You can hide the gray and use as many anti-wrinkle creams as you like. But the one part of growing older, if you’re a woman, that you can’t stave off is menopause. Menopause, which is defined as the time after which you haven’t had a period for 12 months, can come with a series of symptoms that affect every woman differently. You may have some, all, or none of them.
Dr. Susan Pitman, a physician with Summit Medical Group’s obstetrics and gynecology practice in Livingston, New Jersey, says, “Women experience menopause in many different ways. There’s no rule book, only guidelines.”
Dr. Pitman describes hot flashes, night sweats, and vaginal dryness as hallmarks of the condition but emphasizes that not everyone has all the symptoms. “The ferocity of the symptoms,” she says, “is also extremely variable.”
Some of these symptoms can directly impact your sex life, from the desire you have to engage in sex to the quality of your sexual experience itself. Both may differ from what you were used to during your years of fertility. Most notable of these symptoms are loss of libido, vaginal dryness, and pain during sex.
Other symptoms of menopause can indirectly affect your sex life, such as difficulty sleeping at night, which can make you too tired to have sex, hot flashes that might make a partner’s touch uncomfortable or undesirable, and changes in mood that can affect emotional intimacy. With all of these changes, you might think your sex life is over.
But that doesn’t have to be the case. Quite the contrary; menopause can actually signal the start of a new sex life, perhaps an even better one than you enjoyed before.
According to an article from Harvard Health Publishing, a 2007 survey conducted by researchers at the University of Chicago survey suggested that more than 50 percent of Americans maintain active sex lives well into their seventies. A second survey from researchers at Indiana University indicated that 20 percent to 30 percent of Americans are sexually active into their eighties.
But to get to this point, it may require you to devote some extra attention to your body and your mind. If you’re single and dating and don’t have a steady partner with whom to have sex, not to worry; menopause doesn’t have to be the reason you stay celibate or unpartnered. Menopause, if given your attention, can become your biggest dating superpower yet. Here’s how.
Seek medical help for the physical symptoms first.
No matter how hard you try, you won’t be able to wish the symptoms of menopause away. Given they are rooted in hormonal changes in your body, your doctor may want to prescribe specific treatments to help you manage the effects you’re experiencing.
In the University of Chicago survey, 43 percent of women reported a lack of interest in sex, 39 percent difficulty with lubrication, and 34 percent an inability to climax. In addition, 23 percent of the women surveyed reported a lack of pleasure from sex, and 17 percent reported pain during sex. As for the Indiana survey, 30 percent of the women age 50 and over reported experiencing some level of pain during their most recent sexual experience involving a partner.
One of the most popular protocols for relieving symptoms of menopause is systemic hormone replacement therapy. This treatment comes in a pill, skin patch, ring, gel, cream, or spray and can help with hot flashes, vaginal dryness, and any of the common symptoms of menopause. Systemic hormone replacement therapy can also help with bone loss.
However, Dr. Pitman warns that “hormone replacement treatment [or] HRT usually can curb the worst of the symptoms but doesn’t rekindle the libido and carries [an] increased risk for formation of blood clots as well as [other] potential effects.”
Dr. Pitman further notes that “lubrication can suffer even with the use of vaginal hormones or other agents like hyaluronic acid. She suggests “coconut oil could be a woman’s best friend.”
If you still have a uterus, systemic hormonal therapy may include progesterone or progestin (a medication similar to progesterone) in addition to estrogen. The effect of hormonal therapy on cardiovascular disease and breast cancer, however, is debated widely, so it’s best to consult with your physician regarding your personal health history.
Low-dose vaginal estrogen is another type of common therapy if you’re perimenopausal or in menopause. Administered as a cream, tablet, or ring, vaginal estrogen can help with vaginal dryness as well as urinary tract infections, which can become chronic in menopause for some women. Unlike systemic hormonal replacement therapy, the body absorbs less estrogen with this treatment.
For those women who don’t want to introduce hormones into their system, Dr. Pitman says there are ways around it. “There are non-hormonal treatments for the vasomotor symptoms including non-hormonal supplements like Estroven and products from a company called Bonafide which has a brisk online business.”
Even so, she says, “Some women cannot function because of the severity of symptoms and must resort to HRT even if they have risk factors that are relative contraindications.”
As for the mind, it, too, can cause physical symptoms. To help, consider seeking the assistance of a mental health professional. Dr. Pitman says, “some women do well with SSRIs like Effexor, Prozac, etc., [but] the downside to the medications is often suppression of libido.”
Accept that menopause is a part of life.
People who aren’t content also tend to be unhappy. Unhappy people, especially those who spend a lot of time feeling sad or who suffer from depression, often don’t have enjoyable sex lives. So even if it’s not the hormones causing your depression, your attitude could be.
An effective step toward treating depression is to seek professional counseling. Depending on the professional you choose, whether a psychiatrist, psychologist, or another type of counselor, they will use either talk therapy or medication or a combination of the two to get to the root of why you’re depressed. You may want to enlist the help of a psychiatrist and a therapist to get the combination of services you need.
Feeling depressed due to a loss of fertility is common, as is sadness about growing older and getting to the midpoint (or beyond) in life. A mental health professional can help you see the positives about menopause, including viewing it as a beginning instead of an end. “It’s all about being able to survive your life and hopefully feel well,” says Dr. Pitman.
Talk to your partner about how you’re feeling.
Open communication doesn’t mean only telling your partner how you feel when they don’t put their dirty underwear in the hamper or take out the garbage. Though these issues can certainly cause tension, it’s also important to be open about how your sex life is with each other, even if it’s not bad per se. A lackluster sex life doesn’t have to suffice, nor should you have to suffer in silence if you are.
For starters, if you’re experiencing discomfort or pain during sex where you never did before, and menopause is to blame, discuss how these symptoms make you feel physically and emotionally during sex. Healthy relationships require constant communication. If your partner isn’t meeting your needs, you should speak up.
But be prepared; once you open up the menopause conversation and how it relates to your sex life, your partner may have a few ideas of their own. Even if the feedback is hurtful or shocking at first, remember, communication allows you to work out situations, including those occurring in the bedroom.
Once your issues are on the table for discussion, find solutions together. If you’re in pain, tell your partner what hurts you and what feels good. Discuss the introduction of lubricant or sex toys or whatever you think may help you feel better and enjoy sex with them. “As we age, a sense of humor becomes a tremendous enhancer,” says Dr. Pitman. “Expectations need to change to fit the circumstances.”
Address feelings of rejection either of you might have, too. Your low libido may cause your partner to feel as though you’re rejecting them, which, in turn, may make them hesitant to initiate sex, causing you to feel rejected as well. Unless you voice these feelings, they will only fester.
Dr. Pitman suggests libido is mostly in the mind, and boredom is anti-libido. In her experience, most women find that their libido rebounds on vacation. “Day-to-day drudgery can kill it as can fatigue.”
Take your time finding the right partner for you.
Lack of worry about pregnancy can make sexual experiences more relaxing and, therefore, pleasurable. “New relationships have an infatuation phase which is libido-enhancing,” says Dr. Pitman.
However, it’s still important to protect yourself against STIs. According to a recent study, between 2014 and 2018, the average rate in the U.S. of STIs among those 55 and over has increased 107.3 percent, meaning many post-menopausal women have gotten older but not necessarily wiser.
Dr. Pitman says, “I tell my [patients who are in their] teens that prior to beginning a sexual relationship, they should be able to discuss STIs and birth control. Except for birth control, the rules are the same [for menopausal women].”
When women are dating during their peak fertility years, often it’s a desire to become a biological parent that drives them to find a suitable partner. It’s also what causes women to rush into a relationship or continue dating, even marry someone who may not be the best choice for them, given certain red flags.
Menopause takes the incentive to birth a biological child off the table. With the pressure gone, women can free up time and mental space to focus on what’s important in a partner and a relationship. Many women find this liberating and discover they’re content to wait before introducing sex into new relationships.
As Dr. Pitman reminds, “It’s important for women of any age to value themselves enough to choose only worthy partners.”
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Cassie Zampa-Keim is a nationally known matchmaker, relationship coach, and online dating strategist based in Marin County, C.A. For more than three decades, Cassie has helped thousands of clients find satisfying relationships and love. Cassie has been happily married to her husband, Mike, for over 20 years. Together they share two daughters, Kaylie (20) and Lauren (17), a son, Evan (13), one dog, a bunny, and lots of laughs.