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Dur­ing the menopause, lev­els of the sex drive hor­mone testos­terone fall and lack of es­tro­gen can cause vagi­nal dry­ness, loss of col­la­gen and blood sup­ply de­plet­ing sen­si­tiv­ity in the area. If that were not enough, lower self-es­teem be­cause of age­ing, mid­dle age weight gain, fam­ily re­spon­si­bil­i­ties – plus bed­room bore­dom af­ter years with the same part­ner – they can all mit­i­gate against nights of pas­sion!

An amaz­ing 40% of women ex­pe­ri­ence menopausal sex­ual and re­la­tion­ship prob­lems, so if symp­toms are mak­ing sex dif­fi­cult you need to ex­plain what’s go­ing on. “If your part­ner doesn’t know how you feel, he or she can’t be sup­port­ive,” says Dr Mullin.

Don’t be afraid of us­ing HRT to treat hot flushes or vagi­nal dry­ness, she adds, be­cause doses are very low. “There are also non-hor­monal and herbal sup­ple­ments that can al­le­vi­ate symp­toms – but check with your GP that prod­ucts such as plant oe­stro­gens from soy, for ex­am­ple, will not in­ter­act with other med­i­ca­tion. They are also un­suit­able if you have had, or are be­ing treated for, breast can­cer.”

“Vagi­nal mois­turis­ers such as Re­plens and Sylk are avail­able over the counter and some on pre­scrip­tion,” says Dr Mullin. “They need to be used for sev­eral weeks be­fore they are ef­fec­tive enough to make sex more com­fort­able. Prod­ucts that con­tain sil­i­cone are specif­i­cally for sex.

“How­ever, vagi­nal es­tro­gen is the most ef­fec­tive. It is not a form of HRT be­cause it is not ab­sorbed else­where, it just treats that part of the body. It is a very low dose and can even be used by women who have breast can­cer or are at higher risk of blood clots.”

The prin­ci­ple of use it or lose it ap­plies to sex, says Dr Mullin – with­out use, the vagina will shrink in size, mak­ing sex even more dif­fi­cult.

Com­mu­ni­ca­tion and sup­port are


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