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How can menopause affect your sexual health, and what are some ways to manage those effects? |
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The decline in estrogen and other hormones, such as testosterone, during menopause can lead to a range of physical and emotional symptoms that affect sexual function. One of the most common is vaginal dryness, which occurs as estrogen levels drop and vaginal tissues become thinner, less elastic, and less lubricated. This can lead to discomfort or pain during sex, a condition that, if left untreated, may worsen over time.
Many menopausal people also report decreased sexual desire, arousal difficulties, and changes in orgasm intensity. These shifts can be exacerbated by emotional factors like anxiety, mood changes, and body image concerns.
Genitourinary syndrome of menopause, which includes both vaginal and urinary symptoms, may affect more than 50% of people experiencing menopause and is a leading contributor to sexual dysfunction. Relationship dynamics and age-related changes can further contribute to these challenges.
There are many effective strategies to help manage these changes. Over-the-counter lubricants can help relieve vaginal dryness during sex, while vaginal moisturizers can be used regularly to maintain vaginal health and comfort. For those with more persistent or severe symptoms, localized vaginal estrogen therapy is considered the first-line treatment and is available in creams, tablets, or rings. These therapies are generally safe for most people. Systemic hormone therapy may offer modest improvements in sexual function, particularly in people also experiencing hot flashes or night sweats, though its risks and benefits should be carefully reviewed with a healthcare professional.
For a lack of sexual desire, off-label low dose transdermal testosterone may be considered using the lowest effective dose and regular monitoring.
The International Menopause Society encourages a biopsychosocial approach to sexual health, combining medical treatment with psychological and relationship strategies. These include:
- counseling and psychological support, such as cognitive behavioral therapy (CBT) and sex therapy
- strengthening the pelvic floor through physical therapy to improve arousal and orgasm response
- lifestyle changes, such as regular physical activity, a balanced diet, and stress management
Equally important is maintaining open communication with a partner about sexual needs, concerns, and comfort. This can help build intimacy and reduce the emotional distance that may arise during this transitional period. Menopause does not have to signal the end of a satisfying sex life. With knowledge, support, and individualized care, you can continue to enjoy sexual wellness and intimacy throughout midlife and beyond.
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| Do you have any questions for our menopause experts? Let us know at menopause@healthline.com, and the answer may be featured in an upcoming edition! |
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| HEALTHY TIP |
| Ingredients to avoid in personal lubricants |
- glycerin, which can cause yeast infections
- parabens and fragrances, which may irritate sensitive skin
- propylene glycol, which may cause irritation or allergic reactions
- sodium lauryl sulfate, which can disrupt the natural balance of bacteria in the vagina, potentially causing irritation or infection
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