Let’s Talk About Sex! Menopause and sustaining a healthy sexual relationship

love-3512618_1920.jpg
 

Let’s talk about sex!

In the run up to our website launch one year ago today, on World menopause Day 2017 (yes, today’s also our birthday!), we talked to, and videoed, many women experiencing sexual well-being problems. A common discussion tended to lead to the sore and painful topic of vaginal atrophy. None wanted to be identified on film, yet were happy to talk candidly to us, in private. Why was this and can we change their attitude?

There’s really not a lot of positives one can say about vaginal atrophy other than it’s miserable, however it’s not normal and can in most cases be treated. But understanding how it can be treated and finding the right health professional who knows, understands and can direct women to the correct treatment, is key to helping these women.

 

As the International Menopause Society state, ‘Sexual health is a state of physical, emotional, mental and social well-being related to sexuality.’

‘Sexual well-being after menopause’: An International Menopause Society White Paper published in July 2018 released some pretty startling statistics.

In survey data regarding symptoms related to vulvo- vaginal atrophy (VVA) – ‘prevalence of symptomatic VVA is consistently about 50%. The International Vaginal Health: Insights, Views, and Attitudes (VIVA) Study reported the prevalence of specific symptoms including vaginal dryness (83%) and pain during intercourse (42%). Ultimately, 62% of women with discomfort reported the severity of their symptoms to be moderate or severe.’

Further statistics in this study state that 55% of women and 61% of men avoid sex because of pain. And 46% of women and 43% of men had ‘diminished sexual desire’.

We’re not medical experts but that does go to show that VVA is bound to have some impact on personal relationships.

hands-1246170_1920.jpg

What positive light can we bring to this revelation?

VVA is only one symptom that many women encounter when tip toeing through the menopause minefield. Fatigue, insomnia, low mood, self-esteem and libido are all culprits that can tackle you from the side lines creating a sexual menopausal maelstrom.

Women need to be open with partners about what they are feeling. Menopause is the “prefect relationship storm” according to Counsellor and Psychotherapist Pam Custers, from The Relationship Practice, as often partners don’t understand what women are going through.

Relate published an article reporting that partnerships who perceived to have good sex, found it improved their relationship by 20% and relationships where there was no sex, showed a decline in the relationships of 70%.

So, SEX and INTIMACY is IMPORTANT in sustaining a healthy sexual relationship.

In an article published by Relate in 2017, research showed: ‘Sex, for most people, is an important part of good-quality, satisfying relationships. The evidence shows it’s also good for us! And not just the physical activity – although research does show apparent health benefits of sex. More importantly, it is clear that sexual satisfaction is intimately related to the quality of our relationships, which, in turn, is central to our wellbeing. Satisfying sex is likely to be both a result of and also a contributing factor to good quality relationships. Sex isn’t everything, of course, but the research shows clear associations between sexual satisfaction, our satisfaction with life overall and with our relationships, as well as our health and wellbeing. When our sex lives are not going well and we experience dissatisfaction and/or sexual problems, this can have a profound impact. So – we need to talk about sex.’

BOOM!!! Well done Relate.

We’ve had many discussions with Women’s Health Physios and the women’s health campaigners #pelvicroar who are evangelical about raising awareness of women’s gynaecological problems.

Large-scale research (Published in the British Medical Journal) has emphatically suggested that people who have sex regularly tend to have better all-round health as well.

We’ve outlined the 5 top tips to improve women’s sexual well-being, before, during and beyond menopause.

Line_orange.png

Muscles, oestrogen & testosterone are a girl’s best friend

Muscles are your friend in menopause. Doing pelvic floor exercises three times a day (yes, there are electronic pelvic toners and apps to remind you – also, download the NHS-approved Squeezy app now) and general physical exercise; including weight training, resistance training and impact exercises for all your big muscle groups, helps your cognitive wellbeing and improves testosterone levels.

Vaginas are big fans of oestrogen, it’s like water in the garden, vaginal tissue needs lots of oestrogen, to plump it up and stop the tissue from going dry - it keeps your vaginal tissue thick, elastic and moist. When oestrogen declines during menopause, problems may arise. Testosterone is not just a male sex hormone, woman need it too, and it can be generated by exercise.

Arousal and orgasms are good for you

Women get a lot of physiological benefits from sex - orgasms are good for you. With arousal, more fluid flushes through your vagina and vulval tissue, which helps with all the healthy reproductive hormones. Orgasms act as a decongestant of all these hormones and flushes out the hormones from the vagina.

An orgasm is a pelvic floor contraction – so after an orgasm you can argue that you’ve done one of your 3 times a day sets of pelvic floor exercises – take your pick, exercise or SEX!

All the Women’s Health Physios we’ve met would like to put orgasms on prescription, as pelvic floor exercise improves sensation, makes your vaginal tissue bulkier, improves arousal and you’ll have more intense orgasms. Good for you and your partner!

Love and lubrication

No way should the menopause interfere with enjoyable and pain free sex. Vaginal atrophy caused by lowering of sex hormones creates a dry vaginal wall, “no way is this normal and, in most cases, it can be treated” says Women’s Health Physio, Christien Bird, from the White Hart Clinic. Use a good lubricant and use it generously. Talk to your GP about topical oestrogen, if they are unable to help, asked to be referred to a Women’s Health specialist.

Christien says “Never give up, there’s nearly always another solution if one lubricant doesn’t work.” There are lots of lubricants on the market, water-based ones create less friction, or silicone based that may be more suited for those with sensitive skin, as it doesn’t get absorbed into the skin which is thought to result in fewer topical body reactions. You can use a combination of the two, and ideally, they should be paraben-free.

Physiotherapy

Long standing painful sex, urinary tract infection or irritation may all cause muscles in the pelvic floor to develop a guarding response. This contraction decreases the blood flow and creates a negative feedback loop. Basically, the vagina says NO!

Physiotherapy can help this tension like any other tense muscle you would get treated. Combined with topical local oestrogen, (low dosage Hormone Replacement Therapy) HRT, as a pessary or cream, is helpful and has no known risk with many benefits.

Don’t be embarrassed to talk about sex

Women need to talk about their sexual well-being and have the courage to sort out any irritation or pain.

Be proactive - talk about sex, to your partners, mothers, daughters and seek help, whether from your GP for symptom relief or a counsellor for advice, but most of all, don’t suffer in silence!

Women’s Health campaigner and Women’s Health Physio, Myra Robson, developer of the pelvic floor exercise reminder app Squeezy, and member of the campaign group #pelvicroar, advises women to “Take a pause and be positive, because there is so much that can be done to improve sexual function and sexual health…take a step by step approach and learn/ask/implement an action plan!”

Happy World Menopause Day 2018

#positivepause

Line_orange.png

Hot Flush vlogs to watch on sexual wellbeing.

Women’s Health Physiotherapist Christien Bird from the White Hart Clinic‘Talking About Menopause & The Pain Of Sex’

Counsellor and Psychotherapist Pam Custers, from The Relationship Practice - ‘Talking Menopause & Relationships’

Related blogs

‘Sex and the Menopause’ by Sylk

The low-down on lubricants and vaginal moisturisers the Yes Yes Company

Special thanks

We’d especially like to thank women’s health campaigners #pelvicroar pelvic toners Kegel8 and Nutritional Therapist Jackie Lynch from WellWellWell for their support and collaboration in our #positivepause campaign.

Line_pink.png

If your looking for a friendly place to chat with like-minded menopausal women why not join our Private Facebook Group the ‘Hot Flush Chill Zone’.

To keep up to date with all our latest news, events and Hot Flush happenings, why not sign up to our Newsletter?