Sex and the menopause
WOMAN - UK|July 27, 2021
The taboos around intimacy, women’s pleasure and sex as we age can mean that women are less likely to ask for help so we need to keep talking about it
DR PHILIPPA KAYE

I see many women in my surgery with symptoms related to the menopause; everything from hot flushes to joint pains, the menopausal brain fog to mood changes. And yet until I bring it up, they rarely mention the topic of sex. Sex and intimacy play an important part in many people’s lives irrespective of age,and regular sex and orgasms, be they solo or with a partner boost mood, help sleep and relaxation as well as being a form of physical activity with all the health benefits that that involves and boosts your immune system, too. Added to that, sex is not simply about sexual gratification but plays an important role in intimacy and relationships.

Sex drive, or libido, is complicated and involves both physical and psychological factors. For example, if you are physically unwell with a cold or a headache, you don’t want to have sex; if you feel low or sad you don’t want to have sex; if intercourse hurts, you won’t have the drive to have sex, or if there are problems in your relationship your sex drive might drop. And quite often, there will be a combination of issues.

‘Sex plays an important role in intimacy and relationships’

Menopause is defined as the last period. However, you can have symptoms in the years leading up to the last period and for many years afterwards. These symptoms are related to the change in hormone levels,and the menopause can be thought of as a long-term oestrogen deficiency state. There are receptors for the hormones oestrogen, progesterone and testosterone all over the body including the brain, not just in the genitals and reproductive organs, so if all the levels of these hormones fall you can get symptoms all over the body. Even before we consider the impact of the hormones themselves on your libido, any other menopausal symptoms can affect your sex drive. For example, hot flushes, fatigue, irritability and joint pain – which are all due to oestrogen deficiency – may well mean that your libido falls.

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