Discover the ways hormonal changes and menopause symptoms can affect sexual desire and arousal. Get insights on managing menopause symptoms like vaginal dryness and painful sex, and learn how to sustain sexual health and wellbeing during this life stage.

Key Takeaways:

• Menopause can impact sexual desire due to hormonal changes leading to vaginal dryness and other symptoms.
• Emotional stress and body image issues also play a significant role in sexual desire during menopause.
• Several treatments, like hormonal replacement therapy, testosterone therapy, and the use of vaginal moisturisers, can help manage menopause symptoms.
• Professional help, such as a pelvic floor physiotherapist, can aid in addressing issues like painful sex and incontinence.
• Maintaining good sleep hygiene and practising relaxation strategies are beneficial for managing menopausal symptoms.

Sexuality plays an integral role in our human experience, significantly contributing to our overall wellbeing and intimate relationships. However, the transitional period of menopause can potentially impact this aspect of life. Hormonal changes occurring during menopause can lead to vaginal dryness and a decrease in sexual desire, thereby causing distress within relationships. Nevertheless, it's crucial to understand that hormonal changes are not solely responsible for sexual issues; several other factors may be at play.

The role of stress and body image

Stress and body image issues can significantly impact sexual arousal after menopause. During this stage, women often face numerous social pressures. Juggling between work, adolescent children, ageing parents, and other life changes can cause considerable mental and emotional stress. This strain can significantly impact a woman's sexual desire and overall willingness to seek intimacy.

Moreover, menopause often brings about changes in body composition and physical appearance. Menopause can cause weight gain, especially around the midsection, thinning hair and changes in skin texture due to a drop in oestrogen levels. These changes can influence a woman's self-perception and body image. Feeling less attractive or desirable can have an effect on a woman's self-esteem, potentially leading to a decrease in sex drive.

Managing sexual arousal after menopause therefore requires addressing stress and body image issues. Maintaining an open line of communication with one's partner, as well as thinking positively about oneself, are some helpful ways to address these challenges.

The impact of hormonal changes on sexual desire

The hormonal fluctuations that take place during menopause can have a profound impact on a woman's sexual health. The primary female hormones — oestrogen, progesterone and testosterone — undergo significant changes during menopause and vaginal dryness becomes a serious problem for a woman. These changes not only affect the physical aspects of sexual health, such as the tissue quality of the vulva and vagina, but they also play a vital role in a woman's emotional response towards sexual intercourse.

As oestrogen levels drop, the vaginal lining becomes thinner, drier and less flexible. These physiological changes can result in vaginal dryness, irritation, and a condition known as dyspareunia or painful sex during menopause. The discomfort or pain associated with sex can cause feelings of anxiety about intercourse. This can lead to a negative feedback loop that reduces a woman's interest in sex, which renders it an unpleasant experience.

Moreover, the decrease in oestrogen can lead to urinary symptoms such as incontinence or frequent urination, which can be another source of anxiety or discomfort, further decreasing a woman's desire for sexual activity.

On the other hand, testosterone, which is not only a male hormone but is also produced in smaller amounts in women, plays a significant role in sexual desire or libido. During menopause, levels of this hormone may decrease, potentially resulting in reduced sexual desire or arousal.

Furthermore, these hormonal changes can contribute to other menopausal symptoms like:

• hot flashes
• night sweats
• fatigue
• poor sleep
• mood alterations

Notably, the hormone progesterone, which also sees a decrease during menopause, has calming and sedative effects, so its reduction can exacerbate issues related to sleep and mood. These symptoms can affect a woman's overall wellbeing and energy levels, leaving her less interested in sexual activity.

Understanding these hormonal changes is crucial, as it highlights that these alterations are physiological and a natural part of ageing. Knowledge about this can help reduce any guilt or anxiety a woman might experience about changes in her sexual desire and aid in seeking appropriate treatments and interventions.

Coping with changes in sexual desire

Changes in hormonal levels during menopause can lead to a decrease in sexual desire, arousal and overall sexual pleasure. However, a variety of treatments are available to help manage these changes:

• Topical Treatments: Vaginal moisturisers and lubricants can provide immediate relief from vaginal dryness and discomfort during sexual activity. Vaginal lubrication can help replenish the natural moisture of the vaginal lining and make sexual intercourse more comfortable.
• Vaginal Oestrogen Therapy: When vaginal dryness is severe and persistent, topical oestrogen therapy might be recommended. This treatment, available as a cream, tablet or ring that's inserted into the vagina, can help restore the thickness and elasticity of vaginal tissues.
• Hormonal Replacement Therapy (HRT): This treatment can help balance the levels of oestrogen and progesterone in the body. HRT can alleviate several menopausal symptoms, including hot flashes, night sweats and mood swings, which could indirectly improve sexual desire.
• Testosterone Therapy: Though it is primarily known as a male hormone, testosterone also plays a crucial role in female sexual health, particularly in driving sexual desire. Testosterone therapy, used under the close supervision of a healthcare provider, can help enhance libido in women experiencing a significant decrease in sexual desire during menopause.
• Non-hormonal Medications: Certain antidepressants (SSRI's and SNRI's) can be used to help manage hot flashes and mood swings, while specific non-hormonal medications, like ospemifene, can help address painful intercourse due to vaginal dryness.
• Pelvic Floor Physiotherapy: For women experiencing painful intercourse, seeking the help of a specialised pelvic floor physiotherapist can be beneficial. These professionals can provide exercises to strengthen the pelvic floor muscles and techniques to help with relaxation, which can improve sexual function.
• Lifestyle Adjustments: Regular physical activity, a balanced diet, adequate sleep and stress management can boost overall health and wellbeing, leading to improved sexual function.

Remember that everyone's experience with menopause is unique, so it's crucial to consult with your healthcare provider to identify the most suitable treatment options for you. Treatments can often be combined and tailored to your specific needs and symptoms.

Importance of sleep and relaxation

Good sleep and relaxation strategies can significantly improve your overall wellbeing and, in turn, your sexual health during menopause. This phase in a woman's life can often be stressful, characterised by fluctuating hormones causing hot flashes, night sweats, mood swings and sleep disturbances, all of which can lead to increased stress levels. High stress and poor sleep can negatively impact your libido, hence the need for strategies to manage them effectively.

Consider implementing the following relaxation strategies:

• Mindfulness and Meditation: These practices can reduce anxiety and stress levels. Through mindfulness and meditation, you can learn to focus on the present moment, which can help you manage the changes associated with menopause more effectively.
• Deep Breathing Exercises: Deep breathing can have a calming effect on your mind and body. Taking slow, deep breaths can help you relax, lower your heart rate and reduce stress.
• Progressive Muscle Relaxation: This technique involves tensing and then relaxing each muscle group in your body. It can help you become more aware of physical sensations and achieve a state of deep relaxation.
• Yoga and Tai Chi: These forms of exercise incorporate physical postures, breathing techniques and meditation. They can help to reduce stress, improve flexibility and promote better sleep.
• Aromatherapy: Scents like lavender and chamomile are believed to have calming effects and can be used as part of your relaxation routine.
• Regular Exercise: Physical activity can act as a natural stress reliever. It stimulates the production of endorphins, known as 'feel-good' hormones, which can enhance your mood and promote better sleep.
• Balanced Diet: Eating a healthy diet can improve your overall health and wellbeing, which can help you manage stress better. Avoid excessive caffeine and alcohol, especially close to bedtime, as they can interfere with sleep.
• Sleep Hygiene: Maintain a regular sleep schedule, keep your sleep environment cool and dark, and establish a calming pre-sleep routine. Avoid screens for at least one hour before bed, as blue light can interfere with the production of the sleep hormone melatonin.

Managing stress and maintaining good sleep quality can play a significant role in enhancing your sexual health during menopause. Implementing these strategies can contribute to better physical and emotional wellbeing.

Seeking professional support

Intimacy forms a significant part of healthy relationships, and disruptions to this due to menopausal symptoms can be challenging. Open communication with your partner about the changes you're experiencing is key, and seeking help from a qualified professional can make a significant difference.

Pelvic floor physiotherapy can assist in addressing issues such as painful sex and incontinence, common during the menopause period. The guidance of a specialised pelvic floor physiotherapist can help you become more aware of these muscles and teach you ways to relax and strengthen the area.

In addition, hormone therapy is emerging as a viable option for managing a decrease in sexual desire, a common concern among women during menopause. However, it's essential to undergo this treatment under the close supervision of your doctor.

The Vively connection

Towards the end of your menopause journey, maintaining metabolic health is also of utmost importance. Poor glucose control can exacerbate symptoms like fatigue, which in turn can further dampen sexual desire. As you navigate these changes, it's crucial to take control of your health. With Vively, a metabolic health app, you can monitor and improve your glucose control, supporting you in maintaining your wellbeing, including your sexual health, during menopause.

Remember, each woman's menopause journey is unique. With the right support, care and treatment, you can effectively manage the changes and sustain your sex life and overall wellbeing.