Menopause and Sex

Menopause and Sex

Improving Sex into the Golden Years

I remember when I turned forty years old I was excited and proclaimed true adulthood. I went to bed and woke up sore! I didn’t party last night and I know for sure I didn’t go rock climbing. So why in the heck am I so sore after waking up from what I thought was going to be a great night of sleep. I called my favorite aunt and asked her the same question. She started laughing and stated, “you’re just getting old”, and as a matter of fact, now laughing so hard I thought she was crying, she belted out “wait until sex changes!” It is true, sex does change just as the years of your life change with the seasons. Ongoing sexual pleasure and activity as one ages requires planning, education, attention to detail, and maintenance. So what do we do about it? Do we accept it as the norm? Do we need to explore, educate, and empower ourselves to “get it back”?

In this blog, I’ll give you specific advice for maintaining vulvovaginal health geared toward continuing pleasurable sexual activities.

Menopause is defined as the cessation of menstrual cycles for one year. Not only do cycles stop, but estrogen levels also decline and testosterone activity plummets. This transitional period leads to hot flashes, sleep disturbances, skin sensations that decrease one’s desire/motivation to be sexual, and struggle to remain focused during sexual experiences. Needless to say, all these changes seem to occur at the same time as the “old man” has found Viagra and a men’s clinic for testosterone replacement. Well, guess what? The vagina loves the hormone estrogen! Those of you that have born children may remember how “juicy” and expansible your vagina was during pregnancy. This was due to the heightened levels of estrogen circulating through your bloodstream. Pregnant or not, when you were younger estrogen and testosterone were abundant. With aging, estrogen and testosterone levels exhibit a slow and steady decline. Those postmenopausal women not receiving systemic estrogen therapy or intravaginal and perineal topical estrogen leads to vaginal changes that can make sexual activities difficult at best and unthinkable for many.

Happy couple

There are many topical and systemic estrogens that can be used. In particular, I feel transdermal and bioidentical hormones, whether it be a cream, medication applied directly to the vagina, or hormonal pellet should be used over those estrogens or testosterone given orally. Therefore, women and their health care providers should be educated about the physical, sexual, and psychological benefits of local topical, as well as systemic, estrogen therapy.

I am often asked, “Do I have to do hormones first?”, “Is there something I can do before taking that leap?” Yes, of course, I call it “liquid lovemaking!” Or you might call them moisturizers and lubricants.

Moisturizers maintain the vagina and lubricants are for lovemaking. Drink plenty of water! I recommend at least eight, eight-ounce glasses of water each day. This small all-natural intake can be so powerful. Haven’t you heard the phrase our bodies are 70% water!? Another alternative is Luvena. This option is a combination of a vaginal moisturizer and lubricant in one. This can be purchased at a local pharmacy over the counter or via Amazon. A regimen of regular moisturizers increased hydration, and on-demand lubricants will surely help to regain and retain vaginal moisture and keep sex pleasurable rather than painful.

Now on to more novel therapies for vulvovaginal atrophy, painful intercourse, obstinate atrophy not amenable to estrogen therapy, or in women declining to utilize estrogen therapy. What we do know is that estrogen and testosterone play a vital role in increased vascular flow, collagen growth, and greater sensory nerve experience. Collagen is a protein that makes your skin firm and elastic. The natural aging process can diminish collagen. When the vagina has less collagen it can lose its youthful appearance and its ability to withstand the stamina of intercourse. Femi-Lift is a physician controlled, fractional CO2 laser, non-surgical treatment that stimulates and re-builds your body’s own collagen naturally. Femi-Lift rebuilds collagen and increases blood flow, which in turn provides a greater sensory nerve experience, greater vaginal moisture, vaginal tightening, and can help with mild to moderate urinary incontinence. It is my hope that you found this blog to be educational and empowering and lets you know we can “get it back and keep it”!