Maintaining an active sex life is important to many midlife women, but menopause doesn’t always make it easy. Here, we speak to two experts and a menopausal woman about lowered sex drive, and what you can do about it (if it’s bothering you!).
Before she entered perimenopause, Susan Jarvis had always had a strong sex drive.
But things started to change when she reached her mid-40s and was confronted by the classic symptoms of perimenopause. Hot flushes, night sweats, palpitations, weight gain, low energy and brain fog set in as did a loss of sexual desire.
“For a while, I mourned the loss of my libido [sex drive] and felt like a failure because I wasn’t producing my own natural lubrication,” says the 54-year-old business owner.
Eventually, during a night of intimacy with her partner, Susan burst into tears. “That opened up a conversation,” she says. “I…poured my heart out” and “he was immensely relieved [that the issue] wasn’t from his lack of trying.”
The couple took steps to reconnect, attending two intimacy workshops – one face-to-face, another online. Susan saw her GP for a health check and she wrestled with her own feelings about vaginal dryness.
“I initially avoided lube because of a bit of pride and embarrassment...[but] it makes everything more comfortable,” she says, adding “I let go of my angst…[and] lube has become my best friend”.
Australian research tells us that Susan’s story is not unique. More than 32% of women aged 40 to 65 experience low sexual desire that causes them personal distress.
According to Jean Hailes GP Dr Fiona Jane, around menopause, various factors can affect a woman’s libido. First are declining levels of the hormone oestrogen, which can change vulval and vaginal tissues. There’s also an age-related decline of testosterone.
These changing hormone levels can lead to vaginal dryness, not enough lubrication, pain during penetration and struggles achieving orgasm – issues that can make it difficult to get or stay in the mood, explains Dr Jane.
“Other aspects of menopause may impact a woman’s level of desire too,” she says, pointing to sleep issues, night sweats, fatigue, joint pain and mood changes.
Then, there are the other parts of midlife that may affect sex, including desire. According to Dr Jane, these include alcohol intake, relationship stress and issues that impact mental or general wellbeing.
Of course, for a number of women and couples, reduced libido, infrequent sex or none at all isn’t a problem. Says Jean Hailes psychologist Gillian Needleman: “There are some healthy couples who are quite happy not to have sex.” But, she adds, for other couples, finding ways to stay sexually active while supporting each other’s changing needs is “essential”.
So, what if you’re among the women who are bothered by lowered sex drive?
With age comes knowledge…around what we like and the confidence to ask for what we want."
Chantelle Otten, psycho-sexologist
According to Dr Jane, better sex at midlife can start with education. Our newly updated menopause webpages, for example, are a good place to start. It can also be helpful for sexual partners to educate themselves about menopause to understand what you are going through, adds Chantelle Otten, a Lovehoney ambassador and psycho-sexologist. (Psycho-sexologists are professionals trained in the physical, mental and social aspects of sexual wellbeing. As we saw earlier in Susan's case, libido is complex and not just a physical issue. Emotional factors can have an impact too).
Here Dr Jane and Ms Otten share their tips to improve life in the bedroom:
Common problems, such as vaginal dryness, pelvic floor issues, incontinence and depression, “can affect sexual functioning and be treated successfully”, says Dr Jane. Where vaginal dryness is related to menopausal changes, she says vaginal oestrogens are a safe and effective form of treatment. Whatever the problem, your GP or a referral to a specialist might help.
“It may feel embarrassing to talk about your sexual concerns…but sexual health is an important part of your general health and wellbeing,” says Dr Jane. Besides talking to a professional, such as your GP, a pelvic health physiotherapist or a sexologist, Ms Otten recommends confiding in your partner if you’re in a sexual relationship. “Let them know how you feel and work together to find ways to work on your libido,” she says.
This includes keeping active, maintaining a healthy weight, watching your alcohol intake, finding ways to de-stress and keeping up to date with your health checks, says Dr Jane.
“A lot of the time we aim towards sex that is penetrative, but maybe shifting your focus towards sex that is pleasurable, and enjoying outercourse (non-penetrative sex), can be very helpful and enjoyable,” says Ms Otten. Also remember that other forms of intimacy, such as cuddling and massage, can be rewarding, she adds.
Sex toys, orgasm gel (stimulating gel that increases sensitivity) and good quality lubricant can be great tools, says Ms Otten. “They can lead to new experiences and sensations and even help get us back to the basics of touch and intimacy.”
When it comes to reduced libido, Dr Jane says there is often more than one factor at play and “management should be based on the woman’s and partner’s preferences and goals”.
The good news, adds Ms Otten, is that “with age comes knowledge…around what we like and the confidence to ask for what we want”.
“Sex in midlife and beyond,” she says, “can be some of the best sex you have”.
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