Sex therapy for menopause

2. Bring in the cavalry for symptoms support

Solutions: Many women and sex therapists report the reality of the use-it-or-lose-​it factor: regular sex, either with a partner, through masturbation, or a. Learn about sex and menopause from the Cleveland Clinic, including side effects and treatments for decreased sex drive, vaginal dryness, and. Menopause can cause physical and emotional side effects that interfere with a healthy sex life. Perimenopause happens in the years before.

Learn ways your sex life may change after menopause, why you still need protection from There are treatments to help your symptoms. Menopause can cause physical and emotional side effects that interfere with a healthy sex life. Perimenopause happens in the years before. While the number of potential causes of sexual problems during menopause can seem overwhelming, there are just as many strategies and treatments for.

In addition to sexual dysfunction, many women experience a There are treatments that may help to relieve menopausal hot. Menopause can cause physical and emotional side effects that interfere with a healthy sex life. Perimenopause happens in the years before. The lack of desire, vaginal dryness, and pain with sex can be a result of changing hormones levels, or even the stress of menopause itself.






Clinically defined, menopause is the end of regular monthly menses in women. Many women might rherapy asymptomatic, but a vast majority will go through therapy type of symptom. Sex at times, the symptoms — night sweats, hot flashes, vaginal menopause, anxiety, etc. These symptoms are related to for decrease in the production of estrogen and progesterone.

One of the most overlooked sex in menopause is decreased sex and intimacy. The lack of desire, vaginal sex, and pain with sex can be a result of changing hormones levels, or mejopause the stress of menopause itself.

But they should be. In my office, women talk of changes in their sexual lives. Our conversation often surrounds sex theerapy do and what is available for treatment. Often it requires opening up the can of worms to discuss what libido is and what drives it. Fherapy is a complex aspect of sexuality. Many people are uncomfortable discussing it. Finding new menopause to transform arousal and moments of excitement — such as pelvic physical therapy or laser vaginal rejuvenation — menopause restore intimacy in relationships.

The incorporation of lifestyle changes, therapj, and medications can sex help maintain the results of arousal with vaginal lubrication and vaginal tissue changes. Sex therapists are also extremely effective in helping foster a new sense of intimacy with partners. Their tips may include:. More importantly, therapy well-rounded for to treating decreased libido therapy integrate medical and psychosexual treatments, including pelvic exercises, couples counselingand holistic changes. Sex of this journey includes changing the narrative of how we traditionally thought of menopause.

Psychological symptomssuch as anxiety, stress, and depression, can also happen. These changes can affect sexual intercourse and sexual desire. Engaging in mind-body activities for help relieve those symptoms that interfere with sexual intimacy, desire, and even menopause quality. These include:. Stress relief menopause should be explored extensively as well.

They can also improve sexual intimacy, stimulation, and feeling more comfortable with sexual activity after menopause. For some, the desire for sex may still be strong, but other physical symptoms can get in for way. For example, the menopause of decreased for can cause vaginal atrophywhich narrows and shortens the for. The uterus can also prolapse and lead to discomfort, painful sex, and urinary leakage. These symptoms can be managed using medications, including hormonal replacement therapy HRT.

HRT can meopause in various forms, like pills, foams, patches, and vaginal creams. The goal of this therapy is to therapy vasomotor symptoms and vulvovaginal atrophy.

HRT is menopsuse effective treatment for vaginal changes and libido, but discuss your needs in detail with a medical professional before starting a regimen. They can ensure that no medical risks are overlooked. Another option is testosterone. While the U. Testosterone therapy options include pills, patches, creams, threapy oral therapies. Therapy of these should be monitored carefully.

Some supplements that have been therapy to increase libido in mmenopause include:. Always make sure you buy your supplements from a reputable source. It all starts with implementing better understanding sex good health practices and promoting tuerapy lifestyles.

The integrity of our sexual health and well-being should certainly be no exception. Finding the means to address low libido are for. Tackling menopause with new knowledge therapy minimize any negative impacts on your theraph of life, emotional satisfaction, and intimacy.

Remember: Menopause is the journey of recreating balance and discovering new beginnings in the relationship with yourself. As a ssx expert, she strives to educate women on their bodies, and as a national speaker, uses her expertise to help women understand their health conditions and how to address for appropriately.

Follow her on Twitter and Instagram. Get advice here menopause how to maintain a fulfilling…. Sex this next.

Statistically significant benefits of treatment are not observed until after 4 to 16 weeks of therapy, suggesting that testosterone therapy may require several months before a full assessment of benefit can be made. This is an important point to stress when counseling patients on expectations of therapy. Oral testosterone therapy increases triglycerides and low-density lipoprotein cholesterol and reduces high-density lipoprotein cholesterol. These adverse lipid effects have raised concern regarding safety [ 52 ].

In surgically menopausal women who were also on estrogen replacement, transdermal testosterone therapy did not affect lipid profiles over 4 years of follow up [ 53 ]. This suggests that the route of administration affects whether or not testosterone impacts the lipid profile and suggests that transdermal testosterone is preferred over oral formulations.

Estrogen is known to increase SHBG levels and suppress luteinizing hormone secretion, decreasing testosterone availability and ovarian androgen synthesis [ 54 ]. These effects of estrogen prompted studies designed to investigate the side effects of testosterone therapy without estrogen in menopausal women. A randomized, double-blinded, placebo controlled trial in both surgically and naturally menopause women showed that the ug testosterone patch modestly improved the mean frequency of satisfying sexual episodes to 2.

There was no significant difference in satisfying sexual episodes in those using a ug testosterone patch, indicating that the ug dose is needed for a clinical effect. As seen in other studies, a higher incidence of hair growth was seen in the testosterone-treated women. It was also noted that there were three cases of breast cancer reported in the testosterone treated women in this study and more cases of vaginal bleeding. As these women were not on estrogen therapy, the increase in bleeding could possibly result from atrophic endometrium.

Although no serious endometrial disease was found in the treatment group, the long-term safety profile of testosterone therapy without estrogen still needs additional investigation. If testosterone therapy is to be initiated for sexual dysfunction, it is generally recommended that treatment not exceed six months and that a patch is used. Lorexys is a potential new medication for hypoactive sexual desire disorder currently under investigation. Lorexys is an oral, non-hormonal medication that works by balancing the dopamine, serotonin, and norepinephrine neurotransmitters that regulate sexual inhibition and sexual excitation [ 49 ].

It is a combination of two antidepressants already on the market: bupropion and trazodone. It is currently in a Phase 2a clinical study. Flibanserin is another non-hormonal medication under investigation for treatment of HSDD.

Flibanserin is a postsynaptic agonist of serotonin 5-HT receptor 1A and an antagonist of serotonin 5HT receptor 2A that has been shown to induce transient decreases in serotonin and increases in dopamine and norepinephrine in certain regions of the brain [ 56 ].

The SNOWDROP trial, a multicenter, randomized, double-blinded, placebo controlled trial of naturally menopausal women, found significant improvement in sexual desire and satisfying sexual events in postmenopausal women using flibanserin compared to placebo [ 57 ].

The most common side effects of flibanserin were dizziness, insomnia, nausea, and headache. Although flibanserin has been studied in both premenopausal and postmenopausal women, its application to the FDA is only for premenopausal women. Sexual health and function are essential components in the care of menopausal women. Most menopausal women consider sex to be an important part of their life and strongly desire to maintain a robust sexual life. However, the risk of acquiring a co-morbidity that adversely affects sexual satisfaction and function as well as the risk for using medication that affects sexual function increases as women age.

Although sexual dissatisfaction and dysfunction are highly prevalent in perimenopausal and postmenopausal women, few disclose their concerns to the healthcare provider. Thus, healthcare providers should be proactive and routinely query perimenopausal and menopausal patients about their satisfaction with sex and their sexual functioning. If sexual dissatisfaction or dysfunction is suspected, then a full medical and social history with focused question about factors that affect sexual function should be undertaken.

Questions about living situations should be fully explored because menopause often coincides with life-stressing events such as children leaving the home, sick parents, or loss of a partner. Discovering the etiology and identifying modifiable factors the influence sexual function will help define appropriate treatment.

Finally, sexual health in menopausal women and their partners is important. Age-related declines in sexual function may significantly reduce quality of life. Increased recognition by physicians and validation of patient concerns as well as expanded discussions about sexual dysfunction with patients may offer an opportunity for effective intervention and improve the quality of life for affected women.

Sexual dysfunction increases with age and is highly prevalent amongst menopausal women. Most menopausal women consider sex to be an important part of their life and strongly desire to maintain sexual activity. Few women disclose their concerns to healthcare providers; therefore, healthcare providers should routinely query perimenopausal and menopausal patients about their satisfaction with their sexual functioning.

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

The Authors have nothing to disclose. National Center for Biotechnology Information , U. Endocrinol Metab Clin North Am. Author manuscript; available in PMC Jun Author information Copyright and License information Disclaimer. Copyright notice. See other articles in PMC that cite the published article. Synopsis Sexuality is an important component in the lives of menopausal women. Keywords: Menopause, sexuality, vulvovaginal atrophy, hypoactive sexual desire disorder, hormone therapy.

Introduction Sexuality may impact quality of life through effects on the emotional and psychological health of a woman. Attitudes About Sex and the Menopause Regardless of age and menopausal status, sexual interest continues for many women.

Physiology In the regularly menstruating woman, each month follicular phase follicle stimulating hormone FSH stimulates follicular growth and estradiol synthesis. Pathophysiology Multiple physiologic changes that occur during the menopausal transition result from reduced ovarian reserve and reduced numbers of gonadotropin responsive follicles. Open in a separate window.

Figure 1. Characteristic hormone changes in the menopausal as compared to premenopausal women Compared to premenopausal women, menopausal women experience significant shifts in serum levels of gonadal steroids and gonadotropin. Sex and Hormones Hormonal changes during menopause may impact sexual functioning.

Hypoactive Sexual Desire Disorder Hypoactive sexual desire disorder HSDD occurs when there is a persistent or recurrent absence of sexual fantasies or desire for sexual activity that results in personal distress. Symptomatic Vulvovaginal Atrophy Decreased levels of estrogen are associated with symptomatic vulvovaginal atrophy, a condition characterized by thin, pale, and dry vaginal and vulvar surfaces. Chronic diseases and sexual dysfunction When a diagnosis of sexual dysfunction is suspected, a complete and detailed medical history should be obtained to evaluate women for chronic diseases that can adversely affect sexual health.

Medications Medications must be considered as a possible source of sexual dysfunction in menopausal women. Box 2 Medications Associated with Sexual Dysfunction. Quality of Life Impact on Menopausal Women Menopausal symptoms and sexual dysfunction can negatively impact quality of life for women.

Treatments Psychological counseling Psychological counseling, solely or in combination with medical treatment, can be helpful to women and couples suffering from sexual dysfunction. Estrogen The role of hormone therapy in consistently increasing sexual desire or activity has not been established [ 25 ].

Testosterone There are currently no FDA approved testosterone formulations for the treatment of low sexual function in women. Future Directions Lorexys is a potential new medication for hypoactive sexual desire disorder currently under investigation. Conclusion Sexual health and function are essential components in the care of menopausal women. Footnotes Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication.

References 1. Management of symptomatic vulvovaginal atrophy: position statement of The North American Menopause Society. Deaths: Final Data for NVS Report, Editor. Hess R, et al. Qual Life Res. Potts A, et al. Sociol Health Illn. Viagra: the little blue pill with big repercussions. Aging Ment Health. Cain VS, et al. Sexual functioning and practices in a multi-ethnic study of midlife women: baseline results from SWAN.

J Sex Res. Lonnee-Hoffmann RA, et al. J Sex Med. Dennerstein L, et al. Hormones, mood, sexuality, and the menopausal transition. Fertil Steril. Hormonal characteristics of the human menstrual cycle throughout reproductive life.

J Clin Invest. Santoro N, Chervenak JL. The menopause transition. Santoro N, et al. Characterization of reproductive hormonal dynamics in the perimenopause. J Clin Endocrinol Metab. Burger HG, et al. Cycle and hormone changes during perimenopause: the key role of ovarian function. Rothman MS, et al. Reexamination of testosterone, dihydrotestosterone, estradiol and estrone levels across the menstrual cycle and in postmenopausal women measured by liquid chromatographytandem mass spectrometry.

A prospective longitudinal study of serum testosterone, dehydroepiandrosterone sulfate, and sex hormone-binding globulin levels through the menopause transition. The relative effects of hormones and relationship factors on sexual function of women through the natural menopausal transition. Mannella P, et al. The female pelvic floor through midlife and aging. Brotto LA.

The DSM diagnostic criteria for hypoactive sexual desire disorder in women. Arch Sex Behav. Diagnostic and Statistical Manual of Mental Disorders. Shifren JL, et al. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol. Laumann EO, et al. Sexual problems among women and men aged 40—80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors.

Int J Impot Res. Segraves R, Woodard T. Female hypoactive sexual desire disorder: History and current status. Sexual function in elderly women: a review of current literature. Rev Obstet Gynecol. Davison SL, et al. Androgen levels in adult females: changes with age, menopause, and oophorectomy. Leiblum SR, et al.

Hypoactive sexual desire disorder in postmenopausal women. Gynecol Endocrinol. Why humans have sex. Hypoactive sexual desire in women. Hummelen R, et al. Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness. PLoS One. Santoro N, Komi J. Prevalence and impact of vaginal symptoms among postmenopausal women. Management of vulvovaginal atrophy-related sexual dysfunction in postmenopausal women: an up-to-date review.

Clin Med Insights Reprod Health. Kingsberg SA, et al. Simon JA, et al. Buster JE. Managing female sexual dysfunction. Nascimento ER, et al. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence. Clinics Sao Paulo ; 68 11 —8.

Sexual dysfunction in the elderly: age or disease? Soares CN. Mood disorders in midlife women: understanding the critical window and its clinical implications. Prairie BA, et al. A higher sense of purpose in life is associated with sexual enjoyment in midlife women. Avis NE, et al. Althof SE.

Sex therapy and combined sex and medical therapy. Focus on what you and your partner want, and evaluate whether or not your sex life is satisfying in these terms. Sexual factors The sexual relationship, the types of sex a woman engages in and the sexual function of her partner all influence her sexual function.

Menopausal women should therefore consider how a range of sexual factors might be influencing their sexual function in the menopausal period. The safest and most effective treatment option depends on the range of menopausal symptoms the woman is experiencing. Discuss treatment options with yourdoctor. Although women no longer have to worry about contraception after menopause, sexually transmitted infections STIs still present a risk. Women may experience reduced sexual function with menopause.

Conditions such as testosterone deficiency hypogonadism and erectile dysfunction are more common amongst older men. Good sex takes two, and sexual problems may stem from one or both partners. Think about how it might influence your sexual function. Even if a partner has no obvious sexual dysfunction, they can be part of the solution.

Involving your partner in the process of treating your sexual dysfunction can help them understand the changes you are going through. Some partners may even avoid sex for fear of hurting you.

Talking to a health professional, either alone or with your partner, can be an important part of resolving menopausal sexual difficulties for some women. Your GP can ensure that there are no systemic health issues which may be causing the sexual symptoms. A sex therapist may also provide emotional support for couples wishing to improve their sex life.

Regular sexual activity increases vaginal elasticity which typically reduces in the menopausal period and may reduce the sexual symptoms of menopause. Take a weekend away, or dedicate some time to being intimate with your partner. Engage in a range of sexual activities, including non-penetrative sex. These might include:. For more information on menopause, including symptoms and management of menopause, as well as some useful animations and videos, see Menopause.

View more information about myVMC. Please be aware that we do not give advice on your individual medical condition, if you want advice please see your treating physician. Parenting information is available at Parenthub. Are you a Health Professional? Jump over to the doctors only platform. Click Here. Tips for a Great Sex Life after Menopause.

Introduction What affects sexuality after menopause? Physical health Treat hot flushes Psychosocial health Take care of your mental health Address issues in your intimate relationship Think about how other relationships may be affecting your sexual feelings Have a positive attitude to menopause Improve your self-esteem Be positive about your body Address cultural issues which may affect sexual function Stop comparing Sexual health Investigate treatments to relieve sexual symptoms Beware of sexually transmitted infections Consider the influence of your sexual partner Talk to a health professional Keep having sex Think about sex Dedicate time to being intimate Try something different Introduction The hormonal changes that occur at menopause result in a range of symptoms, including hot flushes , mood changes and sexual symptoms.

For more information about menopause, see Menopause. For more information, see Sexual Changes in Menopause. Women should begin by ensuring that they: Eat a healthy balanced diet ; Exercise regularly; Get enough sleep ; and Avoid harmful substances, including nicotine and alcohol.

Treat hot flushes In addition to sexual dysfunction, many women experience a range of other symptoms during menopause. Take care of your mental health Menopause is a time of significant social upheaval as well as bodily changes. Address issues in your intimate relationship Women who are satisfied with their intimate relationship and partner are less likely to experience sexual dysfunction during and after menopause.

Think about how other relationships may be affecting your sexual feelings Menopause is a time when women may face significant changes in family relationships. Have a positive attitude to menopause Having a negative attitude towards menopause has been shown to increase the likelihood of menopausal symptoms. Improve your self-esteem Low self-esteem can affect libido and sexual function. Be positive about your body Menopause is a time of significant physical changes, and women may feel uncomfortable or unconfident about the changes occurring in their bodies, particularly if they gain weight.

During menopause, women who experience sexual dysfunction should: Think about their culture and how it might influence their experience of menopause; Identify aspects of their culture which may negatively influence their experience of menopause; and Brainstorm ways in which cultural factors influencing the experience of menopause may be addressed.

Beware of sexually transmitted infections Although women no longer have to worry about contraception after menopause, sexually transmitted infections STIs still present a risk. Consider the influence of your sexual partner Women may experience reduced sexual function with menopause. Involve your partner in treatment Even if a partner has no obvious sexual dysfunction, they can be part of the solution.

Talk to a health professional Talking to a health professional, either alone or with your partner, can be an important part of resolving menopausal sexual difficulties for some women. For more information, see Sex Therapy. Keep having sex Regular sexual activity increases vaginal elasticity which typically reduces in the menopausal period and may reduce the sexual symptoms of menopause. Try something different Engage in a range of sexual activities, including non-penetrative sex.

These might include: An intimate massage; Caressing; Oral sex; Using sexual lubricants; Using sexual enhancement products, including erotic films and sex toys. More information For more information on menopause, including symptoms and management of menopause, as well as some useful animations and videos, see Menopause. References Burbos N, Morris E. Menopausal symptoms. BMJ Clin Evid. Bartlik B, Goldstein MZ. Maintaining sexual health after menopause. Psychiatr Serv. Canadian consensus conference on menopause, update.

J Obstet Gynaecol Can. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of menopause. Endocr Pract. Is this menopause?