Menopause does not mean your pleasure is paused
How can perimenopause and menopause affect my sex life? When does this happen and what does it look like?
Any change in our lives - particularly when it comes to how our bodies and brains are functioning - can impact how we experience, pleasure, sex and relationships.
Perimenopausal symptoms develop over a number of years, marking the transition out of our menstrual phase, with periods becoming less frequent until they finish entirely before we reach menopause. This is an important, natural process of hormonal changes experienced by half of our population.
Many of us do not have access to the relevant support, research and education that would allow for a smooth and empowering transition through menopause. Some cultures celebrate this powerful period through ceremony, gifts and support, while many women in Ireland are sadly expected to put up and shut up, particularly when it comes to sexual satisfaction.
We know that menopause impacts people differently depending on genetic, biological and hormonal make-up, as well as lifestyle, financial freedom and support network. Hormonal changes can affect psychological and emotional processing for some people. It can also impact what’s happening physically, so we may see our weight distributed differently on our body, muscle mass and bone density may reduce, or we may notice the colour, shape or sensation of our vulva changing. There are therapies and treatments to help us adapt and thrive, but of course when we don’t know what’s causing these changes or when we are not able to communicate our experience to those around us, it can leave people feeling very isolated and lower our confidence.
While the needs of every person will be different - for example, Hormone Replacement Therapy will suit some, while others will thrive solely with lifestyle changes or herbal treatments - we can all benefit from increased education about our bodies and from practicing healthy communication of our needs. Menopause is finally becoming a point of public and political discussion and in the coming years my hope is that it becomes the new norm for everyone - our partners, family, friends, employers, healthcare providers and political representatives - to understand and practice informed, supportive approaches in their personal and professional relationships with those approaching menopause.
The age that people start to experience perimenopausal symptoms can vary widely from 30s to 50s. However those with particular genetic make-ups, or those who undergo particular surgeries or medical treatments, even in their teens and 20s, may experience induced menopause. Several of the cancer patients and survivors who contributed to my upcoming project SCI (Sex - Cancer - Ireland - www.sciprojectireland.com) experienced induced menopause. They were not given appropriate support or information from their healthcare providers regarding changes in their sexual relationships, sexual desire levels, changes in physical sensation, vaginal dryness and thrush. Sexual satisfaction continues to be wrongly treated as an afterthought when it comes to our overall health.
What can I do to improve my sex life?
Knowledge is power. We’ve generally come to associate sex education with being young and being in peak physical health. This idea that sex education is only relevant for certain demographics needs to be done away with. Our bodies, our sexual functioning, and our experience of sensation and pleasure will all change throughout our lives and it is important to our health and wellbeing that we are up to date with what’s going on in our body.
Some people never get to access that knowledge and peer support with others because of the myth that has been ingrained in to many of us, that wanting sexual pleasure and intimacy is only acceptable if you’re young, or thin, or male, or able-bodied. The restrictions we place on who is ‘allowed’ to be sexy and sexually satisfied is often decided by cultural influences. Reflecting on your beliefs about women, bodies and sex is key to recognising any restrictive attitudes you may have inherited about yourself as a sexual being.
Many women experience dismissive responses from their healthcare providers when expressing a desire to maintain or boost their sex life after middle-age. It’s a total disservice to women that there is not more support for what can be, for some, a crucial element of their wellbeing, identity and relationships. We all deserve to safely enjoy our body regardless of what age or stage we are at in life. If sex is important to you and your GP is not open to discussing safe options to support your sexual functioning or sensation, try to get a second opinion. This is surely easier said than done when people are struggling to get appointments, not to mind pay for them. But there are other resources available - in Cork, Lucy Kenefick just launched the Nume Collective which has a directory of professionals and services focused on menopausal health.
For some people lubrication becomes very important if vulvar skin is becoming thinner or the vaginal canal is reducing in size. Brands such as ‘Sutil’ and ‘Yes’ are best for supporting your sensitive skin. You can buy them on sexsiopa.ie and Shawna Scott, the owner of Sex Siopa can advise you on sex toys too whether you’re a curious first-time buyer or seasoned toy user. Suction toys like the Satisfyer brand are often handy for anyone with increased sensitivity or pain in the vulva - they focus externally and emulate the sensation of oral rather than anything penetrative. But there’s all kinds of devices and (literally!) different strokes for different folks.
For anyone experiencing difficulty with penetration and wanting to practice without pressure, you can buy dilators at various sizes which you can practice using at or in the vaginal opening, at your own pace. You can also get those on sexsiopa.ie. Orlagh Reid (@thewellbeingpsychotherapist on Instagram) runs online meet-ups for people experiencing vulvar pain (including vaginismus) and I co-facilitate some of these with her. Attendees discuss valuable tips and shared experiences about supporting their bodies, while Orlagh and myself offer information on mental wellbeing, pleasure and healthy relationships.
Unfortunately most of us have learned to prioritise penis in vagina sex as the gold standard. But it’s really just one way to experience pleasure, and actually most women won’t reach full arousal from penetration alone. I run my own sex education workshops for adults as part of the Sx Sláinte project which I founded last year, and at those I always recommend coconut oil for full body massage - the extra virgin coconut oil from the cooking aisle in the shop does the job! You can practice taking away your focus away from the genitals entirely. Pleasure and pressure can not co-exist - our bodies need to feel relaxed and safe in order to really benefit from touch. Many women and people with vulvas will need well over 25 minutes for their body to reach a state of full arousal so taking it slow is a game-changer. Old habits die hard so this may feel alien at first but its worth developing a self-pleasure practice that focuses on relaxing and appreciating your body in its entirety, and prioritising pleasurable sensation rather than climax or penetration. And remember - if you’re using condoms you need a water-based lubricant so put down the coconut oil for those sessions!
Being able to share with a sexual partner what suits us and what feels good is the next thing - if we’re not confident with putting it in to words, we can physically show them, if they want us to, with their hands or our own! If you are re-discovering yourself sexually it’s usually best to mention that in a neutral, unsexualised setting with a partner - for example if you’re telling them you want sex to include different kinds of touch other than penetration, or you’d like to try lube or a toy, it could be helpful to mention that when you’re on a walk or having a cup of tea rather than when you’re half naked! Change can be uncomfortable and there is a good chance our partners won’t have received adequate education on sex or menopause either, so let your conversations about sex be ongoing, honest and caring explorations of what you’re both open to for the next time you’re being sexually intimate.
