice that theyre not as easily aroused, and they may be less sensitive to touching and stroking. That can lead to less interest in sex. Also, lower levels of estrogen can cause a drop in blood supply to the vagina. That can affect vaginal lubrication, causing the vagina to be too dry for comfortable sex but theres help for that read on! The fluctuating hormones during perimenopause can also affect a womans mental health which then, in turn, may cause a decrease in libido.
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Why Is Sex Painful After Menopause
Dr. Vahora notes that many of her patients experience pain or discomfort during sex, which in turn leads to less interest in sex. The pain tends to stem from declining estrogen levels, which can cause vaginal tissue to become drier, thinner, and less elastic.
The vagina and vulva are mucus membranes, she explains. When it gets dry and the skin becomes irritated from friction, its like a rug burn.
Also Check: What Causes Hot Flashes Besides Menopause
Hot Flushes And Night Sweats
Many herbal therapies have been tried for relief of hot flushes and night sweats in menopausal women. Some herbs have been found to be effective in reducing hot flushes, whereas others have been found to be no better than a placebo . Some have not been studied rigorously.
Black cohosh is perhaps the most extensively researched of all herbs used for managing menopausal symptoms. It is available in many different products, which vary in quality and effectiveness, and it can be combined with other herbs to tailor a formula specifically for hot flushes. Evidence is conflicting: some studies show it is effective and others do not.
St Johns wort, on its own or in combination with other herbs, has been shown to be significantly better than placebo in the treatment of menopausal symptoms. In combination with black cohosh or passionflower, St Johns wort may decrease hot flushes significantly and improve your mood compared to placebo.
Hops contain a potent phytoestrogen , and some research has shown that it may be useful for menopausal symptoms such as hot flushes.
Red clover also contains phytoestrogens called isoflavones that may help ease hot flushes and night sweats, but seemingly more so in women who are postmenopausal than perimenopausal .
Other herbal therapies such as dong quai, evening primrose, Korean ginseng and linseed continue to be used for hot flushes, but evidence is lacking, or shows they are no better than placebo.
Physiologic Changes At Menopause And Their Effect On Sexuality
Hormones affect sexual arousal through sensory perception, central as well as peripheral nerve transmission and discharge, peripheral blood flow, and capacity to develop muscle tension. Impairment of this mechanism can lead to diminished sexual responsiveness, dyspareunia, decreased sexual activity, decline in sexual desire, and sexual aversion.
Decreasing estrogen affects the integrity of female reproductive tract tissues. Decreased vaginal lubrication and atrophic vaginitis result in dyspareunia. Decreased blood flow to the reproductive organs results in diminished vasocongestion. Progressive ischemia, thinning of the barrier layers of skin and mucous membrane tissue, loss of subcutaneous fat, and a shrinking introitus are among many changes which occur in the genital structures as a result of hypoestrogenemia. Extragenital effects include loss of pelvic muscle tone, decreased intraurethral pressure, a smaller bladder, and thinning of the mucous membrane lining of the bladder and urethra. These effects have been found to be somewhat ameliorated by continuing sexual activity despite no estrogen replacement. Women who were sexually active had less atrophy than those who were not. In general, the health of the vaginal tissues decline in the absence of estrogen stimulation, despite sexual activity.
Read Also: Perimenopause Light Headed
How Does Menopause Affect Libido
According to the Cleveland Clinic, one of the main culprits behind a decreased libido during menopause is the loss of estrogen that occurs. Also known as the primary female sex hormone, estrogen can take a nose dive during the change, which can in turn decrease the blood supply to the vagina. This can lead to dryness , leaving many women struggling or unable to become aroused. Furthermore, this lack of natural desire can take a mental toll, leading some women to lose all interest in sex or sexual contact completely.
Its important to note that estrogen isnt the only thing that can lead to a diminished sex drive during menopause. From incontinence issues and sleep disorders to depression and various medications, there are numerous other factors to be aware of while searching for a fix.
Keep An Open Mind To Keep Your Sex Life Satisfying
My takeaway was that we need to be more routinely asking women in midlife about their sexual function and whether there are barriers such as having pain during intercourse or if theyre having problems with low sexual desire thats bothering them, says Stephanie Faubion, MD, director of the Mayo Clinic Center for Womens Health in Rochester, Minnesota, and medical director of NAMS.
Sexual function is usually under addressed in women in general but certainly in women beyond menopause, adds Dr. Faubion.
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Incorporate Sex As Self Care
Yep, you read that right. Her advice? Make masturbation and sex part of your self-care routine, she advises. As well as helping you figure out what feels good, it can help improve mood, reduce anxiety and improve blood flow to your vulva a definite win, win.
Dont miss our guide to free self care ideas, while youre here.
How Can I Improve Intimacy With My Partner
During menopause, if your sex drive has dropped but you don’t think you need counseling, you should still take time for intimacy. You can still show your partner love and affection without having sex. Enjoy your time together: take walks, eat dinner by candlelight, or give each other back rubs.
To improve your physical intimacy, try these tips:
- Consider experimenting with erotic videos or books, masturbation, and changes to sexual routines.
- Use distraction techniques to boost relaxation and ease anxiety. These can include erotic or non-erotic fantasies, exercises with sex, and music, videos, or television.
- Have fun with foreplay, such as sensual massage or oral sex. These activities can make you feel more comfortable and improve communication between you and your partner.
- Minimize any pain you might have by using sexual positions that allow you to control the depth of penetration. You may also want to take a warm bath before sex to help you relax, and use vaginal lubricants to help ease pain caused by friction.
- Tell your partner what’s comfortable and what’s not.
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A Womans Guide To Reviving Sex Drive
Know that old song Where Did Our Love Go? Many women in their 40s, 50s, and 60s are asking, Where did our sex go?
Loss of desire is common in the years before and after menopause. Desire problems peak around ages 35 to 64.
Why? Itâs a time of life with a lot going on! Changing hormones can cause spontaneous desire or craving sex out of the blue to plummet.
âTo blame it all on hormones is unfair, though,â says Stephanie Faubion, MD, director of the Mayo Clinicâs Womenâs Health Clinic.
Whatâs called receptive desire being turned on when your partner makes the first move keeps going. At least, it can if related issues in your body, mind, or relationship usually some mix donât get in the way, Faubion says.
The fix for sex drive issues: Tease out the complex causes and address them.
Menopause Hormones Are Changing:
There are 3 main hormones that influence sex drive during menopause.
And, during menopause, estrogen levels can be all over the place. During fluctuations where estrogen surges, women can experience an increase in sex drive.
This is especially true during perimenopause when estrogen levels can fluctuate the most.
Dr. Lara Bridens book, The Period Repair Manual, is a great resource for this topic.
Medical News Today shares that an increase in progesterone will actually decrease sex drive in women.
And just like with estrogen, progesterone can fluctuate during menopause. It can go up. It can go down. Or, at times, it can stay steady.
As it surges up or dips below normal, women can experience changes in sex drive.
Dr. Lara Briden also supports evidence that progesterone is the mood boosting hormone and may need support during this transition.
Others argue that testosterone definitely DOES increase sex drive in women.
So, who is right? Does it really matter?
In this case, it doesnt really matter. What matters is that testosterone levels are changing. And while its still unclear whether or not testosterone increases or decreases sex drive, its clear that testosterone influences sex drive to some degree.
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Factors That Affect Desire
Your estrogen takes a nosedive during menopause and the years leading up to it, called perimenopause. This change has a huge impact on your sexual function. It can lower desire and make it harder for you to become aroused. It can also make the vaginal canal less stretchy and you may experience dryness, which can cause intercourse to be painful. More than a third of women in perimenopause, or who are postmenopausal, report having sexual difficulties, from lack of interest in sex to trouble having an orgasm.
Additionally, with age youre more likely to experience health problems. Chronic illness and injuries can deplete your energy, cause physical pain and lower your body image all of which affect your sex drive.
Also Check: Does Menopause Cause Dizzy Spells
What Are Treatments Are Available For Sexual Problems During Menopause
Estrogen therapy is available for women to treat symptoms of menopause, although due to some health risks , not all women choose to take estrogen therapy. Estrogen, in pill, patch, trandsdermal spray, or gel form is the single most effective therapy for troubling symptoms of menopause. Because ET alone can cause uterine cancer , a progestin drug is typically given together with estrogen in women who have a uterus to eliminate this increased risk. Hormone therapy has been shown to have other risks, including small but significant risks of stroke and heart disease. Because of these risks, women who have no major menopausal symptoms may choose to avoid hormone therapy altogether. Most doctors agree that hormone therapy, when used for symptoms of menopause, should be used in the lowest effective dose and for the shortest time period of time possible.
Estrogen is also available for use in the treatment of vaginal dryness as an isolated symptom. Topical estrogen is available in forms of creams, vaginal rings , and vaginal tablets. These products are inserted directly into the vagina, and they can help relieve some of the symptoms of vaginal dryness and discomfort. Water-soluble lubricants can also be effective in the relief of vaginal dryness. Estrogen administered vaginally is given in very low doses, and it is noit associated with the risks of systemic hormone therapy such as that given to treat hot flashes and other widespread menopause symptoms.