Sex and the middle-aged woman

Published in Blog by Marian O'Connor on February 20th 2019

How our Psychosexual therapy expertise helps with female desire in mid life and beyond.

A journalist from 'The Telegraph' phoned me last week to ask how the menopause affected women’s sexual functioning. As always, when it comes to sex, there is no straightforward answer.

Body, mind, emotions all affect one another, so that a menopausal woman who has recently divorced and embarking on a new love affair may find that her sexual desire has reawoken and that she is experiencing the best sex of her life. Another who is sitting across from her partner of thirty years who is slumped in his armchair with a bag of crisps, a pint of beer and a scowling expression may feel that sexual interest and passion is a distant memory.

We can’t blame a lack of sexual interest solely on the menopause when so much else might be going on in the life of the average 50 plus woman. Nevertheless, there are hormonal and physical changes which can affect women’s sexuality at this time of life.

The loss of oestrogen and testosterone can lead to women feeling they are less easily aroused or that their orgasms are less intense. Although a drop in testosterone levels may lead to less sexual interest in some women, studies show that boosting testosterone levels does not generally lead to increased desire. As in the example given at the beginning of this blog, when the testosterone comes in the form of a new lover (male or female) there is likely to be a resurgence of sexual desire.

Lower levels of oestrogen do cause a drop in blood supply to the vagina and this can affect vaginal lubrication. In such cases, it is highly recommended to use a lubricant. Unfortunately, because the menopause is often not talked about or seen as a shameful secret, many women are unwilling to talk to their partners about their need for extra lubrication and instead will say no to sex, as a dry vagina leads to uncomfortable sex. The thinning of the skin around the labia also means that clitoral stimulation and foreplay may need some changes. A conversation and a tube of lube can really help in all these cases.

Some women have problematic menopausal symptoms which may require a visit to the doctor to find out whether medication or hormone treatment is required. They may feel lethargic, depressed, suffer from hot flushes, sleep disturbances, bladder problems, dermatological complaints or weight loss. Again, being able to talk about these problems with a partner and not seeing them as a shameful secret can empower women, making them feel less overwhelmed, more confident, and able to ask for appropriate sexual touch and stimulation rather than shutting down completely from all sexual pleasure.

The menopause does not mean having to say no to sex. It does not even mean putting sex on pause until a woman is out the other side. For some women the menopause can be liberating and lead to new sexual discoveries and adventures. For many, though, it may mean changing sexual practices and learning to discuss preferences with their partners. At Tavistock Relationships psychosexual therapists, who are trained in both relationship and sex therapy, can help individuals and couples, both gay and straight, through this phase of life.

Where can I get help?

We offer a psychosexual service. You can read more or book an appointment here.

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