Heading Off The Changes Menopause Makes In The Bedroom

menopauseThe word menopause was coined by a Frenchman from Greek words that mean, roughly, “end of monthlies.” However, it has come to stand for the full spectrum of emotional and physical changes that are brought on when the ovaries stop functioning. In Hormones, Hot Flashes and Mood Swings: Living Through the Ups and Downs of Menopause, Dr. Clark Gillespie asserts that a woman can not only live through, but enjoy, these changes.

Regarding sexuality during menopause and beyond, Dr. Gillespie finds that “if both partners understand the age-related changes that normally take place at mid-life, they will be more likely to prevent serious sexual and marital problems down the line.” In his chapter “The Menopause and the Bedroom,” Dr. Gillespie outlines these changes and suggests methods for coping with them.

Menopausal women can expect several changes that normally take place as time goes by. For example, a woman’s sex drive often rises somewhat at menopause as ovarian estrogen levels drop while androgen (a malelike hormone) levels persist. This is not always the case and certainly not true if the menopause has been surgically induced and the ovaries are absent. Sexual desire continues in women (but at decreasing levels as the years go by), and is not at all unusual in women in their seventies and eighties.

Testosterone is available for those women who suffer from a significant loss of sexual drive during and after a natural or surgical menopause. Proper dose levels of this male hormone — in combination with estrogen — will generally prevent excess hair growth and other masculinizing effects. Regular medical monitoring and dose adjustment is necessary.

Excitement and arousal, which are usually marked by vaginal lubrication and swelling, also change. Sexual arousal now often requires more foreplay and local stimulation; indeed, without hormonal replacement therapy (HRT), natural lubrication may not be possible. In addition, if HRT is absent, vaginal skin atrophy occurs and leads to painful intercourse along with many other local discomforts.

Orgasm continues but “time-to-orgasm” may be lengthened without HRT. Menopausal and post-menopausal women may continue to experience multiple orgasms as before.

Yet there are several other factors in your new sexual equation. First, what about him? If he is your partner of long standing and about your age, his sex drive started declining several years ago and will diminish more rapidly than

Some special situations may affect the ways in which you express your sexuality. For instance:

* May-December relationships require special attention. If your loved one is much older than you, it is necessary that you make generous allowances for his sexual limitations which, as you are aware, are real and progressive.

* May-December relationships require special attention. If your loved one is much older than you, it is necessary that you make generous allowances for his sexual limitations which, as you are aware, are real and progressive.

* A snoring issue can severely limit sexual drive. The exhaustion that comes from interrupted sleep is a real issue, as is your partner’s mindset towards the snoring. A stop snoring mouthpiece can help.

* If your spouse becomes permanently impotent because of medical or other reasons, and if it is the wish of both partners, penile implants are now a reasonable solution. However, without any help, many older men remain sexually active and erectile well into their eighties.

* Now, then, the reverse. A much younger husband, biologically, should be the ideal sexual companion for a mid-life woman. That is probably the case, although we do not have the statistics to prove it. What is proven, though, is that the non-sexual complications of this kind of relationship are difficult to maintain.

* Surgical or radiation treatment. The latent time between successful orgasms increases so that by age 60, male orgasm cannot be repeated for about two days. This is sharply different from the female’s experience. While testosterone medication will increase men’s drive somewhat, it does not increase their erectile or orgasmic ability.

It is clear that many diseases can and will hasten the usual aging changes in sexual activity of both men and women. Diabetes, high blood pressure, obesity, arthritis and heart disease are common medical obstructions to sexual pleasure. Men who have suffered one heart attack often fear that sexual activity may induce another one. That for cancer of the breasts or of the uterus can have profound effects upon future sexual activity. As you already know, hormone replacement cannot be given for at least five years after arrested cancer of the breast or the uterus. Thus the vagina becomes dry and painful and sex drive is diminished. Some physicians will give oral testosterone or vaginal estrogen creams, but most fear the consequences in the patient — or in court.

Removal of a breast or other massive disfigurement of the sexual organs has a very understandable emotional impact. Fortunately, in almost every community, there are now support groups made up of women who have sustained ostomies and mastectomies and destructive vulvovaginal surgery, and who very successfully counsel others who join their support group. In most instances, adequate professional counseling and the judicious use of hormones will alleviate the most distressing circumstances. Partners can be instructed in a variety of loving techniques as time heals the psyche. understandable fear may decrease the level of performance, even though studies indicate sexual exertion to orgasm is the exercise-equivalent of walking up one flight of stairs. It is worth noting, though, that 70 percent of the sex-related heart attack deaths occur during an extramarital event!

Many of the medications necessary to maintain reasonable health at mid-life act as sexual depressants. These include drugs for anxiety and depression, heart disease, high blood pressure and fluid retention. Sedatives and many others also have this effect. The only valuable medications for women, sexually speaking, are the sex hormones — HRT.

Alcohol abuse is a serious and common cause of sexual dysfunction for both sexes.

The last, and perhaps most important, factor in your new sexual equation is the quality of your partnership. This is really the key to a rich — or barren — sexual life. All of the factors noted above, taken together, depend upon the depth and stability of the union along with an understanding of the changes that accompany aging. An unstable relationship filled with pent-up angers and frustrations will surely fly apart at this time. A healthy, mature, growing relationship will be able to explore more erotic and sensual sexual depths than ever before.


Remember what you just read, particularly two things: first, your same-aged mate will likely be undergoing a decline in sexual drive more rapidly than you. Second, this is particularly true if you are being supported by HRT and he is not. At the present time, HRT (testosterone, in this case) is not generally recommended for men.

If both partners understand the age-related changes that normally take place at mid-life, they will be more likely to prevent serious sexual and marital problems down the line. Thus, as an example, if you both understand that it now takes direct stimulation of his genitals (orally, mechanically, thermally, digitally, or whatever it takes) in order to produce an erection, then no one’s feelings are hurt. You don’t feel you’ve lost your appeal and he doesn’t feel that sex as he knew it is over.

On the above basis, minor sexual problems can generally be worked out at home in bed. Major sexual problems that occur at this time are generally a result of serious disorders in your relationship and require professional sex and marriage counseling.

Vaginal penetration is neither the beginning nor the end of sexual love-making. It sometimes cannot be accomplished — at any age. Shared intimacy, sensual pleasure, holding and caressing are often equally meaningful and enjoyable.

Sex should not be performance-oriented, but rather pleasure-oriented. For both of you. Together you should seek an erotic arousal environment, comfortable to both, with no demands and only the exploration of new pleasures.

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