The Daily Courier

Talking about menopause

- ELLIE TESHER Send relationsh­ip questions to ellie@thestar.ca. Follow @ellieadvic­e.

It’s time to discuss how menopause affects women and their male partners.

A recent question from a man complainin­g that his wife wouldn’t discuss menopause but arbitraril­y ended sex with him raises the question:

Is it the woman’s hormonal changes, or her reaction to them, or the quality of the couple’s relationsh­ip that causes her to give up on having sex?

Some facts – menopause refers to when a woman stops having her period permanentl­y, which may follow a perimenopa­usal phase of having night sweats, and mood swings.

Some symptoms and side effects of menopause: Anxiety, bladder control issues, decreased sex drive and sexual desire, depression, difficulty sleeping, thinning hair, and weight gain.

Little wonder that this can be a very trying transition for a woman!

The reality is that decreased estrogen levels can result in reduced blood flow to the vagina, which can cause the tissues of the vagina and the labia to become thinner. If this happens, the two areas become less sensitive to sexual stimulatio­n.

Decreased blood flow also affects vaginal lubricatio­n and overall arousal. As a result, a woman may not enjoy sex as much and may have difficulty achieving an orgasm. Sex can not only become uncomforta­ble, but also painful.

But it’s not always only bad news. Many women who experience this transition seek medical advice from a women’s health clinic. Their family doctor or, if needed, a gynecologi­st on how best to handle menopause, given their particular symptoms.

Those who benefit from using lubricants, herbal therapies such as black cohosh, trying new sexual positions or other approaches to intimacy, and those who seek and are given medical approval for using hormonal replacemen­t therapy (HRT), learn to navigate their new sexual realities.

If their relationsh­ip includes being able to discuss openly with their partners why something works towards maintainin­g a sex life together, and why something else doesn’t work, they stand a good chance of still enjoying intimacy in their post-menopausal and senior years.

Reader No. 1 – “After menopause, many women experience atrophy of the vulva and clitoris, ending the sex drive. It’s a mostly irreversib­le condition that can happen unexpected­ly and within two months.

“Despite being in a happy and long sexual relationsh­ip, you can find yourself stopped dead in your sexual tracks. Hormonal changes can also lead to very painful conditions that prevent sex. My post-menopausal female friends said this also occurred with all of them.

“When older males experience a similar phase of hormonal decrease, it also affects their female partners.

“Their decrease in testostero­ne and male pheromones result in a woman’s decrease in sex drive, which can also be very distressin­g for women.

“If a man wants to increase his wife’s interest, he should perhaps investigat­e increasing his own pheromone emissions, to arouse her.”

Reader No. 2 – “Menopause’s hormonal changes cause many women to experience a dramatic decrease in libido.

“It’s a physiologi­cal reaction, independen­t of mood swings, relationsh­ip issues, etc., although of course those don’t help. Mood swings can obviously affect a couple’s relationsh­ip, but they’re not a requiremen­t for the loss of libido.

“I am post-menopause, have not had much trouble with mood swings, my relationsh­ip with my husband is excellent, we talk all the time about menopause and my symptoms, he’s extremely supportive – but I have still lost my libido. We work at maintainin­g our intimacy, but that doesn’t change the fact that my hormone levels have changed.”

FEEDBACK: Regarding the man disappoint­ed in the “amazing” woman he’d considered for a joint future, when she went quiet on first meeting with his friends:

Reader: “As a proud introvert, I am usually much more animated in one-toone conversati­ons than when among groups of people, especially strangers. I don’t regard this trait as a flaw in my personalit­y.

“While your suggestion­s regarding opening up communicat­ion are wellplaced, I’d add that the phrase he used – ‘woman of my dreams’ – is quite telling. Perhaps he should stop dreaming and look at the multi-faceted personalit­ies of the women he dates.

“He wants to ‘head for the hills’ when his adored one doesn’t perform like a trained seal in front of his friends.

“Maybe he should look into whether he’s shallow and self-absorbed, looking for a dream woman instead of a real one. If I were that woman, I’d head for the hills!”

Ellie’s tip of the day

Couples should openly discuss together the changes in libido caused by menopause (and/or men’s aging symptoms), to find new approaches to intimacy.

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