Doctor K: Hormone drop can affect sex life

DEAR DOCTOR K: I have recently entered menopause. Can you discuss how menopause might affect my sex life?

DEAR READER: As a woman approaches and enters menopause, her ovaries gradually make less and less of the hormones estrogen and progesterone. The drop in these hormones – of estrogen in particular – can affect how a woman experiences sex.

Estrogen stimulates the growth of breast tissue. It maintains blood flow to and lubrication of the vagina. The decline and eventual end to estrogen production provokes a host of symptoms. These include hot flashes, fatigue, vaginal dryness and loss of libido. Many of these changes can have unwanted effects on a woman’s sex life.

Other physical changes also take place, to varying degrees, as a woman enters menopause. For example, as a woman gets older, blood flow to her genitals decreases. She will experience a thinning of the vaginal lining. Her vagina will lose muscle tone and become less elastic. These changes can make sex more painful and less enjoyable.

A woman may have less sexual desire, or fewer sexual thoughts and fantasies. It may take longer to become aroused.

Orgasm may become less certain. It may take longer to achieve orgasm, or it may not occur at all. When it does occur, it may be less intense. Finally, as a woman gets older, she will return more quickly to an unaroused state.

Does this mean the end of a fulfilling sex life? It certainly doesn’t have to. For some older couples, fewer inhibitions and a deeper understanding of their needs compensate for the physical consequences of aging. And these physical changes can provide an impetus for developing a new and satisfying style of lovemaking – one that’s based more on extended foreplay and less on intercourse and orgasm.

The physical changes can be reversed or reduced with vaginal lubricants and moisturizers, or hormone therapy (cream, not pills).