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Video: Menopause and your sex life

TODAY contributor
updated 5/27/2008 10:28:12 AM ET 2008-05-27T14:28:12

Nothing strikes fear in the hearts of women like the thought of menopause. The shifting hormone levels that are associated with “the change” can lead to everything from mood swings, insomnia and weight gain to decreased sex drive. However, despite the common dread most women have for this time, the truth is that menopause does not have to be the end of the world … or the end of a woman’s sexuality. As long as women are educated about the changes occurring in their bodies, they can easily treat the symptoms of menopause and continue enjoying their lives to the fullest.

Menopausal symptoms first begin as estrogen levels decrease in a woman’s body. As a result of this decline, a range of physical and emotional symptoms can occur, including sleeplessness, moodiness/mood swings, low desire, mild (or sometimes major) depression, vaginal dryness and difficulty with sexual response. Lower estrogen levels also cause hot flashes, which are extremely upsetting and uncomfortable and often interrupt sleep. Lower estrogen levels also contribute to a weakening of the pelvic floor, so women often experience incontinence (when they cough and sneeze) as well as lowered sexual response. 

In addition to these physical woes, many women find that menopause is also a time in their life when they encounter many changes in their environment. For instance, some women might find themselves facing an empty nest as the kids go off to college, while other women become part of the “sandwich generation” (in which they care for young kids and aging/ill parents simultaneously). Furthermore, menopause can also encourage women to take stock of their lives … and for some women, they might find that they haven’t accomplished everything for which they once hoped. It is a difficult time, particularly since there are very few positive role models of older women in the media or in society.

Not only are there few positive role models, there are also few sexual images of women after they reach a certain age. In our ageist society, it seems that sexuality excludes older women. Indeed, some women view menopause as the end of their sexuality. Not so! It is merely the end of fertility … which can actually be quite liberating for women who have been grappling with birth control side effects and menstrual pains for the last 40 years. A newfound freedom can be part the menopausal journey, as long as women are encouraged to embrace their sexuality and independence at this time. Think about it: No more worrying about kids walking in on you and your husband’s “alone time,” no more stressing about getting your period on vacation, no more cramps or killer migraines. 

This is not to say that menopause does not come with its own unique set of physical woes, but thankfully, these can be abated with a few treatments. First, pay attention to your body’s changes, and don’t sweep fears or concerns under the rug. Make sure you talk to your doctor about your symptoms — don’t just dismiss your suffering as part of being a woman. Unlike when our mothers and grandmothers were enduring menopause, there are now many exciting new treatments out there for menopausal symptoms. There are a few nonhormonal treatments, such as gingko biloba (for mild hot flashes) and “wick-away pajamas” (which are designed to “wick” away sweat from the body to prevent hot flashes at night). Pelvic floor or core work (Kegel exercises, yoga, Pilates) can help with pelvic floor strength. There are also topical estrogen treatments that are considered safe for women to use for dryness and reproductive health. 

In addition to these tried-and-true methods, there is also a new pilot study that has just been published in the Lancet on the stellate ganglion block. It’s being done by a doctor of anesthesiology out of Chicago, Eugene Lipov. Stellate ganglion block is an anesthetic injection in the neck that basically reboots the insular cortex of the brain — the part of the brain that is responsible for temperature regulation. Findings show that it alleviates hot flashes and sleep deprivation for anywhere from three months to longer. They found that the treatments also seemed to improve sexual function and desire, probably because of the proximity to the amygdala of the brain (the sexual center of the brain) and also because patients are getting more sleep and are more comfortable. 

Thanks to modern medicine and good health practices, our life span is getting longer and longer and we can live a healthy, happy and vibrant sexual life for many years beyond menopause.

Dr. Laura Berman is the director of the Berman Center in Chicago, a specialized health care facility dedicated to helping women and couples find fulfilling sex lives and enriched relationships. She is also an assistant clinical professor of OB-GYN and psychiatry at the Feinberg School of Medicine at Northwestern University. She has been working as a sex educator, researcher and therapist for 18 years.

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