30
MAKING A POSITIVE CHANGE:
Wo m e n ' s Health
Painful sex related to menopause: common and curable By Dinah Olson, PA
S
ex, like so many issues life brings us, can be complicated. It can be fun, relaxing and so many other great things. But physical changes associated with menopause commonly cause sex to become uncomfortable or painful. Fortunately there are treatments available. Before we look more at the physical changes of menopause, it’s important to acknowledge how complicated sex can be. A lot goes on ‘above the belt.’ Sexual health, personal experiences, level of interest, enjoyment all vary wildly across people.
For some people their sex lives hold a place of high importance. For others it plays a much lesser role. And that role will likely change over the course of our lives. Our attitudes about sex, feelings about our sexuality, body image, physical health, emotional stressors all change over time. And then there are relationships issues. We may have long term sexual partners, brief relationships or sometimes no relationship at all. Even in a healthy longstanding relationship challenges come and go. Stressors related to finances, jobs, children, health concerns occur and these issues invite themselves into the bedroom. The point is that sex is complicated because so many factors are at play. That said, there are very common, purely physical changes that may result in decreased enjoyment of sex and sexual function that occur as women age. These changes occur around the time of menopause when a woman’s ovary function decreases and results in decreased levels of the hormone estrogen. Changes associated with lower levels of estrogen are usually noticed gradually.
September 2020
Some women may start to notice changes as early as their early 40s and others may not notice changes until their late 50s. Some women are severely affected and others may experience mild symptoms. The physical changes that occur with lower estrogen levels can significantly impact how you feel about and experience sex. The desire for sex, known as libido, may fall. The tissue that lines the vagina may become thinner, less lubricated, more easily irritated and even tear. Women may experience sensations of vaginal dryness, burning or itching. This can make sex or masturbation very uncomfortable. The skin of vulva (the area outside the vagina) may similarly become less robust and women may experience increased irritation or itching in that area as well. Our lower urinary tract (the bladder and urethra) may also be affected by lower estrogen levels. Some women experience urgency of urination, leakage of urine, painful urination or increased frequency of urinary tract infections. It is not surprising that these changes can make sex less enjoyable or downright painful. These physical symptoms associated with lower estrogen levels are now referred to in the medical literature as genitourinary syndrome of menopause (GSM). The good news is GSM is a
A Decade of A Circle of Red Edition
