Do you know that your love life can be enhanced even after the menopause? The passion revoked and the sparks reignited? Usually, when children grow up and leave home, a woman has more freedom, time and independence to be intimate with her partner and start the second innings of her love life. However, many women going through menopause do worry that their hormonal changes may put a damper on their sexual relationships. On this score, however, the evidence is encouraging. In a recent survey report, 40 per cent of women said that their relationships with their husbands improved after menopause and that they enjoyed sex more without the fear of becoming pregnant. Studies of this sort dispel the myth that old age is a sexless wasteland. No woman should feel trapped because she is unable to consider sexuality positively or to explore the wide range of expressions of sexuality that are available, and age is certainly not a bar in this case.

The libido damper
Many women sail through their menopause with very few symptoms, or if they are extremely lucky, none at all. However, a large proportion of women experience some of the physical or psychological symptoms. Some menopausal symptoms can temporarily hamper a woman’s ability to enjoy a fulfilling sex life. Symptoms like night sweats and hot flushes can be counterproductive to relaxation and romance. Relative oestrogen deficiency can bring about vaginal dryness and thinning of the vaginal lining. The lack of lubrication and support for the vaginal walls can reduce arousal during sex and increase friction, which in turn may produce soreness, burning or irritation. Psychological symptoms such as mood swings, insomnia and depression can compound physical effects. Even women who used to initiate sex with their partners may determinedly avoid it, although many say that once they do make love, they are surprised that they enjoy it. Husbands may feel rejected at this time and relationship difficulties can arise. But despite its psychological dimensions, menopause is a physical event.

Nevertheless the heroine, as well as the vamp, of this drama is oestrogen. Oestrogen is actually a ‘feel-good’ hormone and women grow accustomed to its high. When regular doses of oestrogen disappear the crash landing may be a hard one. The good news is that all these problems can usually be remedied,

informs Dr. Usha Dubey, a professor in Life science, who has also done some research on the subject.

Hormone replacement therapy (HRT)
HRT consists of natural or synthetic female sex hormones that replace the hormones a woman loses around the menopause. It comes in the form of tablets, patches or gels and always contains oestrogen (either in a natural or synthetic form). HRT can improve many symptoms of the menopause that can hinder a satisfactory sex life. Vaginal dryness, loss of lubrication, soreness, irritation and vulnerability to bacterial infections and thrush may all be vastly improved by HRT. Hot flushes and night sweats may also be banished.
Many studies have suggested that low-dose testosterone is effective and well worth trying for postmenopausal women who have low sexual drive. The therapy seems of particular value for women who have a surgical menopause (which occurs when both ovaries need to be removed surgically) at a relatively young age.

The bright side
It is now known that women have at least the same ability as men to enjoy sex, plus the additional advantage of retaining their capacity to have several orgasms one after another until much later in life. Young men are capable of frequent love-making, but as they get older they become satisfied with less frequent love-making. Ironically, many women discover a renewed or even redoubled libido if they start taking hormone replacement therapy for menopausal symptoms and not uncommonly report that their husbands can no longer keep up with their sexual demands.

For many post-menopausal women, the fact that their husbands take longer to reach a climax becomes a bonus; it makes love-making far more enjoyable than when they were younger and everything seemed to be over in a matter of breathless seconds. This provides time to explore new sensations and enjoy a variety of feelings,

explains Bangalore based psychologist Neelam Saraswat.

The Magic of touch
After the menopause, touching and intimacy often become more important than the physical pleasure of penetrative sex. This need to touch and be touched, physically and emotionally, is well worth nurturing. Such contact offers reassurance and comfort and the opportunity to show tenderness, companionship and love.

Around the menopause, the physical focus of sex tends to be overtaken by the emotional, social and spiritual ingredients of love, as the couple and the relationship become more mature. Remember that there are many expressions of love other than sexual intercourse and all can boost confidence and enhance feelings of self-esteem and worth,

confirms Saraswat.

Be Cautioned

Hormone Replacement Therapy is safe if given for a suitable patient under close supervision of a gynecologist. It does help to increase the libido after menopause but it should not be prescribed just for this particular reason. It is effective only if given for at least six months to few years. It is expensive but if you look at the benefits, they are great. For example, it increases the mental concentration, the bone density and in general the feeling of well being.

says Dr Madhu Rao, Senior Gynecologist,
Indraparasth Appolo Hospital, New Delhi