Don't Let Menopause Affect Your Sex Life

Menopausal straw poll: Would you rather sleep or make love? The majority of women would choose the former (depending on who asked the question, of course), and roughly half of those who claim they'd rather make love might not quite be owning up to the truth.

In the years leading up to menopause, a decline in testosterone, the hormone of desire, paired with the steep drop in estrogen and progesterone, often produces a similarly sharp fall in sexual desire and enjoyment. Decreased blood flow to the genitals slows arousal, and vaginal dryness and burning can make intercourse feel more like sanding than something sensuous. In addition, tissue atrophy in menopause can narrow the vagina, also causing discomfort with sex.

I wrote the book, "End Your Menopause Misery," to help us get our mojo back the way we want it, while acknowledging that the nature of intimacy can change. But that this isn't necessarily a negative thing. As women, we are often unsure of where to begin to reignite the spark of desire, feeling wistful, embarrassed or depressed about this change in our sexuality. Fortunately, many menopause-related changes in vaginal tissue are reversible with prescriptions and over-the-counter options to make intercourse more comfortable and pleasurable again. This is a start, but a fully reinvigorated sex life involves heart, mind and body.

I suggest a plan to address all three, beginning with the mouth. Yes, use your mouth to kiss, lick, nibble and so on, of course; but more important, use it to talk with your husband or partner about how you feel. Some of us need guidelines in clearly and honestly communicating with our spouse or partner about our changing needs. It's okay to say, "I'm not feeling like making love right now." Remember that women and men may experience a lessening sex drive in midlife. And, that by expressing our own concerns we encourage our partners to express theirs.

Try out a communication activity to do together, with your partner. It will not only help you think through how you're feeling, but it's also a way of letting your partner know that you're actively seeking to increase your sexual enjoyment. Choose a place where you're relaxed and comfortable, and add any amenities you like: a fire in the fireplace, a shared glass of wine, some candlelight. Take turns reading each question aloud and responding. Be clear with your partner that this is a fun, sexy activity with no right or wrong answers. See what happens!

• I prefer making love:
a. In the dark
b. With the lights on
c. By candlelight

• My favorite turn on is:
a. When you put your arms around me
b. Nuzzling my neck
c. Kissing
d. None of the above, but I really like _______________________.

• I love to make love most when:
a. You're naked
b. You let me undress you, and you undress me
c. One (or both) of us still has some clothes on

You get the idea, right? Now, try it out!

Consider the words of Bonnie Prudden, the amazing rock climber and fitness expert who lived a vigorous and exciting life until she died at age 97. She said, "You can't turn back the clock, but you can wind it up again." Hormonal changes do not have to signal the decline of sexual desire or pleasure. The challenge is to remember that this is yet one more stage in our life's journey. And it is a part of the journey that we can enjoy and savor when we actively pursue changes that enhance "the change."

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