“Sexual difficulties can be life-long or recently acquired, but they are a common presentation at the menopause. They may also be situational (limited to certain types of…”.¹

Umbrella
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Sexual Health

What may influence a woman’s sexual health?

In Sexual Health & Menopause Online: Causes of Sexual Problems the North American Menopause Society (NAMS) explain:

“If you had to choose one word to describe women’s sexual function and sexual health, you’d be wise to go with “complex.” The factors that contribute to women’s sexual health and satisfaction—as well as to their sexual problems—are many, and they are often interrelated. These factors range from the physical changes of menopause and aging (reviewed earlier) to a woman’s physical health, her cultural and religious standards, issues in her relationship, her self-image, and stress and lifestyle issues”.²

Menopause, Aging, Other Factors

Is there an association between menopause, aging, other factors and sexual health?

In Sexual Difficulties In the Menopause the Australasian Menopause Society note:

“Sexual difficulties can be life-long or recently acquired, but they are a common presentation at the menopause. They may also be situational (limited to certain types of stimulation, situations, or partners) or generalized”.³

In Sexual Health & Menopause Online: Changes At Midlife the NAMS elaborate on:

“Every woman experiences her midlife years differently. The changes that occur during this period, including changes in sexual well-being, are typically caused by a mix of both menopause and aging, as well as by typical midlife stresses and demands”.⁴

In Sex & Relationships: Sex & Menopause the (Australian) Jean Hailes for Women’s Health (JH) also note:

“At midlife and menopause, many things are likely to be happening, both to your body and in your relationships. There might be partners, children and ageing or unwell parents to consider, as well as work demands and even your sense of identity as a woman. These changes can affect your sexuality and, together with the hormonal changes, sexual problems may occur”.⁵

Sexual Activity

Is there an association between regular sexual activity and menopause?

In Sexual Health & Menopause Online: Changes In the Vagina and Vulva – Vulvovaginal Atrophy the NAMS explain:

“When a woman doesn’t have intercourse or other vaginal sexual activity on a regular basis following menopause, her vagina may also become shorter and narrower. Then, when she does try to have intercourse, she is likely to experience pain, even if she uses a lubricant. That’s because dry, fragile vulvovaginal tissues are susceptible to injury, tearing, and bleeding during intercourse or any penetration of the vagina. The resulting discomfort can be so great that the woman avoids intercourse and the condition worsens. Sometimes, even women who are not sexually active are bothered by vaginal dryness and the irritation that may accompany it”.⁶

How may regular sexual activity help?

According to the NAMS:

“Continuing to have regular vaginal sexual activity through menopause helps keep the vaginal tissues thick and moist and maintains the vagina’s length and width. This helps keep sexual activity pleasurable”.⁷

Other Factors

What is it helpful to sort out with sexual problems?

In Sex & Relationships: Relationships – What Can You Do To Help Your Relationship? the JH note:

“If sexual problems are causing difficulties in your relationship, it is helpful to sort out how many of them are due to the physical symptoms of menopause, and how many might relate to other issues, or both. When you have worked this out, then you can seek the appropriate help”.⁸

Concern or Not

Are the changes menopause causes to a woman’s sexual life a concern?

Not necessarily. In Sex & Relationships: Sex & Menopause – The Impact of Symptoms the JH explain:

“Some women are concerned by the changes menopause causes to their sexual lives, and others are not so worried. It really depends on you, your attitude to sex, your age, how menopause has affected you, whether you are in a relationship, whether you want to have sex and whether there are other things happening in your life you are more concerned about”.⁹

Partners

Where may partners find more information about sexual health and menopause?

In Information for Partners: Sex & Menopause the JH elaborate on:

“A key issue for couples and relationships may be that your partner is no longer keen to have sex. This can be for a range of reasons related to menopause symptoms. One key symptom is a dry vagina: Lower levels of oestrogen directly affect a woman’s vagina and can make it thinner, drier and less elastic. Also, testosterone levels fall gradually with age and this can have an impact on a woman’s level of desire at menopause”.¹⁰

Health Care Provider

What if I would like help with my sexual health and menopause?

If you would like help with your sexual health and menopause, it may be in your best interest to choose to talk to your health care provider about this.

The (United States) Mayo Clinic also encourage us to talk about sex explaining:

“Your health has a big impact on your sex life and vice versa. Don’t be embarrassed about discussing sex with your doctor. Your doctor can be a reliable source of information on sexual health. He or she can help you manage chronic conditions and medications that affect your sex life. Your doctor can help you understand how sexual activity may change throughout your life”.¹¹

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Topic Last Updated: 18 March 2021 – Topic Last Reviewed: 11 February 2021