Embracing Intimacy: Navigating Sexuality Through Menopause

Menopause marks a natural transition in the lives of those with a uterus, signaling the conclusion of reproductive capabilities. Accompanying this are a myriad of physical and emotional adjustments which can influence sexual health and pleasure. A key physiological shift is the reduction of hormones such as estrogen and progesterone. In a conversation with Dr. Kirstie Cunningham, a menopause expert and certified OB/GYN, we delve into how these hormonal fluctuations during menopause can impact one's sex life and the proactive measures that can be taken.

Understanding Hormonal Fluctuations

Estrogen and progesterone are pivotal in the reproductive process, and their decline during menopause can lead to symptoms like vaginal dryness, diminished vaginal blood flow, a decrease in sexual desire, hot flashes, and mood variations.

"Libido, hot flashes, brain fog, and low energy are the most common concerns my patients express," Dr. Cunningham shares. "These issues are particularly challenging for women who are in demanding careers, as they may experience a notable decline in cognitive functions, impacting their professional performance." She continues, "Libido is crucial as it can significantly affect personal relationships, sometimes to the brink of divorce. The drop in estrogen can cause vaginal dryness, making sex uncomfortable, which can lead to a cycle of fear and avoidance of sexual activity."

Dr. Cunningham emphasizes that these changes are often linked to hormonal alterations and that with appropriate treatment, many women see improvements in their relationships.

Initiating the Conversation Early

There's often confusion between perimenopause and life after menopause. Menopause typically occurs at 51 in the United States, with many experiencing symptoms up to a decade prior. Dr. Cunningham advocates for discussions about menopause to start in one's 30s or even earlier, noting that about 1% of women experience premature menopause. She shares her own early menopause symptoms, which she encountered in her 20s.

"As testosterone levels drop during perimenopause, libido may wane as well," Dr. Cunningham explains. "However, not everyone is affected, and for those who are, treatments like bioidentical hormone therapy and the O-shot, which addresses stress incontinence and orgasm disorders, can be beneficial." The O-shot, consisting of plasma and platelets, is injected into the vaginal wall and clitoris after blood is drawn and processed, all under the comfort of numbing cream for a pain-free experience.

Strategies for Sexual Wellness During Menopause

• Embrace lubricants: They can alleviate vaginal dryness and enhance comfort during sex.
• Open dialogue: Communicate candidly with your partner about the changes you're experiencing and discover new forms of intimacy.
• Self-care prioritization: Self-care is crucial for health during menopause. This includes a balanced diet, regular exercise, and stress management.
• Reliable information: Seek out credible sources such as the NIH or CDC for accurate menopause information. You can also follow experts like Dr. Cunningham on social platforms to broaden your understanding.
• Professional guidance: Reach out to healthcare providers for support. Not all have the same level of menopause training. The North American Menopause Society (NAMS) certifies physicians in this field. Visit their website to locate a certified menopause specialist near you.

Though hormonal changes during menopause can affect sexual health and satisfaction, a myriad of interventions exist to help women preserve their sexual wellness at this stage of life. With the proper attitude and proactive strategies, it is entirely possible to continue enjoying a gratifying sex life during and after menopause.