First, the good news: No matter how you feel right now, there is sex after early menopause. Good sex. Satisfying sex. Sex like you used to have!
But often, especially in the beginning stages of premature ovarian failure or early menopause, sex is a problem. It may be painful for you.
Your libido might be lagging, or virtually non-existent. Or it might just be that you aren’t in the mood because you feel so depressed.
As you can imagine, this definitely has repercussions in your relationship. Your partner often can’t figure out what is happening — and may feel angry, upset, or all of the above. Or indeed you may feel that way, as though sex will never be a part of your life again.
But there is a way to cope with this often difficult problem — a way to work things out with your partner and to enjoy sex again.
First, let’s look at the physical side of things.
As you’d expect, hormones are often the culprit where both discomfort during sex and low sex drive are concerned. When your estrogen levels drop, often your vaginal tissues dry and become less elastic, making sex painful.
You may even get vaginal atrophy — a condition in which the vaginal tissues constrict and your vagina actually gets smaller, again leading to pain during sex.
Needless to say, this also can affect your desire to have sex. If you’ve gotten accustomed to the idea of discomfort during sex, it definitely can make you less inclined to want sex or enjoy it.
In addition, low estrogen and testosterone levels can definitely have an impact on your sex drive. You’re just not in the mood any more… and the idea of watching late night television seems a lot more enticing than having sex with your partner.
But — this doesn’t have to be the end of the story!
How Can You Make Sex Enjoyable Again?
• Probably the most significant and helpful thing you can do is go on hormone replacement therapy (HRT). Raising your estrogen levels will replenish your vaginal tissues — and the discomfort you may have been feeling should disappear. However, your doctor is the best person with whom to discuss all the pros and cons of HRT.
• In some cases, if you go on regular HRT and find that you are still experiencing discomfort, you might benefit from using an estrogen cream — a cream form of estrogen directly used in the vagina. This won’t raise your blood levels of estrogen markedly, but will greatly help the vaginal tissues.
• Consider using vitamin E capsules as vaginal suppositories. Just insert the softgel capsule right in your vagina… and that’s that! The Vitamin E helps with dryness and discomfort — along with the common symptoms of vaginal atrophy (source).
• Talk to your doctor about testosterone supplementation. This hormone is getting more and more attention lately for younger women going through premature ovarian failure (POF), early menopause and surgical menopause. It is thought a low libido can sometimes be traced to low testosterone levels — so adding testosterone to your HRT regimen may make a difference.
Also, check our symptoms helpsheet for lots more information and suggestions for coping with vaginal dryness.
Okay, so that’s a very quick rundown of how to take care of the physical side of things. All well and good, but what about the emotional side of this journey — particularly if you aren’t on HRT yet and are still going through the whole diagnosis and treatment process.
How can you — and your partner — cope with the changes you’re going through? The best thing to do is the most obvious thing of all, but sometimes the most difficult: explain.
This is no time to be shy. If you are having problems with sex, the worst thing to do is say nothing. Going along with sex when you’re not enjoying it can breed resentment and lead to bigger problems. By the same token, not having sex, but not explaining why can cause misunderstandings and problems as well.
Before I went on HRT, I found sex uncomfortable. Added to the discomfort, was the fact that premature menopause had made me feel distinctly undesirable. I felt old, fat, and generally unsexy.
So I found that I wasn’t interested in sex. I’d try to avoid it, or hope to get it over with quickly. Eventually, I realized that by saying nothing, I was hurting both myself and my husband. So I told him about my discomfort and about my terrible self-image.
I also explained that it wasn’t that I had lost interest in him, it was me. By opening up to him and explaining what I felt — physically and emotionally — we were able to work through the sexual problem and strengthen our relationship.
Sex is an important part of a relationship — so it is important to let your partner know how you feel, what you need, and what you want. By the same token, talking openly with him will enable you to learn about his feelings… which can help you enrich your sex life in the long run.
The Emotional Side: Talking To Your Partner About Early Menopause
• Be assertive. If you find that you need more foreplay to be adequately lubricated, say so. If certain positions are more comfortable than others, explain which ones you’d rather try. Even if you’re not used to talking about this or of taking charge, remember that you’re the only one who knows what feels good and what doesn’t!
• If you are feeling undesirable and unsexy, let him know. Your partner doesn’t necessarily know what’s going on in your head. In fact, chances are that, from his perspective, you’re the same woman you’ve always been.
But often this physical change has caused your self-image to founder. You may need reassurance about your sexuality and desirability. Instead of feeling this way, explain to your husband that now, more than ever, you need to know that you are loved and attractive.
A little love goes a long way to erasing the self-doubts that may have arisen since you entered premature menopause.
• Encourage your husband to talk about his feelings about sex as well. Communication is, of course, a two way street. And often your partner may be feeling a bit neglected or upset if you aren’t as interested in sex as you used to be.
You may also find it useful to read our helpsheet on working together with your partner. It contains tips and information on getting the most from your relationship(s) after your early menopause diagnosis.