Menopause can lower your libido and cause other unpleasant symptoms.
Menopause, which marks the end of women’s menstrual cycles, can produce a raft of unpleasant symptoms. It’s diagnosed after a woman has gone 12 months without a menstrual cycle, according to the Mayo Clinic. Menopause can happen to women in their 40s and 50s; in the U.S., women experience menopause at an average age of 51, according to the Mayo Clinic. Symptoms can include hot flashes, urinary incontinence, weight gain, mood changes, irritability and loss of libido. “When your estrogen supply begins to diminish, your skin and other tissues lose collagen — the substance that keeps skin supple and youthful-looking. Loss of collagen causes vaginal and genital tissue to become thin and dry,” says Dr. Barbara DePree, an obstetrics and gynecology specialist in Zeeland, Michigan. “You may also notice that your vagina no longer lubricates well when you become aroused. This is called vaginal atrophy, and it can make sex very uncomfortable. Vulvo-vaginal atrophy can also exacerbate urinary tract infections and cause burning, itchy genitals.” Fortunately, there are approaches to ease this and other manifestations of menopause. If you’re experiencing menopause symptoms, experts recommend these strategies:
To improve your libido, try talking to your partner or a therapist.
The fact that some women’s libido wanes as they get older doesn’t mean they should give up on having a healthy sex life, says Dr. Sheryl A. Kingsberg, chief of the division of behavioral medicine, University Hospitals Cleveland Medical Center and president of The North American Menopause Society. “Long-term relationships do not have the advantage of the lust and passion that new relationships have,” she says. “Many couples assume that there is something wrong with the relationship if they have lost that easy passion. Do not fall for the myth that older women do not nor should not want to have a satisfying sexual life. The majority of women who are in their 50s, 60s and beyond report that they want to remain sexually active!” Seeing a couples therapist could also be helpful, says Dr. Lisa Valle, an obstetrician-gynecologist at Providence Saint John’s Health Center in Santa Monica, California. “Counseling via sex therapy or couples therapy should always be considered, especially if there are communication issues or relationship conflicts,” Valle says.
To ease vaginal dryness, try lubricants.
Surveys have shown that many women don’t discuss issues related to their sexual health with their physician because they’re uncomfortable talking about the subject, says Dr. JoAnn V. Pinkerton, executive director of The North American Menopause Society. She’s also a professor of obstetrics and gynecology at the University of Virginia Health System in Charlottesville, Virginia. “So, the first step is [for women] to admit they have vaginal dryness or that sex is painful, to find out what options are available.” For vaginal dryness during sex, over-the-counter vaginal lubricants can be helpful. If you’re concerned about day-to-day vaginal dryness, treatments include vaginal moisturizers that are typically applied two or three times a week, she says. If those approaches aren’t enough, women may choose from an array of FDA-approved low-dose vaginal estrogen therapies available as creams, tablets or a vaginal ring, which is a small, flexible piece of plastic inserted into the vagina. The prescription medication ospemifene (with the brand name Osphena) is also an option; this drug inhibits estrogen effects in some parts of the body, like the breast, but mimics estrogen effects in the vagina. A caveat: These therapies may not be the best approach for women with prior uterine or breast cancer. Women who have had those diseases, particularly those on anti-estrogen therapy (or aromatase therapy), should discuss each of these therapies with their oncologist, Pinkerton says.
Ramp up the foreplay.
In your teens, 20s and 30s, passion can be quickly lit. Desire doesn’t always spark so fast later in life, particularly if you’ve been with your partner for a while, says Dr. Leah S. Millheiser, an obstetrics and gynecology specialist and director of the Female Sexual Medicine Program at Stanford University in Palo Alto, California. “Sometimes when you’ve been together a while, you start to cut corners,” Millheiser says. “But as we get older, women’s bodies need a little more time to ramp up to the main event. If your partner is starting to rush it, have a little talk to let them know that you’re going to need a little more time to get warmed up from now on. Don’t skimp on the foreplay! Slowing things down will likely remind both of you how much pleasure you used to take in each other’s bodies and reinvigorate the romance.”
To mitigate hot flashes, consider hormone therapy.
Drops in estrogen levels with the cessation of ovulation during menopause can result in torturous hot flashes that can ruin any day or night, Kingsberg says. Research suggests taking estrogen can mitigate hot flashes associated with menopause, says Dr. Mache Seibel, an obstetrics and gynecology expert in Boston and author of “The Estrogen Fix: The Breakthrough Guide to Being Healthy, Energized, and Hormonally Balanced,” which describes how estrogen replacement can improve the health of women and lower their risk for breast cancer, heart disease, diabetes and osteoporosis. Prescription estrogen is available in pills, patches and sprays, Kingsberg says. Ask your doctor which approach is best for you.
Avoid hot weather and spicy foods.
To prevent or mitigate the effects of hot flashes, avoid hot and humid weather, smoking cigarettes, eating spicy foods and wearing tight clothes, which can be triggers for hot flashes, Pinkerton says. Physical activity is fine, in moderation, she advises. “Although exercise and being active may help [mitigate] hot flashes, exercise to the point of sweating may make them worse,” she says.
Adjust your diet to fight weight gain.
The hormonal changes associated with menopause can cause women to gain weight, often around their abdomen, according to the Mayo Clinic. Add to that the fact that muscle mass typically declines with age while fat increases, and it can be quite a challenge for women experiencing menopause to maintain their ideal weight. If you’ve put on unwanted pounds during menopause, cultivating and maintaining good eating habits help you attain your best weight, Seibel says. He and Karen Giblin of Bridgewater, New Jersey, co-authored the book “Eat to Defeat Menopause: The Essential Nutrition Guide for a Healthy Midlife.” She’s the founder and president of Red Hot Mamas, which she says is the nation’s largest menopause education program providing midlife women’s health information and support. To ward off weight gain during menopause, “avoid packaged and processed foods, eat whole foods and fresh veggies and limit sugary drinks and desserts,” Seibel says. “Your body will also appreciate grass-fed beef and organic goods as much as possible.” The book advises readers to eat the right foods in the proper amounts and exposes “fictionoids” in favor of factoids; for example the idea that skipping meals will help you lose weight is a “fictionoid,” the authors write. “Skipping meals can make us ravenously hungry,” the book states. “That makes us more likely to snack or eat more calories when we eat next. If you do need a snack, grab a piece of fruit or six to eight almonds or walnuts.”
To prevent urinary incontinence, try exercising your pelvic floor muscles.
It’s common for women in menopause to experience incontinence and urinary tract infections, DePree says. “This is because decreasing estrogen affects genital tissue and muscles in unhelpful ways,” she says. To ward off these unpleasant symptoms, DePree suggests doing Kegels — exercises that strengthen your pelvic floor muscles, according to the Mayo Clinic. Your pelvic floor muscles support the uterus, bladder, small intestine and rectum. You can learn how to do Kegels on websites like the Mayo Clinic’s site, or by watching videos online. For example, to identify your pelvic floor muscles, try to stop urination in midstream; if you succeed, you’ve located your pelvic floor muscles, according to the Mayo Clinic. Then, you can tighten those muscles, hold the contraction for five seconds, then relax for five more. Try it four or five times in a row, and work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions. You can do these exercises in any position, but it may be easiest to do them initially while lying down. Aim for at least three sets of 10 repetitions daily, the Mayo Clinic advises.
Learn a language and do crossword puzzles to ease memory problems.
Many postmenopausal women have greater memory problems than pre-menopausal women, according to research published in 2014 in the journal Integrative Medicine Insights. For example, 230 women, whose average age was 47, participated in the Seattle Midlife Women’s Health study. Overall, 62 percent of the participants reported “difficulty recalling words or numbers, needing memory aids and forgetting why one was involved in a certain behavior,” according to the research article. “Losing car keys, not remembering what you needed at the supermarket or even temporarily forgetting names is often a symptom of menopause,” Giblin says. To improve their memory, women should do crossword puzzles, read and take up a new language, she suggests. “This will help stimulate your brain and build new neural connections. Make lists: a to-do list, shopping list, birthday list, reminders for health checkups and so on,” Giblin says. “If you tend to lose your keys or any other item, have a designated place for them. Exercise your body and keep moving, as it will keep the oxygen flowing to your brain, which may help improve your memory. Get enough sleep. And don’t smoke, as it restricts blood flow to your brain.”
Maintain an extensive social network and stay active.
“Difficulty concentrating and remembering are common complaints during perimenopause [the time during which your body transitions naturally to menopause, marking the end of your ability to reproduce] and the years right after menopause,” according to the NAMS website. Some women may experience memory problems during menopause, but after their transition, tend to find their ability to remember things just as good as before. Some memory issues can more related to normal cognitive aging than to menopause. Nonetheless, to help prevent memory loss, NAMS suggests these strategies can be helpful: maintaining an extensive social network, remaining physically and mentally active, consuming a healthy diet, not smoking and consuming alcohol in moderation.
Use moisturizers and lubricants to treat vaginal atrophy.
Vaginal atrophy is the thinning, drying and inflammation of the vaginal walls, caused by your body having less estrogen, according to the Mayo Clinic. This condition occurs most commonly after menopause and can make intercourse painful. It can also cause an array of uncomfortable and painful urinary symptoms, such as vaginal burning, genital itching, urinary tract infections and incontinence. Treatments for day-to-day discomfort include vaginal moisturizers, which you’d typically apply every two or three days. To avoid discomfort during intercourse, try water-based lubricants. Stay away from petroleum jelly or other petroleum-based products for lubrication if your partner is using a condom; petroleum can break down latex prophylactics on contact. While lubricants can improve comfort during sex, they do not treat the thinning of the vaginal walls, Kingsberg says. If these over-the-counter approaches aren’t effective, there are prescription medications that are, Kingsberg says. These include topical estrogen creams, estrogen tablets or the vaginal ring. Intrarosa, a vaginal insert of DHEA, is also effective, Kingsberg says. DHEA is a hormone produced by your adrenal glands. In turn, DHEA helps produce estrogen and other hormones, according to the Mayo Clinic. Intrarosa is a suppository or insert you place in your vagina with an applicator, according to the Intrarosa website. These prescription therapies can improve vaginal dryness and painful sex and reverse the atrophy in the vaginal tissues, Kingsberg says.
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10 Strategies for Coping With Loss of Libido and Other Menopause Symptoms originally appeared on usnews.com
