No sex because of menopause? There’s no need to suffer in silence, writes Helen Grange
MENOPAUSE. Most women have a loose understanding of what it is. Yet how many of us have a grasp of how is it affecting our sex lives and relationships? In the first South African study of its kind into the impact of menopause on women’s sexuality, the results have underscored the anecdotal evidence – that many women in this phase of their lives are disinterested in sex, and as a result, lack the physical and emotional intimacy they once shared with their partners.
The study, called CLOSER (Clarifying Vaginal Atrophy’s Impact on Sex and Relationships), was conducted by Adcoc Ingram among 200 postmenopausal women and 200 men. It found that 50% of post-menopausal women are affected by vaginal dryness, and that this has had a negative impact on their self-esteem and relationships, with many of them losing interest in sex altogether.
Menopause is the natural end of a woman’s menstrual cycle, due to the decline in the production of the reproductive hormones (oestrogen and progesterone), and it normally happens in your late forties and fifties. The symptoms include irregular periods, hot flushes, sweating, weight gain, mood swings and insomnia. Over and above this, the vagina is less lubricated.
“The vagina has no glands. In menopause, the vaginal wall thins and become dryer. The vagina also shortens and becomes less elastic. So sex can be painful or uncomfortable, and many women avoid sex,” said Dr Trudy Smith, a Joburg gynaecology oncologist and obstetrician who presented the findings of the CLOSER study recently.
Nearly 70% of the women surveyed avoided any intimacy, and 52% had sex less often. One in five said this change had created feelings of loneliness, even within their relationship.
Over half the women surveyed said they felt they’d “lost their youth”, or were upset that “their bodies didn’t work as they had before”. A third said they no longer felt sexually attractive, and a quarter felt “less of a woman”.
The comforting part of this study is it shows postmenopausal women that they are not alone. But what can be done? Eating well and exercising is essential for women at this stage of their lives to feel sexy again and enjoy life in general.
Alcohol and smoking are no-nos, but Dr Smith adds that douching is also unhealthy, as it alters the balance of normal bacteria in the vagina. “And avoid using those scented soaps down there,” she said, adding that showering is better than bathing for vaginal health.
Know that hormone therapy, usually taken by pill, treats symptoms like hot flushes, but not vaginal dryness, according to Dr Smith. What is effective, she said, is vaginal oestrogen therapy, which can be taken orally or administered directly into the vagina in the form of vaginal tablets, cream or a ring.
“Topical application is preferred because the oestrogen is absorbed locally in the vaginal tissue where it is needed. Only small doses of oestrogen are needed to treat vaginal symptoms of menopause, and the vaginal response to local oestrogen therapy may be long-lasting, provided you take it as indicated,” said Dr Smith.
In the Closer study, 21% of the women used vaginal oestrogen therapy and said it had a positive effect on their sexual relationships, with their partners also recognising the benefits. Some 74% of the women using vaginal oestrogen tablets said they would recommend them, and 61% of these women reported that the treatment worked.
“Vaginal oestrogen is safe, effective and easy to use,” said Dr Carol Thomas, gynaecologist and president of the SA Menopause Society. “The changes in the body as a result of menopause are normal, and there is no need to suffer in silence. Convenient treatments are available and women need to speak to their doctor or pharmacist about their options.”