Menopause: how does it affect a woman's sex life?

What is menopause? 

For the majority of women, menopause corresponds to the end of the monthly menstrual cycles, which occurs when the ovarian follicular function ceases, and the ovaries stop releasing eggs for fertilisation.

Menopause generally occurs between the ages of 45 and 55 and it is considered to be definite after 12 consecutive months without menstruation and in the absence of other physiological or pathological causes that could stop the menstrual cycle.

Hormonal changes associated with menopause can have a significant impact on physical, emotional, mental and social well-being.

Women can develop different symptoms during and after the transition to menopause, but these symptoms vary considerably from one woman to another.

The most common symptoms are:

• Hot flushes: a sudden sensation of heat in the face, neck and chest, generally accompanied by reddening of the skin, sweating, palpitations and an acute feeling of physical discomfort that may last several minutes,
  
• Night sweats,
  
• Changes in the regularity and flow of the menstrual cycle,
  
• Vaginal dryness,
  
• Pain during sexual intercourse,
  
• Incontinence,
  
• Sleep disorders,
  
• Mood swings,
  
• Depression and/or anxiety.
  

Menopause can also be accompanied by changes in body composition and loss of bone density, which can significantly contribute to higher rates of osteoporosis and fractures.

How does menopause affect your sexuality? 

Physical changes

Menopause is the result of a decrease in the production of the female hormones oestrogen and progesterone, which stops the menstruation, but also leads to various consequences for women's internal and external genitalia.

There is less pubic hair and the vagina can become smaller and narrower if there is no sexual activity.

The vagina actually suffers a number of consequences: vaginal dryness, loss of elasticity and a change in local acidity (pH). This increases the risk of infection, inflammation and mechanical injury, which can make sexual intercourse painful.

Thinning of the vaginal epithelium (the mucous membrane lining the inner wall of the vagina), loss of elasticity and vaginal dryness could lead to post-coital bleeding and pain.

Emotional changes that affect your libido 

Physical and emotional changes associated with menopause can lead to low libido, or even a complete cessation of sexual intercourse.

It is important to remember that menopause often comes at a time of transition, such as when children leave home or when a woman retires.

These changes can lead to distress and irritability, and depression. Loss of libido is a symptom that very often accompanies depression.

How can you improve your sex life after the menopause ? 

Knowing and understanding how your body and sexuality change is an important first step in improving your sex life as you age and reach the menopause.

The quality of your relationship with your partner, tenderness and the perception of the other's desire are essential factors in sexual fulfilment.

In the event of vaginal dryness, a lubricant can be used to make intercourse more pleasant. Some are specifically designed for older women.

Lack of lubrication due to a lower level of oestrogen can also be compensated for by hormone treatment with oestrogen. There are various types of intravaginal oestrogen treatment such as rings, tablets or creams.

Couple therapy could help you reawaken your libido after the menopause. You can also join an online and anonymous women's discussion group to discuss your concerns with other women. This helps you better understand the menopause and come to terms with all the changes it brings.

And finally, the more sexually active you are, the more relaxed your vaginal area will be, improving natural lubrication!