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SEX AT THE MENOPAUSE: CONTRACEPTION, VAGINAL DRYNESS, SEXUAL SATISFACTION
Contraception
As a rule of thumb you should wait for two clear period-free years before abandoning contraception if your menopause starts before the age of fifty. If you were over fifty when it started, a year free of periods is considered safe.
Vaginal dryness
As well as the Kegel exercises and the vitamin E supplementation I have already recommended there are some lubricants available. One good one is a US product called Astroglide. It’s a gel that closely resembles our own body’s lubricant and is mildly acidic like our own secretions. Many vaginal lubricants sold over the counter alter the balance of the bacteria in the vagina designed to protect us from infection. But Astroglide, which is available in the UK, is water-soluble, non-hormonal and safe to use with condoms if you are still having periods and need a contraceptive.
Sexual satisfaction
There is no reason why sex should not be as satisfying now as at any other time of your life. And several good reasons why it should actually be better. Women have always taken longer to become aroused than men and when we are young the difference can be quite striking. A man in his twenties can achieve orgasm within two to five minutes whereas his partner may take twenty minutes. As a man gets older he needs longer to reach an orgasm, so the timing, in theory, becomes more compatible. Sex can take longer and intercourse may not necessarily be the main focus. You may have sex less often than in your twenties but it can be a deeper, more satisfying experience. The truth is that the ageing process has an effect on both men and women – and the so-called ‘male menopause’ may pose much more of a real problem in sexual terms for your partner. Women may worry about their attractiveness but many middle-aged men become very concerned about their sexual performance. Both partners may need to make adjustments at the menopause. Communication and honesty is the key and can prevent misunderstandings and resentment building up between you and your partner. By communicating honestly about what we like and don’t like, changing positions if one we have always used makes us uncomfortable, and taking the steps recommended to counteract any physical changes there is no reason why sex should not continue to be thoroughly enjoyable.
The biggest sexual problem for many women has nothing to do with hormones, vaginal dryness or anything else that can be explained medically. It is boredom. Many women have stayed in a relationship for the sake of their children. Other couples are happy enough but find that passion and excitement has just fizzled out. A patient once said to me that HRT was wonderful. Not Hormone Replacement Therapy, she said, but Husband Replacement Therapy. Once the children have grown up and left home a couple may find they just don’t have very much in common any more. This can expose weaknesses in a relationship. This is one reason why women feel they have reached an important turning point in their lives. Even if they are happy in a relationship they are conscious of the fact that they have put their children and husbands first for as far back as they can remember.
*84/101/5*
