Have a Sexy Menopause

Menopause is rarely considered a sexy time of life. But, armed with advice from two top North Shore gynecologists, I’m here to change that.

Here’s what you need to know about how menopause can affect your sex life, and what you should do to continue to enjoy it.

Better Sleep Means Better Sex

Hormone changes don’t directly affect a woman’s libido, but symptoms like hot flashes and night sweats can interfere with her ability to get a full night’s rest. The lack of sleep creates other problems that put a damper on desire.

Marcia Krause, M.D, F.A.C.O.G., a gynecologist on staff at NorthShore University HealthSystem in Skokie, says, “One of the biggest issues with menopause is sleep disruption. It affects everything—emotional reactions, energy and the ability to eat properly. When you’re tired, your satiety centers are disrupted and you don’t have a signal that you’re full, so you get cravings. At the same time, metabolism is downshifting, so weight gain becomes an issue, especially around your belly. That affects body image, which is a huge issue when it comes to libido.”

Dr. Lauren Streicher, Associate Professor of Obstetrics and Gynecology at Northwestern’s Feinberg School of Medicine and author of the soon-to-be-released book “Love Sex Again” agrees. “The biggest complaint I get from women is midlife weight gain. It’s not the lack of estrogen that’s causing the weight gain. There are a number of non-hormonal factors that contribute, including lack of sleep. When women don’t sleep, they are more likely to gain weight.”

It’s damn hard for women who feel exhausted, moody and overweight to feel sexy, but it’s reassuring to know that the number one prescription for these conditions is rest. Women should do everything possible to get enough shut-eye at night, or squeeze in a siesta during the day. “Naps are fabulous,” Krause says. “I nap as often as I can.”

Use It or Lube It

One physical change that affects the female sex organs during menopause is vaginal dryness. But that only makes staying sexually active more important, because at this age, says Krause, “it’s absolutely use it or lose it.” Intercourse helps increase the blood flow to the vaginal tissue, which keeps it stretchy and supple and helps prevent atrophy. But sex doesn’t have to hurt.

“Women who experience painful intercourse should start with a silicone-based lubricant,” Streicher says. She recommends the drug-store brand Wet Platinum, and many other lubes can be found at local sex shops or online.

However, if lubricant doesn’t solve the problem, Streicher says, “there are a variety of prescription local-estrogen products in ring, cream and tablet forms, as well as a new non-estrogen oral product, that work very well.”

Discuss Sexual Issues with Your Doctor

Many of the symptoms of menopause that interfere with desire are treatable through hormone replacement therapy (HRT) or new non-estrogen medications; you should definitely discuss your options with your gynecologist. But not all sexual problems in midlife are caused by menopause.

“Roughly 50 percent of women who are post menopause have at least one additional health problem that can affect sexuality,” Dr. Streicher says. “But this doesn’t mean you have to accept that your sex life is over. These dysfunctions are treatable. Part of the challenge is to find someone to help you.

Not every doctor addresses sexual issues when treating medical problems such as diabetes or heart disease. It’s rare for someone to talk about the impact of these health conditions on sexuality, and many women assume that there isn’t anything to do. It’s a very specialized area. Often I am a patient’s fourth, fifth or sixth medical opinion.”

Streicher’s new book is one of the first that discusses all the health issues that can impact a woman’s sexuality.

Take Charge of Your Turn On

Even healthy women shouldn’t expect to be overwhelmed with desire at this age; rather, they should identify the things and situations that turn them on and go after them.

“When we were younger, libido came from horniness,” Krause says. “That goes away as you get older and it makes it very hard to feel desire for sex. Desire in women initiates in our heads and thoughts and emotions—that’s where our sex response starts. Menopause can make it even harder.”

More Ways to Take Control of Your Desire