As if perimenopause doesn’t cause enough grief, it can also kill your sex drive. It seems awfully cruel too, especially if you’ve enjoyed a healthy and satisfying sex life until then. I distinctly remember panicking when I realized that my desire for sex would diminish – or at least, that’s what I was expecting to happen. I had heard this happened to women during menopause, and I wasn’t particularly thrilled about it either.
I am happy to report though, that it doesn’t have to be a long term or permanent condition. For me, it never completely went away, but it did diminish considerably. However, like most everything during menopause, sexuality and libido may require a redefinition for the years to come.
Chances are, if you had a low sex drive before perimenopause, you probably won’t suddenly develop a higher one during perimenopause. In addition, if you also had difficulties in your relationships with sex prior to perimenopause, chances are those difficulties will not only remain, but perhaps even worsen.
I hate to be the bearer of bad news, ladies. But, unfortunately, perimenopause is not known to solve problems. In fact, it usually exacerbates them.
One of the primary reasons for loss of libido in perimenopause is a drop in progesterone, which is linked to ovulation. Most women, barring any physical issues, experience a surge in sexual desire around the time of ovulation because of a rise in progesterone.
However, during perimenopause, ovulation is not consistent. In fact, anovulatory cycles (cycles where you experience blood loss but no ovulation) are one of the hallmarks of perimenopause. So, it doesn’t take rocket science to make the connection: No ovulation. No rising progesterone levels. Diminished sexual desire and libido.
Estrogen also plays an important role in our sexual function. Without healthy estrogen levels women often experience vaginal dryness, thinning of vaginal walls, and vaginal atrophy; all of which can make vaginal intercourse very painful. And let’s face it. Who wants sex when it’s painful?
Estrogen is also necessary for normal sexual response and orgasm. So, in addition to vaginal dryness, atrophy, and the thinning of vaginal walls, the ability to physically respond and reach actual orgasm can also be significantly diminished as well.
In addition to fluctuating estrogen and progesterone levels, a woman’s testosterone levels can become imbalanced as well during perimenopause. Given that testosterone has a powerful influence in one’s sex drive, any drop in testosterone can have a certain negative affect on libido.
Sexual response in women is far more complicated than a simple physical response. If we are having a bad day, if we are tired, depressed, or coping with mood swings during perimenopause, it is very unlikely we are going to be “in the mood” for sex.
Taking into consideration all of the components which make up a woman’s sexual response, and how easily it can become disrupted, it’s enough to make most women want to throw in the towel. But, don’t. If you’re not ready to give up your sex life, you don’t have to. There really are plenty of things you can do.
One very obvious solution for a lagging libido is to put back that which is lost. Re-balancing estrogen and progesterone levels can help restore sexual desire and response. Since the release of the Women’s Health Initiative study in 2001, the debate about hormone replacement therapy and the safety of it has taken many twists and turns.
Currently, many physicians are giving synthetic hormone therapy new consideration and are beginning prescribe it again for perimenopausal women. While I cannot offer a medical opinion on the matter, I can give you my personal opinion based on my own research and study, and that is, I believe bioidentical hormones are a healthier solution to hormone imbalance than synthetic hormones.
I am not alone in my opinion either, as many physicians prefer prescribing bioidenticals as well. Of course, the choice is ultimately yours, but if you are looking for suggestions, bioidentical hormones would be it.
Presently, there have not been enough studies done on the benefits of testosterone therapy for perimenopausal and menopausal women, for there to be a consensus among physicians as to it’s usefulness. However, there have been studies which suggest testosterone is the missing link in hormone therapy, and that women who have testosterone as a part of their “hormonal cocktail” if you will, not only tolerate additional estrogen and progesterone during hormone therapy better, but they also experience a surge in sexual desire and overall feelings of well being.
I have personally used testosterone pellets (you can read a post I wrote about it here) and I can tell you with absolute certainty that it increased my sex drive considerably. Testosterone is also a substrate for the production of estrogen in your body.
Many physicians believe that testosterone therapy alone is all that is needed to help balance hormones during perimenopause. It is a therapy which is gaining traction as more studies are being done. So it might be worth your while to inquire about it with your physician.
In a previous post, I addressed some dietary changes which can help increase vaginal moisture. You can find that article here. Personal lubricants are quite helpful as well. Fortunately, there are plenty to choose from. K-Y, which has long held a solid position in the personal lubricant market, has a product called K-Y Intense Arousal Gel For Her.
I have not personally used it, but from what I’ve read, the results are good. It not only provides much needed lubrication, but is said to enhance orgasm as well. Another popular choice is Durex Play Utopia Female Arousal Gel.
Sex or No Sex: It’s Really a Personal Decision
Though I do not want to say that sex is not necessary, the truth is, many couples find that they can redefine their relationship to include other types of emotional bonding and intimacy, and are quite content without sex, or at least, with less of it.
If both parties are happy with the arrangement, then there really is no right or wrong way to approach it. However, if you wish to continue in a healthy sexual relationship, there is also no reason that you shouldn’t. It may require a little more effort, but it can certainly be done.
By the time women reach menopause, most of us have figured out that we no longer seek the approval of others for our life choices. Our sexual health and well-being should certainly be no exception. So decide what works for you in your marriage, and be well.