Saturday, April 9, 2016

Male’s Guide to Great Sex after Female Menopause

Why do you need to educate your partner?

This post is one of the very few (if not the only one) on this blog, which is prepared not for you, but for your sweet husbands, boyfriends, and soulmates, who are sharing with you, more or less successfully, the “goods” and the “bads” of your new lifecycle stage.

But, really, why they need to know? Should they really care what is happening in your head and in your body?

The answer short answer should be “yes” - they need to know, they need to care, they need to be involved, and they need to be included. It is not just easier and more enjoyable to navigate through your life, when you are not alone on your journey, but also the trust and cooperation between partners helps to strengthen the thighs and deepen the interpersonal relationship. They are numerous challenges and complications on the way, but there are also known and proven approaches on how to minimize the negative consequences. Getting a helping hand and open partner’s heart will make it easier.

The last consideration might be the one, your partner might not agree with. The male menopause (andropause) is similar in some perspectives to the female menopause, and understanding your health related issues, especially psychological, might allow him managing his own “spirits” more efficiently.

So, let your partner read this post, and later discuss with him the main aspects. Trust him and ask for help as needed, and offer him your support and assistance yourself, when you see him in need.

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Introduction to female menopause for male

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, which may affect the frequency and severity of a woman experiencing menopausal symptoms, including sexual problems. And there is no doubt, that woman’s interpersonal 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 is important for men to try and speak openly and honestly with their doctor.

Why men should be involved

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.

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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:

ü  Eat a healthy, balanced diet;
ü  Exercise regularly;
ü  Avoid nicotine, alcohol and other harmful substances; and
ü  Get enough rest.
ü  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 that affect libido. You can help by being knowledgeable about the various treatments available and helping her assess the pros and cons of various treatments. Always show your affection and care and propose to offer your support, advice, and assistance, when needed.

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.

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Psychological factors

Get educated on menopause, and how it may affect a woman

Women experience significant changes at menopause, and it is 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 occasionally). 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 is 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:

ü  Vaginal dryness;
ü  Reduced libido;
ü  Dyspareunia (pain during intercourse); and
ü  Reduce skin sensitivity and arousal.

Be aware that these symptoms occur in many menopausal women, and do not be shocked if you observe these symptoms in your partner. It is 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 is 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. Do not expect menopause to be over quickly; be prepared to support your partner for the long haul.

View menopausal symptoms as a problem for two – do not blame her

Men do not experience menopausal symptoms to the same extent as women do, 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 influence a woman’s libido and sexuality. You will never know exactly what a woman is feeling, but talking to her can help you understand better on how she feels. Take the lead in communicating with her about her menopause experience. Do not 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 is 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.

Do not 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. Do not 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 is 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.

Do not try to read your partner’s mind – you have not experienced and will never menopause to the same degree as you partner is, and should not be expected to understand how it feels. You can, however, enhance your understanding and perception 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 are not interested in having sex with other women (and be reassured that she still loves you, even if she does not want sex as much, as it was before).

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 have read on menopause.

Bear in mind that your own sexual feelings have also changed with age, and it is 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. While medical and hormonal treatments should be approached with special care, after through assessment with the medical professionals, there are many holistic approaches and methods on how to improve relationship, refresh the feelings, and make new highs on the sexual satisfaction scale.

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. And sexual problems will inevitably lead to the deeper psychological distress, escalating the downward emotional spiral. 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 or having romantic vacation. Some couples may benefit from relationship counselling, family therapy, and sexual coaching to address interpersonal issues, including those 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, suffering from so called “empty nest syndrome”. 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:

ü  Put aside special time for herself;
ü  Do something special;
ü  Surround herself with supportive friends;
ü  Pursuing hobbies, which earlier in life did not earn suitable attention due to lack of time or financial resources;
ü  Take on new roles in life, such as joining an interest group or doing charity work; and
ü  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:

ü  Focus on the good, not the bad;
ü  Identify achievements she has made throughout her life, and focus on these if she feels low;
ü  Challenge unrealistic expectations, for example about her body shape or the ageing process;
ü  Set realistic goals;
ü  Tell her you love her as you mean it more often;
ü  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:

ü  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;
ü  Identify aspects of your culture/s which may negatively influence her experience of menopause; and
ü  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.

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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 is 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.

Do not be afraid to use toys during foreplay. Start with skin on skin, but note that the finger and the tongue can only do so much, so do not be afraid to use a vibrator… as long as your partner is into it.

Do not skip foreplay and be creative

Everyone would love to know a foreplay technique that is guaranteed to work, but what works for one woman many not work for another. There are some basic guidelines, however, For example, earlobes or backs of the knees are really good places to start when you are exploring how your partner gets turned on by.

For men, the genitals have more capacity for arousal than the rest of the body, whereas in women, the entire body has the capacity to be an erogenous zone. If you are with a new partner, or with someone you have been with a while but you want to refresh things, do an audit. Explore her entire body and see what works.

Use a lubricant

Following menopause, women generally find that their vaginas are less flexible and less lubricated during sexual arousal than they were prior to menopause. Less lubrication during vaginal intercourse can lead to a good deal of unpleasantness or even downright pain. A water-based personal lubricant, such as Astroglide or Wet, can go a long way in alleviating discomfort stemming from vaginal dryness. A lubricant can be applied to either partner, but for the most lubrication, it can be applied to both!

Try a new position

Some older adults may find that sexual positions that they had used when they were younger are no longer comfortable. This can be a good excuse to try new sexual positions. One effective way for many older adults to have sex is "on the side". In this position, the man and woman both lie on their sides with the man "spooning" the woman. It may take a little practice to get used to, but this position is effective because it allows vaginal intercourse without putting major stress on any joints or necessitating one partner to put his or her weight on the other.

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 is important for you to talk to your partner.

Do not feel like she is 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. Do not feel personally threatened if she does not want sex as often or does not experience orgasm as intensely as she used to. While her satisfaction with her intimate relationship may also influence her sexual feelings, do not 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 does not want to have sex with you, she may still want to masturbate, but do not 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 is therefore important for you and your partner to think about sex.

Dedicate special time for intimacy

Do not 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 does not feel like sex. Even when it does not 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.

Make love in the morning

For retired older adults, more time may mean more time for sexual activity. It is often recommended that older adults should try making love in the morning. Being well-rested after a good night's sleep can mean good sex, and older men are more likely to have a firm erection in the morning.

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. Do not 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 perimenopause

In the perimenopausal period – that is, the period in which women’s menstrual cycles are irregular but still occur – there is 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 is 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 perimenopausal 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.

Do not forget afterplay

Finally, if foreplay is important, cuddling afterwards, and having some together time, even if it's before you go to sleep, is going to make things complete and make your partner more likely to enjoy foreplay the next time around.

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Sources and Additional Information:

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