How Do I Keep Myself And My Partner Intimate And Connected After Menopause?

Dear Thalia,

I'm a femme lesbian in a committed relationship with a butch. I love my partner and crave her touch and to be near her. I have gone through (early) menopause due to a complete hysterectomy. My desire and sex drive is low at best and sex is often painful (penetration of any kind, despite copious amounts of lube) -- ideas on how to keep us both intimate, connected and sexual?

Sincerely,

GrrlNextDoor


Dear GrrlNextDoor:

Thank you for sending in your question.  Dealing with the changes of menopause is something that so many of us face, I'm sure that many of our readers are thanking you also for asking what they were thinking.

I want to start off by saying, as I often do, be sure to work with a gynecologist that you trust and feel comfortable with.  There have been many advancements in the understanding of how menopause affects a woman's health and treatment for problems associated with menopause. The days of having to tolerate the ill effects of menopause are over.

The difficulty for most women is being able to open up with someone about the very personal and private struggles.  You've already taken that first step, both for yourself and for our readers.

Women have traditionally been taught that their need for sex is tied to procreation.  And once the body is no longer capable of procreation, the desire for sex ceases in some sort of primal way.  This is, thankfully, a myth. If we take action to heal any problems associated with menopause which lessen the enjoyment of sex, menopause will be the best and most sexually active time of your life.  By the time you reach menopause, you're life is often once again your own.  You are living your life for yourself and not your children or your job.  Do yourself a huge favor and address any symptoms.  Don't accept the effects of menopause as your destiny.

Let's talk about the most common issues a woman faces during perimenopause and afterward into menopause. 

Vaginal Atrophy. "Atrophic vaginitis (also known as vaginal atrophy or urogenitalatrophy) is an inflammation of the vagina (and the outer urinary tract) due to the thinning and shrinking of the tissues, as well as decreased lubrication. These symptoms are due to a lack of the reproductive hormone estrogen." (source: Wikipedia)

According to researchers, nearly half of all women experience vaginal atrophy, but very few women seek treatment. The symptoms will sound familiar to many of our perimenopausal and menopausal readers. 

  • Vaginal dryness
  • Vaginal burning
  • Vaginal discharge
  • Genital itching
  • Burning with urination
  • Urgency with urination
  • More urinary tract infections
  • Urinary incontinence
  • Light bleeding after intercourse
  • Discomfort with intercourse
  • Decreased vaginal lubrication during sexual activity
  • Shortening and tightening of the vaginal canal

The primary cause of vaginal atrophy is the loss of estrogen.  Estrogen replacement therapy comes with an increased risk of developing cancer.  So many women choose to live with the condition rather than treating it. There are many actions a woman can take to mitigate the symptoms of vaginal atrophy associated with perimenopause and menopause that are healthy and effective.

  1. Exercise regularly. I'm not talking about anything extreme here.  Just get up and move, park farther away from the door when you shop, take the stairs, walk through a park.
  2. Don't smoke.
  3. Eat foods high in nutrition.
  4. Stay sexually active. Sexual activity increases blood flow. But this one is a bit of a catch-22.  If you are experiencing the symptoms of vaginal atrophy, then you are likely not interested in sex, particularly if it is painful.  You mentioned that using lubrication doesn't help with the pain.  You should try different brands of water-based lubrication.  Hopefully, this will help.  If not, temporary use of topical vaginal estrogen may help get you to the place where lubrication will help.  And once that is true, regular penetration may help sustain the relief. And of course, all lesbians know that penetration is not a requirement for great sex.  So experiment with your partner or yourself.  You might find something new works for you that didn't work before menopause.

Decreased/Increased Libido. Much of the decrease in libido can be attributed to vaginal atrophy and other symptoms of low estrogen such as hot flashes, mood swings and memory loss/confusion.  Some women, conversely, experience an increased libido.  When you are one part of a couple, whether going through menopause alone or along with your partner, communication is key to treating this symptom. This, of course, can be easier said than done.

I've written about BDSM and the use of a safe word during scene play.  But I think having a safe word is important for all couples, and in many different scenarios, not just sex. This is especially true when mood swings are a common side effect of menopause.  Agree on a safe word.  If you or your partner start to feel that communication has gone off the rails and it's probably due to hormones, shout out the safe word.  Agree to take a blameless pause before returning to the discussion.  The safe word will also work during sex.  If your partner is doing something that hurts, use the safe word.  Many women find it difficult to communicate effectively during sex. But having an agreed upon safe word can help you overcome the fear and ensure that at least your most essential needs are communicated.