This month the menopause support circles are taking on the somewhat overwhelming subject of sex and menopause in our talks titled- “Sizzle or Fizzle.” I say overwhelming because human sexual behavior and response is so complex. Although it seems alot of women are concerned about their lack of desire or libido there seems no lack of desire to discuss it. So we will tackle it the best we can. Let’s see if we can get some clues to just where the excitement, the romance ,the “sizzle” went and maybe even some ideas in how to regain some of it.
It is important to remember that about 22% of all women regardless of age report lack of desire. After menopause 47% report decreased desire. But 37% of post-menopausal women report no change in desire and 10% actually report increased desire. So I guess I’m just writing to about half of you. But just in case you have a “friend” who might need some information the rest of you can read on too. Although this entry is written from a heterosexual perspective it is easily applicable to any sexual relationship.
Back in the 1960’s Masters and Johnson’s landmark report on human sexuality described a linear model of female sexual response. That is that sexual behavior starts with desire then moves to arousal, followed by orgasm and then finally resolution. If only! At least it was a start but this model is unhelpful when dealing with much of the real world. Although it can happen in that straight forward linear way, just between us, you know it often doesn’t. Particularly if you have been married for say 30 years. About 2001 a researcher/physician, Rosemary Basson proposed a cyclical model of female sexual response. Her idea is that women often do not feel desire first but make a choice to have sexual contact for any number of reasons. Actual desire may arise only after stimulation and arousal. Emotional and physical satisfaction then provides more motivation. This is not as true for men. As a friend of mine might say, ” Women need a reason, men just need an opportunity.” But as Dr. Basson might say ” Women’s sexual response is very contextual.” So just why did that yummy anticipatory desire for sex turn into a desire to do it just to shut him up for a few days. Well, what are the contextual factors?
Length of relationship- This is a normal consequence of being human. We crave novelty. Research has found that it takes about a year for the excitement of a new relationship to settle into routine. Only thing you can do about that is get creative and find ways to make it new. I don’t advise starting over for most of you; in a year you will just be in the same boat.
Environment- If your 25 year old son is camped on the sofa and your mother-in-law is rearranging your kitchen cabinets or the roof is leaking over your bed- it ain’t gonna happen. Kick him out, send her home, get it fixed. Is your home safe and stress free? If not, why not?
Emotional closeness- Talk. Plan dates. Have fun together. Where’s the romance? Work on it.
Relationship issues- Low self image , anger or trust issues may require professional counseling. This has been found to be a major cause of sexual dysfunction. Depression also proves to be a huge issue with low libido.
Inadequate or inappropriate stimulus- Communicate clearly with your partner. Get a book. Get counseling.
Medical/Physical issues- It really goes without saying that hormonal and physical changes do contribute to decreases in desire. Certain medications certainly can cause difficulties as do some illnesses. Limited mobility or partner’s ability to function as well as hot flashes, vaginal dryness and insomnia can really do a number on the libido. Talk to your care provider. More often than you might imagine, medications can be changed or others prescribed to help with problems. Menopausal symptoms can often be relieved with hormone therapy or even life-style changes. You don’t know until you ask.
As far as I can figure, it all boils down to this- How important is sex in maintaining a positive relationship between you and your partner? If it is important then as you get older, sex is just going to need a little more attention and a little more effort. Now how is that any different than anything else these days?
Recent Comments