Embracing the Change-Together

Menopause, once looked upon as a distressing sign of advancing age and retreating
attractiveness, is now seen as a time when women can appreciate life's fullness—
including sexual fulfillment—with some natural help.

By Susan Weiner

April 2005

Menopause is hot, and we’re not talking about flashes. It seems you can’t be anywhere these days without hearing about night sweats, mood swings and other discomforts related to menopause.

Unlike our mothers, who endured the change of life and all its icky symptoms in silence, this generation of women openly debate the physical, emotional and sexual ramifications of menopause. They’ve found a forum in a myriad of women’s magazines, daytime TV talk shows and Internet chat rooms. Even aging-yet-still-alluring celebrities have adopted menopause as a pet cause, assuring us that, with proper care, a fulfilling romantic life after menopause can be a sure thing.

“Well, what can I tell you about menopause?” writes former top model, actress and entrepreneur Lauren Hutton, now age 61. “I’ve been through it, 4,000 women a day go through it, and when I entered menopause I was afraid of it. And what I want to tell you from experience is that the best days of your life may be ahead of you.”

In a culture that places more value on youth and beauty than on accomplishment and experience, menopause can be a hard pill for a woman to swallow. Before the change that marks the end of a woman’s reproductive years, most women still feel vital. Then menopause strikes and the inevitable happens: The body slows down and becomes a hormonal minefield. One of a woman’s topmost concerns during this transition: “Can I still experience intimacy?” But menopause is a natural change of life, not the end of a good life—including a sensual life. It should be celebrated as a freeing time, an opportunity for a woman to reframe the meaning of her life and relationships.

Cycles of Change

Physically, menopause evolves in stages. The first, premenopause, generally occurs when a woman is in her late 30s to mid-40s, when her cycles are becoming slightly irregular. During the following stage, perimenopause, a woman’s cycle may be wildly erratic; for five years or more, she may experience hot flashes, vaginal dryness, night sweats, insomnia, mood changes and fluctuations in weight and skin tone. The term menopause refers to a woman’s final menstrual period, though the exact start date can’t be determined until she has been free from periods for one year from that date. So, technically speaking, menopause occurs on one day. Its signs, however, can span a period of 10 years or longer.

Before the 20th century, when life expectancy was much shorter, most women did not live long after the onset of menopause. These days, women live for decades after the change of life and millions of them live under the misguided notion that sexual drives and desires come to an end during and after menopause. Thankfully, science and research into human sexuality have helped to strip away old myths. While it’s true that a drop in estrogen sets off physical changes, in the 1960s renowned sex researchers Masters and Johnson determined that sex drive is not related to estrogen, and while arousal may come more slowly, the desire for intimacy should not automatically diminish at menopause.

So for women who enjoy the emotional and physical intimacy of lovemaking, there is no medical reason why menopause should deprive them of this pleasure. In fact, for many couples, love and sexuality have actually been enhanced post-menopause.

She’s Got a New Attitude

But what happens during the transition to menopause that affects a woman’s sexuality? Declining estrogen levels trigger physical changes that can make a woman feel less than attractive. Since a woman’s sex drive is complex and tied to hormone levels, body image, weight and mood, these variables can leave a woman feeling like a weather vane in a windstorm. What’s more, intimacy issues often arise from such psychological concerns as relationship issues, fear of the unknown and growing older.

Every woman’s menopause is unique and her responses, including sexual responses, depend on the context in which she interprets them. “Menopause is about transition and change in many areas of a woman’s experience,” explains Dr. Marianne Brandon, PhD, LLC, co-author of Reclaiming Desire: 4 Keys to Finding Your Lost Libido (Rodale). “If she readily relates change to loss and something negative, it is likely that she will experience these changes in her sexuality as more detrimental than a woman who approaches change as an adventure or a challenge.”

A woman can choose to take advantage of this time in her life to nurture a deeper, more mature level of sexual expression; if she does, the reward is a more meaningful love life. “This woman will flow with the menopausal symptoms with more ease than a woman who wants to recover her prior experience of sexuality,” says Dr. Brandon. “A woman who values how age and maturity offer the potential for a deepening understanding of herself and her sexual experience will likely find the sexual symptoms of menopause less threatening, and thus less difficult to cope with.”

At the age of 50, while teaching English in Japan, Dawn had her first brush with menopause. “I was sitting in a convent with a Catholic nun conversing in English and there was a male teacher with us. And I said, ‘My goodness, it’s hot in here!’ and Joan, the nun, looked at me and said, ‘How old are you?’ And then it dawned on me!” A thin, energetic vegetarian, Dawn wasn’t even slightly inconvenienced by the symptoms of menopause. She describes her hot flashes as “a nice wave of heat” and says her sex drive actually increased. “Other than a couple of those flashes and less than a year of night sweats, which didn’t bother me a bit, I didn’t have any symptoms,” says Dawn. “Then, when it came and went, I was too busy to even think about it.”

Let’s Talk

For women like Dawn who have few or no symptoms of menopause, this time of life may be no different than any other. For the many others who undergo emotional and physical changes, support from an understanding partner can make all the difference. But just how do you broach such an intimate and sensitive subject?

The ease of talking about menopause with those close to you may depend on how effectively you communicate in general, but it can be helpful to know that just as a woman may find it difficult to talk about changes to her body, her partner may find it difficult to talk about his changes. “This issue is rarely discussed,” says Dr. Brandon, “but in fact men have more sexual changes with age than women do.” So while you might think you’re the only one feeling confused, concerned and crazed about the changes in your life, he may be feeling the very same way about his.

In fact, communication with your partner—not sex—may be one of the most important factors in a successful relationship. If both partners are well-informed about normal bodily changes, and the accompanying emotional upheaval, each can be more open to making allowances rather than making—or trying to meet—unrealistic demands.

Instead of avoiding sex, express your concerns and communicate what is happening for you emotionally and sexually; candid conversation between partners is important to ensure a thriving love life for years to come. And when it comes to salvaging your sex life, talk is anything but cheap.

At the Sexual Wellness Center in Annapolis, Maryland, where Dr. Brandon treats women with sexual concerns including low libido and decreased arousal, she urges patients to slow down and focus on the process instead of the outcome. “Discuss ways to make sex more interesting, fun and creative so that the focus is on new patterns of relating versus the loss of the old. Focus on feelings, senses and slowing things down.” Keep in mind that sexual problems usually have solutions, especially if couples can talk openly with each other.

Natural Solutions

You can help tame the menopause monster and rouse a sleeping libido with clinically and traditionally time-tested natural remedies, especially since hormone replacement has been shown to pose health hazards.

Declining estrogen levels decrease blood supply to the vagina and surrounding nerves, making vaginal dryness the topic de jour among menopausal women. Most natural food stores offer a range of products with vitamin E, known for its moisturizing effects; a simple lubricant can restore moisture, making intimacy more comfortable. Just be certain the product is intended for internal use.

Red clover, which is rich in isoflavones, may help relieve symptoms of dryness without the increase in postmenopausal cancer risk brought on by traditional hormone replacement therapy (HRT). Following a study of women who took a red clover supplement, Malcolm Whitehead, MD, director of the gynecology/endocrinology unit at King’s College Hospital in London, England, informed the British Menopause Society that red clover is encouraging for women who want to continue enjoying sex naturally.

For fans of herbal remedies, traditional herbs used for centuries to remedy menopausal symptoms include black cohosh, false unicorn, Korean ginseng, St. John’s wort and wild yam. Black cohosh in particular may reduce hot flashes by acting on body temperature regulation, making it a safe HRT alternative, reports the Journal of Agricultural and Food Chemistry.

Damiana, an herb found in hot, humid climates, shows promise when it comes to increasing desire among women. It contains substances that foster improved blood circulation, stimulate nerve function and help to regulate hormonal levels.

Feels Soy Good

In traditional cultures where soy foods are a dietary staple, demographic studies indicate that only 9% of women experience hot flashes, in contrast to almost 80% to 90% of Western women. That’s because soy foods contain isoflavones, powerful plant substances chemically similar to the female hormone estrogen. During menopause, when estrogen levels drop, soy isoflavones can compensate by binding to cell receptor sites, easing symptoms.

Soy protein has emerged as one of the most researched foods in science, with past studies showing that regular consumption of soy can reduce hot flashes by as much as 50%. Ideally, women should consume one or two daily servings of organic, non-genetically engineered soyfoods. If soyfood doesn’t agree with you, taking a high-quality supplement is an option.

Calcium and multivitamin supplementation is a wise idea for any woman over the age of 35. Since the adrenal glands play a key role in the production of female hormones, adrenal support is crucial in menopausal women; helpful supplements include pantothenic acid (B5), the other B vitamins, vitamin C and para-aminobenzoic acid (PABA), which also perks up skin health.

Stimulating Movement

It really can be a matter of the old adage: Use it or lose it. By getting physically active, you can take back control of your body, and your brain, during this transition.

Exercise stimulates circulation, which is good for both your health and your love life, since exercise increases blood flow to every part of your body. Regular exercise also improves sleep, builds bone, lifts mood and stimulates the adrenals, aiding in the production of estrogen. Kegels, a simple and easy exercise that tones pelvis floor muscles, can keep intimacy pleasurable.

If you’ve developed a menopause tummy, try aerobic exercises preceded by gentle stretching, or make yourself more alluring and more flexible by trying yoga. An active lifestyle will improve the way you look, making you feel attractive and self-assured. And if you’re having an especially tough time shaking the weight, take heart: Some extra cushion may actually help a lagging libido and other menopausal symptoms since fat produces a little estrogen and a little testosterone, the male hormone that controls sex drive in both genders.

Saying goodbye to your hormones isn’t easy; after all, you’ve been together a long time. But if you can find a pathway between your current stage and the next, it may turn out to be the happiest time of your life. Remember that no matter what your age, the pleasure of a sunset or the scent of candles is just as satisfying. After all, life is beautiful and you’ve got plenty left to live.

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