In our perimenopause and post menopause years, the impact of low oestrogen on our sex lives is very significant.

The changes to your vulva and vagina and less lubrication with reduced or increased
sensitivity can lead to painful intercourse. This can be frustrating as your brain is saying yes but your
body may be saying no. Add this on top of sore joints, interrupted sleep, mood changes, hot flushes
and fatigue, its no wonder why many will experience a lower level of sexual desire.

Also, certain medicines used for low mood or blood pressure can have an impact of desire and orgasm. I know that this may sound depressing but it is important to empower yourself with these obstacles so you can make the necessary changes where possible. Let me reassure you, where there is a will there is a way and not everyone will experience a drop in desire, for some it may heighten the desire, lucky partner!

Many women in heterosexual relationships express concern, that they have lost the desire or are
just not able or interested due to lack of motivation and fatigue that are associated with
perimenopause, and this in turn has them ‘feeling bad’ for their partner.

Communication plays a key role here, and I know in some cases that this is not the easiest topic to talk about but its important that your partner knows and understands the symptoms that you are experiencing. Even after a chat, you both may feel less pressure and start to find ways in which you can work around this.

Science research has shown that having frequent sexual intercourse can reduce the symptoms of Genito-urinary symptoms of the menopause (GSM) so happy days to that, more sex please. So, I also read that science says that you need your partners penis if you want to maintain vaginal elasticity and pliability. (Yes, I did just go there!)

There is more, its not just their penis, you also need their semen too! Gosh, tough station for the men, ha! Semen contains sexual steroids, prostaglandins, and essential fatty acids, all of which are ‘apparently’ essential to the health of your vaginal canal. I read this information from a book called perimenopause power by Maisie Hill, a fantastic read, highly recommend. Nothing boring about this article or that book.
Women are increasingly staying sexually active well into their 70’s and beyond and my thought here
is happy days, sex is a pleasurable activity and is responsible for releasing feel good chemicals into
our bodies so these sexual problems need to be addressed.

Luckily enough, there are many treatment options available for women. Vaginal oestrogen plays an important role in replenishing oestrogen into the vaginal canal and this hormone therapy acts very locally so most women, even some breast cancer patients, may use this. Lubricants play a massive role here, water-based products are very popular.

‘YES’ products are amazing, they come in the form of internal applicators that can be squeezed into the vaginal canal or just as a gel that you apply with your hands. They can be applied to you and to a penis before sexual activity and they can prevent soreness and add a little pleasure also.

Let’s talk about testosterone! Testosterone is a hormone that is produced by men AND women.
Several studies have shown the benefit of testosterone therapy in postmenopausal women but
mainly in those already using oestrogen therapy. Unfortunately, there is currently no licensed
testosterone products available, so women must use the men’s prescription only products but just
much less of the man’s dose. I get positive feedback in a community pharmacy setting regarding the
use of testosterone for low libido. The dose is so small that the side effects are low.

The trick to getting the benefit from the testosterone, is that it takes time to work, the best effects are noticed six months after starting therapy. The reason for this is because the dose is so small that it takes time to have a therapeutic effect, so my advice is to stick with it. At present, testosterone is only
licenced in women for low libido but personally from what I have read and listening to menopause specialists, that testosterone has many more benefits. Studies are showing that it can help with
fatigue and brain fog and this could well be the missing link to our hormone therapy so watch this
space!

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