Better Sex After Menopause?

Most people don’t like to think of their mother or grandmother having sex.

Our youth-oriented society flaunts nubile, scantily clad women promoting everything from soap to cars. These media images perpetuate the idea that a gray-haired woman who reaches menopause is not “sexy.”

But behind closed doors (and even in nursing homes) many older women are facing the “change of life” with renewed sexual exuberance, now that worries about pregnancy are gone.

Progressive Changes Toward Menopause

By definition, menopause is not having a period for a 12 consecutive months. The average age menopause occurs for an American woman is 51, according to the North American Menopause Society.

But the process toward menopause is progressive, like the need for reading glasses, explains Dr. James Simon, an obstetrician/gynecologist in Washington.

Many women (and men) when they hit their middle 40s come to realize they can no longer see fine print and, one day, they need reading glasses, he says. “It may seem like a sudden event, but it is a slow process of the muscles in our eyes not being able to accommodate and focus so easily,” Simon says.

The same thing happens to women with menopause and their sexuality. As women reach their 30s, 40s and 50s, their hormone levels start to fluctuate, affecting their ability to be fertile and menstruate. Lowered estrogen can result in missed periods, hot flashes, mood swings, sweats, and night wake-ups. One day, they no longer have their periods.

Lack of estrogen also can create vaginal dryness. If untreated, either with lubricants or hormones, intercourse can become painful, Simon says.

Sexual Desire Diminishes With Age

Additionally, as women age, sexual desire may diminish because of reduced androgens, or male hormones. No Food and Drug Administration-approved treatment currently is available for women for loss of libido, but doctors may formulate suppositories or creams of the androgen testosterone to help.

Some women also may lose a passion for sex because they cannot psychologically adjust to aging or to their loss of fertility.

“We are very adolescent about sexuality as a society, thinking it is for young people,” says psychologist June Reinisch, director emeritus of the Kinsey Institute in Bloomington, Ind.

Since most people had their first sexual encounter as teenagers, that experience remains imprinted on us as an adult, she explains. At the time, it was hard to accept our parents having sex, and as we become parents and age, it is hard to accept our own older sexuality.

Other factors that can contribute to a loss of desire and changes in sexual behavior as women age include illness of a spouse (affecting his potency), parental death and job stress, such as downsizing.

Overcoming Obstacles to Pleasure

With time, the majority of menopausal women seem to cope and enjoy sex, with and without either hormone replacement therapy or psychotherapy.

Studies show pleasure and frequency of sex do not diminish as a woman hits menopause, says Nancy Avis, associate professor of public health sciences in Wake Forest University, in Winston-Salem, N.C.

In a recent study of 200 women, Avis found women may have had a lower interest in sex, but that it didn’t affect their frequency of sex or enjoyment. “Women may have had less desire, but men were still initiating the sexual behavior,” she says.

The ability to communicate well with a partner is key to maintaining a healthy sexual relationship, Reinisch says. “That can be very difficult for people when sex is still considered taboo,” she says.

It’s important for couples to know that as women age, it takes longer and more stimulation for them to become aroused and reach orgasm.

The same is true for men. “Seeing his wife come out of the shower might have been enough to give him an erection in the past, but now she may have to be a bit hands on,” Reinisch says.

For recently divorced or widowed woman, talking is particularly important. Although an older woman might not have used condoms while married, she will need to tell a new partner to use them to ensure she does not catch any sexually transmitted diseases. An older woman may not get pregnant, but her vaginal walls are more susceptible to invasion by microbes.

For baby boomers reaching menopause today, it may still be difficult confronting sexuality in their golden years, because of societal attitudes that influenced them growing up, Reinisch says.

But younger people exposed to television commercials discussing erectile dysfunction in older men will probably feel more comfortable with the subject. “As they get older, they will think it their right to be sexual in their old age,” she says.