Western women spend approximately one third of their lives in post menopause and some find their sexuality is adversely affected. Many different issues influence whether a post-menopausal women retains her sexual interest and pleasure in sexual activity.

Studies show women reported that painful intercourse, arousal problems, difficulty achieving orgasm; inhibited enjoyment and vaginal dryness were associated with marital difficulties, depression and anxiety. For some women their sexuality is affected when their partner experiences erectile dysfunction. For others, sexuality is affected by emotional problems secondary to poor communication, guilt and loss of tenderness. In an Australian study of women aged 45-55 years, sexual dysfunction was found to increase two fold from early to post-menopause. There was a gradual decline in sexual desire with age but not in all women: 45% reported a decrease, in 37% there was no change and in 10% there was an increase in sexual desire.

Sexual pain is significantly associated with pelvic floor disorders, poor health, loss of income and work and emotional or stress-related problems. Anxiety, depression, traumatic sexual experiences, chronic illness, mood disorders and negative body image are strongly related to low sexual desire.

Women with pelvic floor dysfunction (PFD) commonly relate the following sexual complaints affect their sexual enjoyment: pain with penetration, vaginal dryness and low arousal and infrequent orgasm. Bladder over activity, loss of urine and pain during penetration and pelvic organ prolapse impact on enjoyment of sexual activity.

Helpful Tips

• Speak to your healthcare provider about using vaginal oestrogen as lower oestrogen levels are associated with vulval thinning, vaginal dryness and painful intercourse.
• Use a non-chemical vaginal lubricant to overcome vaginal dryness and discomfort with intercourse.
• Consult a women’s health physiotherapist to control bladder urgency, urine loss and pelvic organ prolapse. Increased pelvic floor muscle strength improves orgasmic and vaginal sensation.
• When adhesions, scars, trigger points or spasmy muscles cause intercourse pain, treatment with a women's health physiotherapist is effective for symptom relief.
• If hysterectomy is necessary, discuss ovarian removal with the surgeon as 40% of women who undergo ovarian removal with a hysterectomy, report a decrease in their libido.
• When surgical mesh repair is advised for prolapse repair, speak with the surgeon as the U.S. Food and Drug Administration issued an updated safety communication warning health care providers and patients that surgical placement of mesh through the vagina to repair pelvic organ prolapse may expose patients to greater risk than other surgical options. To read the full article go to http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm262752.htm
• This link to the North American Menopause Society (NAMS) is a must read for women with concerns about changes in their sexuality during peri/post menopause: http://www.menopause.org/SHM/problems.aspx