During peri-menopause & menopause, hormonal changes can lead to various physical and psychological challenges, including those affecting sexual health.

By understanding and addressing these issues, you can ensure a satisfying sexual life during and after menopause.

Commonly, problems that affect women can be divided into two groups: physical and psychological. Most sexual problems, both physical and psychological, arise from the drop in hormones, namely oestrogen, progesterone, and testosterone.

Let's discuss the physical problems first:-

The drop in hormones can cause thinning and dryness of the vaginal tissues, which can lead to pain or discomfort during intercourse. Additionally, weakening of the pelvic floor muscles can cause bladder control issues, which can be embarrassing and affect sexual activity.

One option to address the dropping hormone levels is hormone replacement therapy (HRT), but it may not be suitable for everyone and not everyone wants to take HRT.

Another effective option is using a topical oestrogen product, which is applied directly in the vaginal area. Topical oestrogen is well-tolerated by most individuals, as it is only absorbed locally, and it can be a useful alternative to systemic HRT.

In the UK, you can now purchase topical oestrogen over the counter under the brand name "Gina." Alternatively, you can obtain topical oestrogen on prescription from your doctor, which can be more cost-effective.

Most preparations require daily application for two weeks, followed by once-a-week usage.

Using a water-based lubricant, such as KY Jelly, can also help alleviate discomfort during intercourse.

If you wish to improve pelvic floor strength, you can perform pelvic floor exercises or use on of the many available treatments such as weighted cones.

If however you are experiencing significant pelvic floor issues, it is advisable to seek advice and assistance from a specialist physiotherapist who may be able to give additional help & support.

Moving on to psychological effects, a significant problem many women face as they age is a change in body image, which can lead to reduced self-esteem and decreased interest in sex.

Combined with reduced libido due to a drop in testosterone levels, this can result in a lack of interest in sex.

If you believe you might benefit from testosterone supplementation, consult your GP about obtaining a prescription.

Other factors that can affect sexual desire include tiredness, anxiety, and low mood.

Ensuring adequate sleep is essential, as exhaustion diminishes interest in sex. Similarly, addressing anxiety and low mood by taking time for yourself and utilising relaxation techniques such as reading and meditation can be helpful.

Exercising is another effective way to increase libido, as it releases feel-good hormones and improves overall well-being.

Additionally, improving sexual desire involves examining your relationship with your partner.

As relationships evolve with age, accepting these changes becomes crucial. Effective communication with your partner becomes even more important, and seeking help from couples counseling can be beneficial for significant issues.

To recap,  some of the best strategies to try include HRT or topical oestrogen, ensuring sufficient sleep and rest, engaging in regular exercise, and working on your mindset to improve self-perception, relaxation, and connection with your partner.

By implementing these measures, you can start enjoy a healthy sex life once again.