Loss of libido and other intimate issues during menopause

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Ask Eileen


09 October 2017

Today's topic

Today on A.Vogel Talks Menopause, I'm going to be talking about sex and loss of libido in the menopause.

Now, this is one of the most distressing symptoms of the menopause. I get so many women who are literally distraught because they've lost their libido and they don't know what to do.

It can affect our relationships very, very dramatically. Sometimes, it can affect ourselves, the way we feel about ourselves and it is really quite a difficult one to sort out. The reason being is that it's very often a combination of both physical and emotional issues. And a lot of women can have a combination of both. And when you put them all together, it just makes the situation even more difficult to resolve. 

Why does this happen?

So, why does this happen? Well, it's all to do with the hormone oestrogen. When you're having a monthly period, the point when you ovulate (which means you're actually ready for conception) is when your oestrogen is at its highest.

Oestrogen is almost like our "I'm feeling sexy" hormone. The higher it goes, the more sexy we're likely to feel. And every month it goes up to the top and comes down again when you get a period, and next month, it starts to rise again and so on.

But in the menopause, obviously, this doesn't happen. You can have a continual decrease of oestrogen. So we don't get the highs of feeling sexy and the low of feeling a bit miserable. It just gets lower and lower. And this will have a continual dampening effect on our libido and the way that we feel about sex as well. 

What are the symptoms?

So let's have a little look at the different symptoms that can crop up at this particular point.

The physical symptoms

Fatigue

First of all, we've got fatigue. You know, we're busy and I keep saying, in this day and age as women, we're really, really busy. We're busy inside as well. Our bodies are frantically trying to cope with all the hormonal changes that are going on that can lead to fatigue. If you've had a really busy day, if you've had to go to work, if you've had to look after family and come back, you know, by 10 o'clock at night, the last thing you want to do is think about sex. You probably just want to fall asleep and have a really good night's rest. 

Vaginal dryness

The other main issue with sex, at this particular point, is vaginal dryness. Again, it's very often caused by low oestrogen. When you get vaginal dryness, other things can occur at the same time. The walls of the vagina can become less elastic and you can start to get really painful sex. If you're not lubricated enough, if you're not ready enough, then it can be very, very painful. And you only need to have painful or unenjoyable sex once, and that can really put you off time and  time again.

Desensitisation

The other thing that can happen, for some women, is that they get slightly desensitised. They may find it a lot more difficult to climax. And, again, if there's no enjoyment then you just don't feel like doing it at all. 

The emotional symptoms

Now, we've also got to look at the emotional side of losing the libido. This is a really big one. As oestrogen falls, we very often see ourselves differently. We've maybe put on weight, we don't feel so good about ourselves, we can lose our confidence, and that can transfer itself to the bedroom. We don't want to be seen naked very often, if we're starting to get ashamed of the way our body looks.

We might feel that our partner doesn't think we're sexy anymore. That can be extremely off-putting too. We've also got the point that we can have low mood, we can have irritability, we can have anxiety, and in that emotional state then you're probably not even going to think about wanting sex at all. 

Oxytocin

We've also got oxytocin and I have actually done a blog on this, if any of you want to look into this a little bit more. Oxytocin is the "love" hormone, a bit like oestrogen, but oxytocin is about connecting and loving other people. And, when oxytocin levels are high, we're more inclined to love whoever it is that we're with.

When oestrogen starts to fall, your oxytocin can fall as well. It can mean, just simply, that you don't feel as close to your partner. You might find that, you know, some women say they've stopped loving their partners, they don't like their partner anymore. So there can be a huge emotional shift between couples in the menopause. And obviously, that can then have a very big effect on your sex life too. 

Feeling guilty

The other thing that can happen is, and I get a lot of women in this situation as well, they still love their partner dearly. They want to have sex. They just don't feel like it and they feel really guilty for having to say no. And that then sets up feeling bad about ourselves again and it can create a real vicious circle.

And guilt is one of the things that, you know, we really shouldn't feel during the menopause because it's the hormones that are doing this to us and, very often, it's not us ourselves that are actually creating this particular problem. 

What can you do about it?

So, what can you do about this situation?

Talk to your partner

The first thing, if you are having problems, is to talk to your partner about it. Now, I know for a lot of women, this can be really difficult. A lot of us don't like talking about our innermost feelings and our most intimate needs. But it's really important that you let your partner know what is going on.

Men see sex very differently. For women, it's very much an emotional and a physical bond. I think we encompass sex in a much bigger way. For men, very often, if they get a knock-back, they then feel that you don't love them anymore and that's the simplicity of it. So they need to know how you're feeling. They need to know what's going on with you physically, emotionally, and mentally. 

But it can be really difficult because sometimes, in the menopause, we don't have any idea how we're feeling. We can be totally lost in the whole situation as well.

So if you find it difficult to talk to your partner about this, or you're not quite sure how to go about it, I posted a blog a little while ago about eight things men need to know about the menopause. So you can click on to it, you can print it out and you can leave it somewhere where they can see it.

And it's based on questions we've had from men. And yes, we do get men contacting us. They're looking at things from the other side. They are totally bamboozled, worried, heartbroken even, because they don't understand what's going on with their partner, and they're starting to ask lots of questions as well. So this is really the most important thing. If you can talk, you're really halfway there in trying to resolve the situation. 

Ask your partner to watch with you

If you are not sure of the best way to start a conversation with your partner, why not ask them to watch this video with you?

Talking things through can often be the best and easiest way to help!

Solving the physical side of the problem

The other things that you can look at can physically solve the problem, if you like. If you're getting vaginal dryness, you can get really good natural lubricants at your health food shop. You do need to be careful what you put on this particular area so I would always go for something natural.

You could look at raising your oestrogen levels by taking something like phytoestrogens like our Menopause Support or black cohosh. You could go for herbal stimulants like Siberian Ginseng or the herb Maca. These are both known to help with libido as well. 


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Get any serious pain checked by your doctor

The other really important thing here, talking about the vaginal area, is that, very often, you will get pain during intercourse. But if you feel that it's not just vaginal pain, if the pain is actually coming from the pelvic area and if the pain lasts long afterwards, then this is really important that you go and get this checked out by the doctor because it could be something like a prolapse.

And a prolapse is basically where the internal organs, such as the bladder, the bowel, or the uterus can shift. And, during intercourse, pressure can be put on them, and that can cause an awful lot of discomfort. So, any kind of serious pain, please get this checked out by your doctor as well. 

Sea buckthorn oil and exercises

You could look at things like sea buckthorn oil. It's very, very good. Kegel exercises are great too. Sometimes, if you are losing sensation, it can be due to the fact that there's problems with blood flow to the pelvic area. Our circulation can get a bit sluggish in the menopause.

Exercises can be absolutely great. And one of the best forms for this is Pilates. And you can find a really good qualified instructor. They can teach you great exercises to strengthen this whole area. And that, by itself, can sometimes make quite a difference to how you're feeling. 

Make a change

The other things that you can look at are changing your love life, you know. What can happen in the menopause is our body can be so slow to respond, you know, the mind is willing but the body goes, "Sorry, I need a long time to catch up." So maybe change the way you do things.

Have date nights. You know, lots of women tell me that they've now started organising date nights. And, if you remember back to when you were a teenager and, you know, maybe it was a Monday afternoon and you were thinking about going out on a date on Friday night, the anticipation starts to rise as the week goes on. And anticipation is a fantastic aphrodisiac. So be inventive, you know, there's lots of nice things that you can do here.

Remember - it's just a phase

Now, just remember, this is a very distressing symptom of the menopause. If you have it, there are ways round it. You might have to work hard at it but it can be done. But, for the majority of women, remember the menopause is a phase that you are going through, and there is no reason why you can't come out the other side and still enjoy a really good, happy, healthy sex life for a long time afterwards. So, bear in mind that this isn't something that you necessarily lose now and you'll never, ever get back again. 

Increased libido

Just one last thing, there are a small number of women for whom the complete opposite happens. They find that their libido just goes through the roof. Very often, again, it's to do with the hormonal balance. If your testosterone level rises, very often that can increase libido.

It's also the thought that, you know, there's no risk of pregnancy and, for some women, that's a really big turn on, if you like. And also, if you have been together for a long time, your children may be away from home and suddenly you find that you have the house to yourself a lot more often. So this does happen as well. As long as you're happy with the situation, that's absolutely fine, just enjoy it. So that's really good. 

Let me know what helps you

So hope you found this interesting. If any of you out there have tried remedies, have done things to try and improve your libido, I would love to hear about it. For those of you that have changed the way that you organise your love life, if you found that doing different things has really helped, I would love to hear about it.

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