Dr. Rob

The sexual response changes over time. While the early sexual years may be on remote control with a high speed connection, the personal touch may elicit a better response during the menopausal years. Through caring, consistency, time and sensitivity, the sexual response may yield a deeper, more intimate and total mind/body experience.

That said, it is important to know that aging doesn’t always mean we lose interest in—or the ability to enjoy—those pleasures that are personally fulfilling. So let’s dispel some of the myths of sex and menopause.

MYTH: Reaching menopause causes most women to lose interest in sex.

FACT: Not true. Loss of libido (sexual interest and desire) can affect pre- as well as post-menopausal women. While many factors are involved (state of relationship, age, medications, illness, others), one of the best predictors of a women’s post-menopausal sexual interest is her activity and sexual satisfaction prior to reaching menopause.

MYTH: As a woman’s reproductive hormone levels drop, so does her sexual activity.

FACT: Sexual activity is not just based on hormonal levels. Case in point: Despite having high levels of sexual hormones a woman may have zero sexual interest because she is with a partner she doesn’t respect, feel close to, or find attractive. That said, a woman’s lifestyle, emotional and physical health, as well as the availability of a desirable (and healthy) partner may play an even larger role in her sexual activity than does her declining levels of estrogen, progesterone and testosterone.

MYTH: A woman cannot get pregnant once she has stopped having her period.

FACT: Unless you are open to an “Oh my, I’m pregnant” surprise, it is best to use a proven contraceptive method for 12 months after your last period. Late pregnancies can and do occur because a woman may still be fertile enough to conceive during that early time of perimenopausal transition.

MYTH: There are no satisfying alternatives for the vaginal dryness—and the resulting pain—experienced with vaginal penetration during menopause.

FACT: While it’s true that estrogen deficiency during menopause can lead to dryness and a thinning of the vaginal wall lining, there are satisfying solutions. Vaginal lubricants and hormone creams often ease the problems of burning, irritation and soreness. These are very effective and facilitate the ability to one again experience those pleasurable sensations.

MYTH: Too much sexual activity can lead to decreased vaginal lubrication and increased pain.

FACT: This is truly a “use it or lose it” time of life. More frequent vaginal stimulation actually helps increase the blood flow around the tissues in this area—which, in turn, leads to a healthier vaginal wall lining and better ability to lubricate during arousal and sexual activity.

MYTH: A woman’s endurance, as well as her ability to try new techniques and positions, is hindered during this time of her life.

FACT: Simply not true. If you heard the stories of a few of my post-menopausal patients you would know regular exercise and participation in flexibility classes (yoga, tai chi, Pilates, others) can enhance endurance while also providing the ability to maintain a full range of movement. Not only that, but regular exercise may actually stimulate sex drive. No doubt about it, this is functional fitness (ability to carry out activities of daily life) at its best.

MYTH: There is a decreased risk of acquiring a sexually transmitted disease from a woman who has reached menopause.

FACT: Don’t bet your life on it. In fact, you would be doing just that if you didn’t practice safe sex. Any person, no matter what their age or reproductive ability, is capable of harboring—and spreading—a sexually transmitted illness during any type of sexual activity.

MYTH: Menopause only affects women.

FACT: Guys experience a male menopause, or andropause. Aging, blood circulation, and hormonal fluctuations are an equal opportunity part of life. While the changes are often more gradual than those occurring in women, they can affect a man’s sexual interest, arousal, ability (erectile dysfunction), endurance, as well as emotional health.

Menopause is a part of life, not an end of living or enjoyment. If you’re sexual health is not up to par, please see a physician in whom you trust, has a good ability to listen, and is up to date in her/his information on sexuality through the years.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)

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