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  • Dr. Susan

Intimacy Matters: Overcoming Sexual Challenges During Menopause

Thinking about sex during menopause? Don't freak out, there are options! Read on to learn in detail about the changes a woman goes through at menopause and how it affects her sexually and intimately in her relationship.

What Is Menopause?

Menopause is a natural biological process that marks the end of a woman's menstrual cycle. It is officially diagnosed after a woman has gone a full year without

a menstrual period. Menopause typically occurs between the ages of 45 and 55 but can occur earlier or later. 51 is the average age of menopause.

During menopause, a woman's body undergoes significant hormonal changes as the ovaries gradually stop producing estrogen and progesterone. These hor-

monal changes can cause a range of physical and emotional symptoms, including hot flashes, night sweats, vaginal dryness, sleep disturbances, mood changes, and more.

Hormone imbalances related to menopause can have a significant impact on a woman's health and well-being. In addition to the symptoms mentioned above, hormonal changes can also increase a woman's risk for osteoporosis, heart disease, and other chronic health conditions. Additionally, some women may experience a decline in libido or other sexual changes due to the decrease in estrogen and testosterone levels. It's important for women to be aware of these potential changes and be able to speak to their partner and functional nutritionist with their concerns that arise during menopause.

How Does Menopause Affect Sexual Health and Intimacy?

As estrogen and progesterone levels, especially estrogen, this has a significant impact on sexual health and intimacy for women. Estrogen is essential for the health and function of the female reproductive system, including the vagina, uterus, and ovaries. The decline in estrogen levels can lead to a variety of physical changes that can affect sexual health, such as vaginal dryness, thinning of vaginal tissues, and decreased blood flow to the genital area.

In addition to physical changes, menopause can also lead to emotional and psychological changes that can impact sexual health and intimacy. Women may experience mood swings, anxiety, and depression during menopause, which can affect their desire for sex and their ability to enjoy it. They may also experience changes in their self-image or body image, which can affect their confidence and willingness to engage in sexual activity.

Overall, the hormonal changes that occur during menopause can have a significant impact on a woman's sexual health and intimacy. It's essential for women to be aware of these changes and to seek support, realizing that help is available, and they don't have to give up the sexual part of their lives.

Physical Changes of Menopause

Mood changes, depression, anxiety, and self-esteem issues are common during menopause. These changes can be attributed to fluctuating hormone levels, which can affect the levels of neurotransmitters in the brain, such as serotonin and dopamine

, which are involved in regulating mood and emotions.

Depression and anxiety are common during menopause, and women may experience symptoms such as feelings of sadness, hopelessness, and worthlessness, as well as irritability, restlessness, and worry. These symptoms affect a woman's quality of life, including her sexual health and intimacy, leading to a decreased interest in sex or difficulty in achieving sexual arousal and pleasurable orgasm.

As a woman goes through menopause, there are several physical changes that can affect her sexual health and intimacy. Some of the most common changes include:

  1. Vaginal dryness: As estrogen levels decrease, the vaginal tissues can become thinner, drier, and less elastic. This can lead to discomfort or pain during intercourse, as well as a decreased interest in sex.

Another common issue is changes in the structure of the vagina and surrounding tissues. As estrogen levels decrease during menopause, the tissues in the vagina can become less supportive, making them more susceptible to tearing or injury during sex.

2. Changes in libido: Fluctuations in hormone levels can cause changes in a woman's sex drive. Many women experience a decrease in libido during menopause.

3. Decreased sensitivity: The reduced blood flow to the genital area during menopause can cause a decrease in sensitivity, making it more difficult to achieve orgasm and therefore less pleasurable.

4. Urinary symptoms: The decrease in estrogen levels can also affect the urinary system, leading to symptoms such as incontinence or urinary tract infections, which can further impact a woman's sexual health.

All of these physical changes can have a significant impact on intimate relationships. As they lead to feelings of frustration, embarrassment, and even depression, of both partners, it's important for women and their partners to understand these physical changes.

Psychological Changes of Menopause

Menopause can cause significant psychological effects that can impact sexual health and intimacy. The hormonal changes during menopause can lead to mood swings, anxiety, depression, and irritability, which can all contribute to a reduced sex drive and lack of intimacy. Additionally, menopause is a reminder of aging and mortality, which can cause stress and anxiety for some women.

Furthermore, many women experience a loss of self-confidence during menopause, particularly if they are experiencing physical changes that they feel make them less attractive or less desirable. This loss of confidence can manifest itself in decreased interest in sex and intimacy. Additionally, women may feel less comfortable with their bodies during menopause, particularly if they are experiencing weight gain or other physical changes. This can lead to decreased sexual self-esteem and interest in intimacy.

Relationship Changes of Menopause

It is also important to note that women may experience changes in their relationships during menopause, particularly if their partner is not understanding or supportive. This can lead to feelings of isolation, loneliness, and sadness, which can further exacerbate sexual health or intimacy issues. It is important for women to have open communic

ation with their partner about their feelings and needs during this time, and to seek professional help if necessary.

Self-esteem issues can also arise during menopause due to changes in physical appearance, such as weight gain and changes in skin and hair texture. These changes lead to feelings of dissatisfaction with one's body and reduced confidence, which can further impact intimacy.

It is important for women to seek support from their healthcare providers. Counseling, therapy and pelvic floor specialists can be helpful in addressing physical symptoms, mood changes and self-esteem issues that arise.

Communication and Support

Starting a conversation about menopause concerns with your partner can feel embarrassing and be daunting, but it's essential for getting the help and support you need. Here are some tips on how to begin the conversation:

  1. Choose a time and place that feels comfortable: Pick a time and place where you can have an uninterrupted conversation. If you're talking to your partner, you may want to choose a time when you're both relaxed and not distracted. If you're talking to a healthcare provider, make an appointment specifically to discuss your concerns.

  2. Be honest: Don't downplay or ignore your concerns. Be honest about what you're experiencing and how it's affecting your life.

  3. Use "I" statements: Focus on your own feelings and experiences, using "I" statements instead of blaming or accusing language. For example, instead of saying "You never understand what I'm going through," say "I feel like I'm not being heard or understood."

  4. Be specific: Try to be specific about what you're experiencing. For example, instead of saying "I don't feel like myself," say "I'm having trouble sleeping and feeling anxious all the time."

  5. Ask for help: Don't be afraid to ask for help and support. Whether it's from your partner or healthcare provider, let them know what you need and how they can help.

Remember, starting the conversation is the first step towards getting the help and support you need to manage your sexual health and menopause concerns.

Lifestyle Changes Through Menopause

Maintaining a healthy lifestyle is essential for supporting sexual health during menopause. Here are the top three changes a woman can make to achieve this:

  1. Regular physical activity: Regular physical activity can help improve mood, reduce stress, and increase blood flow to the genital area, which can help alleviate vaginal dryness and improve sexual function. Exercise also helps to maintain a healthy weight, which can positively impact sexual health.

  2. Healthy diet: Eating a balanced diet rich in nutrients such as whole grains, fruits, vegetables, lean proteins, and healthy fats can help reduce inflammation and improve overall health, including sexual health. I use my Hormone Balancing Diet to have women avoiding processed foods, sugar, and excessive amounts of alcohol and caffeine can also help support hormonal balance.

  3. Open communication: Communicating openly with your partner and healthcare provider about any concerns or issues related to sexual health is essential for maintaining a healthy sex life during menopause.

  4. Stress reduction techniques: Stress can negatively impact sexual health, as it can lead to decreased libido, fatigue, and mood changes. Incorporating stress reduction techniques, such as meditation, deep breathing exercises, or yoga, can help reduce stress and promote relaxation, which may help improve sexual function and satisfaction. Additionally, reducing stress can have a positive impact on overall health and well-being, which can also support sexual health.

Natural Treatment Options

Menopause-related sexual health issues can be addressed through natural treatment options. These options include natural hormone balancing therapy, vaginal moisturizers, and lubricants.

Natural hormone balancing therapy involves using plant-based supplements such as black cohosh, soy, and red clover to balance hormones and alleviate symptoms such as vaginal dryness, hot flashes, and mood swings. It is important to consult with a healthcare provider before starting any hormone therapy.

Vaginal moisturizers are a non-hormonal option for treating vaginal dryness. They work by hydrating the vaginal tissues and improving lubrication. These products can be ordered online or purchased over the counter at your local pharmacy and can be used as needed.

Lubricants are another non-hormonal option for improving vaginal lubrication. They can be used during sexual activity to reduce discomfort and pain.

If using a condom during intercourse it is important to choose a water-based or silicone-based lubricant that is compatible with condoms and sex toys. Oil-based lubricants can damage condoms and increase the risk of infections.

Wild Yam Cream

Wild yam cream is often used by women during menopause as a natural remedy to relieve symptoms associated with hormonal imbalances, such as hot flashes, night sweats, and vaginal dryness. The cream is derived from the root of the wild yam plant, which contains natural compounds called diosgenin and progesterone.

Diosgenin is often converted to progesterone in a laboratory setting, and it is believed that the natural progesterone in wild yam cream can help to balance hormone levels in the body. This can potentially lead to a reduction in menopausal symptoms and improve overall health and wellbeing.


In conclusion, menopause can have a significant impact on a woman's sexual health and intimacy. Physical and psychological changes can lead to symptoms such as vaginal dryness, pain during intercourse, reduced libido, and changes in sexual response. However, there are many natural treatment options available, including hormone balancing therapy, vaginal moisturizers, and lubricants, which can help to alleviate these symptoms and improve sexual health.

It's important for women to communicate with their partners and seek support and treatment if needed. Remember that you're not alone, and many women experience these same issues during menopause. Don't let embarrassment or discomfort prevent you from seeking the help you need to maintain a fulfilling and satisfying sex life.

By making healthy lifestyle choices such as exercise, a healthy diet, and stress reduction techniques, you can also support your sexual health and overall well-being during this transition. So don't hesitate to seek support and explore the natural treatment options available to you. With the right support and care, you can continue to enjoy a fulfilling and satisfying sex life throughout menopause and beyond.

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