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How Menopause Impacts Sexual Functioning

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There is no such thing as “too old for sex.” Menopause does not signal the end of sexual pleasure—it simply marks a new chapter. With the right knowledge, mindset, and support, women can continue to enjoy a vibrant, satisfying sexual life well beyond menopause.


Physical Changes and Their Impact


As estrogen levels decline during menopause, many women experience vaginal dryness and atrophy, leading to discomfort during intercourse. This condition, known as genitourinary syndrome of menopause (GSM), affects approximately 50–80% of postmenopausal women. Symptoms may include vaginal dryness, burning, irritation, and painful intercourse.


In addition, menopause-related changes may include a weakened or overly tight pelvic floor, pelvic organ prolapse, and urinary incontinence — all of which can affect sexual comfort. Thankfully, there are many treatment options for all of these issues (see below)!



Frequency and Desire: It Varies


The effect of menopause on sexual activity is not universal. Some women report a decrease in sexual frequency, while others notice no change at all. In fact, research by Hinchliff and Gott (2008) found no consistent evidence that menopause leads to reduced sexual desire.

Some women even report an increase in sexual satisfaction after menopause. Without the pressure of fertility or menstrual cycles, some find a new sense of freedom and excitement in their sexual lives.


Cultural Influences and Attitudes


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Cultural beliefs play a powerful role in shaping how women perceive menopause and its effect on sexuality. In some societies, menopause is seen as a time of renewal and empowerment, while in others (like ours), it is mistakenly equated with the loss of youth, beauty, and sexual relevance.

These cultural narratives can significantly affect how women experience menopause — either reinforcing shame and silence or fostering confidence and resilience. The meaning women attribute to menopause often shapes their sexual response more than the physical changes themselves.


Treatment Options: What Works?


There are several effective treatments available to address menopause-related sexual concerns:

  • Topical Estrogen Therapy: Helps restore vaginal tissue and moisture.

  • Silicone-Based Lubricants: Provide comfort and ease during intercourse.

  • Pelvic Floor Physical Therapy: Treats tightness, prolapse, or incontinence.

  • Osphena (ospemifene): A non-hormonal prescription pill that treats vaginal dryness and painful sex due to menopause-related changes.

  • CO₂ Laser Therapy and Vaginal Renewal Programs: Innovative approaches to rejuvenate vaginal tissue.

  • Talk Therapy: Can improve sexual function by addressing mental and emotional factors such as anxiety and self-image.


It’s important for women to speak openly with healthcare providers to find the right treatment based on their symptoms and preferences.

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References


·       Hinchcliff, S., & Gott, M. (2008). Challenging social myths and stereo- types of women and aging: Heterosexual women talk about sex. Journal of Women and Aging, 20, 65–81.

·       Koch, P. B., Mansfield, P. K., Thurau, D., & Carey, M. (2005). ‘‘Feel- ing frumpy’’: The relationship between body image and sexual response changes in midlife women. Journal of Sex Research, 42, 215–223.

·       Krychman, M. (2007). Vaginal atrophy: The 21st century health

·       issue affecting quality of life. Medscape Ob=Gyn & Women’s Health. Retrieved from http://www.medscape.com/viewarticle/ 561934

 

 
 
 

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© 2024 by Esmé Valette 

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