While the Menopause related blog is devoted in general to
the women, this post is not for them. It is for people who share all the
moments of their life – great and not so great – and can vastly contribute to
the general well-being. I think, that is very important for men to be supportive,
understanding, and loving partners through the period of the transition
(actually, before and after the transition as well), especially during the time
of menopause.
Introduction to
menopause
Menopause is a time when women experience considerable
hormonal changes which result in symptoms such as hot flushes, mood swings and
sexual problems. While these symptoms are natural, they can cause significant
distress for menopausal women and their partners, and can disrupt the couple's
sex life.
Having a supportive, understanding partner and being in a
trusting relationship makes it easier for women to cope with menopause and its
symptoms. On the other hand, being dissatisfied with a partner can exacerbate
the sexual and psychological symptoms of menopause. Many men may have little
knowledge of menopause and may be unsure how to react to the changes their
partner is experiencing or unaware that treatments to relieve menopausal
symptoms are available. In addition, they may not have considered their role
and how they might be contributing to (or may be able to help relieve) their
partner's symptoms.
There is considerable evidence that couples can continue
having a great sex life after menopause. However, it is also important to
highlight that there are many factors that influence the possibility of a woman
experiencing menopausal symptoms, including sexual problems. A woman's
relationship with her partner exerts a significant influence on her menopausal
symptoms, in particular the sexual symptoms which she experiences.
Men may be unaware that they play an important role in
keeping up a great sex life during and after their partner's menopause, or
unsure of specific steps they can take to improve their sex life. While general
practitioners and other health professionals are a good source of advice, men
are often embarrassed to discuss their sex life with a doctor. However, doctors
will treat sexual problems just like any other health problems, so it's
important for men to try and speak openly and honestly with their doctor.
Sexual symptoms are typically a problem for women because
they cause a mismatch between her partner's sexual needs and her own. For
example, a woman who takes longer to orgasm after menopause may only be
bothered if her partner experiences quicker orgasms as he ages. Menopausal
sexual problems are a joint problem, most effectively treated by involving both
partners. It helps when the male partners of menopausal women are educated
about why the sexual symptoms of menopause arise and what might exacerbate
them. Educated partners are in a better position to help menopausal women treat
the symptoms and have a great sex life after menopause.
There are many ways in which you can contribute to
ensuring that you both continue having great sex after menopause. As biological
and psychosocial factors indirectly affect a couple's sexual relationship, you
should not only think about sexual factors when you consider how to improve sex
with your menopausal partner, but must also consider how biological and
psychosocial factors influence sexual functioning.
Biological factors
Be healthy and encourage her to be healthy
Physical health influences sexual function, and staying
healthy is an important part of having a great post-menopause sex life. Try to:
* Eat a healthy, balanced diet;
* Exercise regularly;
* Avoid nicotine, alcohol and other harmful substances;
and
* Get enough rest.
Maintaining a healthy lifestyle can provide encouragement
for your partner, because you can exercise or plan healthy meals together.
Encourage her to
treat other menopausal symptoms
Your partner may have special health needs in the
menopausal period, and it is important that you are aware of these needs and
support her. In particular, she may need to take hormone replacement therapy or
another type of treatment, especially to relieve hot flushes which disrupt
sleep and mood changes which affect libido. You can help by being knowledgeable
about the various treatments available and helping her assess the pros and cons
of various treatments.
Offer to accompany
her to see a doctor
You can also provide support by accompanying her to the
doctor. A health professional is your best source of advice about menopause and
can also offer advice about a range of treatments which may be effective in
relieving the symptoms of menopause, including sexual dysfunction. However,
some women may not visit a doctor because they are afraid to discuss the
symptoms or even because they are afraid to admit they are experiencing the
symptoms and menopause.
It is best for menopausal women to visit the doctor with
their partner, as it helps the doctor to assess how the relationship is
affecting her symptoms, and enables the man to play an active role in the
treatment process.
Offering to accompany a menopausal partner to the doctor
is an important way of supporting her. She may be more willing to make the
visit simply because she has a support person. You can also help by
investigating where appropriate health professionals can be found, for example
by finding out if there is a menopause nurse at the local family planning
clinic, or investigating the resources available in the obstetrics and gynecology
department of the local hospital.
Psychological
factors
Get educated about
menopause and how it changes women
Women experience significant changes at menopause, and
it's difficult for those who are close to them not to notice. As her partner,
you likely know her well and spend significant time with her, and are thus
likely to notice mood changes more than others (and perhaps find yourself in
the middle of a menopausal mood swing once in a while). Unlike her friends and
family, your will also notice any changes in her libido or sexual response. All
these changes can cause concern and anxiety, and you may wonder what you are
doing wrong.
Education about the physical changes that occur at
menopause and the symptoms they create can help reassure you that it's all
natural. It can also help you to be a more understanding partner and better
express your support. The sexual symptoms of menopause typically include:
* Vaginal dryness;
* Reduced libido;
* Dyspareunia (pain during intercourse); and
* Reduce skin sensitivity and arousal.
Be aware that these symptoms occur in many menopausal
women, and don't be shocked if you observe these symptoms in your partner. It's
also important to bear in mind that non-sexual symptoms such as hot flushes and
mood changes can indirectly affect a woman's sexuality. For example, a woman
who has poor quality sleep because of hot flushes may experience reduced libido
because she is tired.
Try to view menopause as a gradual transition – it's
important to realize that it will not happen overnight. Women may experience
symptoms before their menstrual cycle changes and symptoms typically persist
for several years. Don't expect menopause to be over quickly; be prepared to
support your partner for the long haul.
View menopausal
symptoms as a problem for two – don't blame her
Men do not experience menopausal symptoms and it may be
easy to point fingers at a menopausal partner, believing, for example, that she
should deal with her quick temper or find some way to get herself in the mood
for sex. Instead of blaming your partner, try to think of menopause and its
symptoms as a stage of life that a couple experiences and faces together. Think
about what you can do to help your partner cope, rather than focusing on
changes she could make.
Encourage her to
talk and listen
Talking is an important strategy for relieving
psychological symptoms, which in turn impact on a woman's libido and sexuality.
You will never know exactly what a woman is feeling, but talking to her can
help you better understand how she feels. Take the lead in communicating with
her about her menopause experience. Don't pretend to know what she is going
through; instead, focus on listening and being empathetic.
You might start a discussion on menopausal symptoms by asking
if there's anything you can do to help. If you notice any changes such as bad
moods or anxiety, bring them up with your partner in a caring way, for example
by saying, "I've noticed you seem a bit stressed. Is everything
okay?" Such a question opens the door for her to talk about her symptoms.
It is also a way for you to show your support and that you care and pay
attention to the way she acts.
Don't be offended
if she wants to talk to friends
Having trusting, understanding friends to talk to and who
listen can be an important part of coping with menopause. Don't be offended if
your menopausal partner wants to talk to other friends – the more friends
supporting her, the better.
Talk about sex and
treatment for sexual dysfunction
To improve sex, it's especially important to find ways of
talking with your partner about how sex feels and how both your sexual feelings
are changing as you age. Women whose desire declines may be concerned that
their partners feel unloved or are looking for other women. Women who
experience increased sexual desire (which is perfectly normal, although less
common than reduced libido) may feel confused because ageing bodies are not
typically viewed as sexual.
Don't try to read your partner's mind – you have not
experienced menopause and should not be expected to understand how it feels.
You can, however, increase your understanding by talking to her about the
changes she is experiencing. It is an opportunity for you both to reassure each
other that the sexual changes are not because of reduced feelings of intimacy
and love. You can also use the opportunity to let your partner know that you
still love her and aren't interested in having sex with other women (and be
reassured that she still loves you, even if she doesn't want sex as much).
If you are worried that you might hurt your partner
during sex, ask her if she ever experiences sexual pain and what causes her
pain during sex. Also ask about her preferences for sexual activities now she
is in the menopausal period. You may find that some aspects of sex from earlier
years may have improved for her. Discuss possible strategies for improving your
sex life with your partner, and be ready to make some practical suggestions.
For example, suggest going shopping for sex toys or talk about articles you've
read on menopause.
Bear in mind that your own sexual feelings have also
changed with age, and it's important for you to explain these changes to your
partner. You may also start a discussion about treatments that can relieve the
sexual symptoms of menopause. Hormone replacement therapy is effective in
relieving sexual symptoms in most women, and there are also treatments
available for male sexual dysfunctions, including erectile dysfunction.
Talk about your
relationship
Problems with the intimate relationship or a lack of
social support may worsen psychological symptoms (e.g. mood changes) during
menopause, and these may in turn worsen sexual symptoms. Try to talk with your
partner about any issues in your intimate relationship, and think about how you
can deal with these. For example, consider practical steps you can take to
improve your relationship, like spending more time together. Some couples may
benefit from relationship counseling to address issues such as lack of trust.
Talk about her
emotional health
Menopause is a time of significant emotional upheavals
for women, and these changes may also influence her sexual function. For
example, a menopausal woman may be coping with changes to her maternal role
because of children leaving home. Talk to your partner about these changes and
how she is holding up emotionally. Just talking may help, although other
strategies may be needed if she is experiencing severe emotional changes which
are negatively affecting her daily life or relationships. For example, she may
need some special attention, and you can encourage and help her to:
* Put aside special time for herself;
* Do something special;
* Surround herself with supportive friends;
* Take on new roles in life, such as joining an interest
group or doing charity work; and
* Talk to her doctor if she experiences severe emotional
symptoms.
Encourage her to
love her menopausal body
The shape, size and texture of a woman's body typically
changes in the menopausal period. These changes may cause women to feel less
confident about their body image. Society tends to value young bodies more than
older bodies, and often equate the normal changes that occur as a woman ages
(e.g. weight gain, wrinkling and sagging skin) with loss of beauty, even though
they are completely normal.
You can help by reassuring her that the changes she is
experiencing are normal, and encouraging her to be positive about her body. You
can also reassure her by telling her that you still love her body, regardless
of the outward changes.
Boost her
self-esteem
A woman's self-esteem influences her sexuality, and low
self-esteem is associated with sexual dysfunction. You may therefore be able to
boost your sex life by promoting good self-esteem in the menopausal period. You
can encourage and help your partner to:
* Focus on the good, not the bad;
* Identify achievements she has made throughout her life,
and focus on these if she feels low;
* Challenge unrealistic expectations, for example about
her body shape or the ageing process;
* Set realistic goals;
* Join an interest group or do volunteer work.
Address cultural
issues which may affect sexual function
The values and roles expected of menopausal women vary
between cultures, and a woman's experience of menopause and its symptoms
depends on how she is perceived culturally. Cultural factors such as diet,
lifestyle, economic status and life expectancy can also influence her
menopausal experience and her sexuality in the menopausal period.
During menopause, you can help keep your sex life great
by thinking about how cultural beliefs influence your partner's experience of
menopause. Encourage her to do the same. For example, consider:
* How your culture/s might influence her experience of
menopause, for example, whether or not the culture promotes valuable roles for
menopausal women, how the culture views ageing bodies, and cultural attitudes
towards older people having sex;
* Identify aspects of your culture/s which may negatively
influence her experience of menopause; and
* Brainstorm ways in which cultural factors influencing
the experience of menopause may be addressed.
Be positive about
menopause
Be positive about menopause and focus on how the changes
it is catalyzing may teach you and your partner new ways of enjoying and
supporting each other. Women who have a positive attitude about menopause, and
view it as a time of positive change rather than a crisis, are less likely to
experience menopausal symptoms, so it's also important to encourage her to
focus on the positive aspects of menopause, such as the cessation of menstrual
bleeding and the associated freedom.
Sexual factors
Vary your sex life
Sexual feelings change as men and women age, so it
follows that the types of sex that feel best will also have to change.
Typically, men and women take longer to become aroused and have more difficulty
becoming aroused. This may mean that you need to spend more time on foreplay
before penetrative sex. If there's a problem like erectile dysfunction,
exploring non-penetrative sexual techniques will be important.
It is important to take the view that changes to sex life
and sexual functioning are normal and can be positive. What happens in the
menopausal period does not matter as long as both partners are satisfied. Try
to find new ways to display affection and intimacy that make both of you feel
desirable. For some couples, that may mean putting penetrative sex on hold and
just kissing and cuddling for a while, or spicing up your sex life with sexual
enhancement products like dildos, lubricants and erotic film or literature.
Consider how your
sexual function influences her sexual experience
Sexual problems including hypogonadism (testosterone
deficiency) and erectile dysfunction are more common amongst ageing men. A
man's sexual function exerts a significant influence over his partner's sexual
function; in about one third of couples, problems with the man's sexual
functioning are responsible for the female's menopausal sexual dysfunction.
Consider your own sexual function and how problems such
as erectile dysfunction or premature ejaculation might be contributing to your
partner's sexual difficulties in the menopausal period. As men typically
instigate sex, changes to his libido may have a significant impact on the
frequency of sex. If he feels like sex less and initiates it less, frequency
will decline unless his partner begins to initiate sex. If you are experiencing
sexual problems or changes, discuss them with a doctor and find out about the
range of treatments for male sexual dysfunction which can help improve your sex
life.
Feelings of rejection or fear of causing your partner
pain may also stop you from initiating sex, even if you feel like it. In these
instances, it's important for you to talk to your partner.
Don't feel like
she's rejecting you because her sexual desires change
Men with menopausal partners report feeling rejected and
undesirable because their partners take longer to become aroused, feel less
like having sex and produce less vaginal lubrication. Be aware that these
changes are influenced by hormonal changes, which are beyond her control. Don't
feel personally threatened if she doesn't want sex as often or doesn't
experience orgasm as intensely as she used to. While her satisfaction with her
intimate relationship may also influence her sexual feelings, don't assume that
you are the source of her changing desires – if she is experiencing menopause,
hormonal changes are likely to be contributing.
Keep having sex
Sexual stimulation promotes vaginal elasticity and may
promote improved sexual function in menopausal women, who typically experience
declining vaginal elasticity. Encourage your partner to keep having sex. If she
doesn't want to have sex with you, she may still want to masturbate, but don't
be offended. Self–stimulation also helps improves vaginal elasticity, so her
masturbating may ultimately improve your sex life!
Think about sex
The brain is an important sexual organ, and thinking
about sex increases sexual desire. It's therefore important for you and your
partner to think about sex.
Dedicate special
time for intimacy
Don't assume sex will happen. Menopausal women and their
partners are usually busy with work, continuing parenting commitments, and new
responsibilities such as caring for ageing parents. You may find that you are
both simply too tired for sex when everything else is finished.
To overcome this problem, try to dedicate some special
time for being together and being intimate. This may involve sex if you are in
the mood. However, a special dinner, a moonlit walk in the park, a secluded
picnic or a romantic massage might be more appropriate, particularly if her
sexual symptoms are severe and she simply doesn't feel like sex. Even when it
doesn't involve sex, spending time being intimate is a way in which you can
show you partner that you want to be close, with or without intercourse.
Stop comparing
Every couple's sex life is different, and in the
menopausal period, a couple's sex life is also likely to differ from that of
other couples. Sex is also likely to be different compared to the
pre-menopausal period. Don't compare your sex life to the sex life of other
couples, or to how you remember your early sex life. Each couple has different
feelings, and what is right for one couple is not necessarily right for the
next. Focus on what you and your partner want, and evaluate whether or not your
sex life is satisfying in these terms.
Help with
contraception in the peri-menopause
In the peri-menopausal period – that is, the period in
which women's menstrual cycles are irregular but still occur – there's still a
risk of pregnancy. Most couples do not want to become pregnant at this time of
life, and pregnancies in menopausal women carry a high risk of complications
such as birth defects. It's therefore important to avoid pregnancy.
You can play a role in helping your partner with
contraception, for example by reminding her that she can still get pregnant,
willingly using condoms, or exploring a range of contraceptive options which
might be appropriate in the peri-menopausal period.
Beware of sexually
transmitted infections
Although women no longer have to worry about conception
once they have passed menopause, sexually transmitted infections still present
a risk. As the post-menopausal vagina is more susceptible to trauma compared to
pre-menopause, the risk of sexually transmitted infections may also increase.
You should play an active role in preventing sexually
transmitted infections – this may be particularly important if you are in a
casual relationship with a menopausal woman.