Sexuality in Menopause: Cynthia's Story

 Cynthia had found sex joyful and fun for most of her adult life. In college, she had felt sexually empowered by the messaging of feminism. “Feminism taught me that I don’t owe men anything. That was validating for me. And, I already knew what the end game was in terms of orgasm and pleasure.” She had discovered masturbation in grade school. “I never felt shame for enjoying sex. And, I always felt in control of saying, ‘Yes, let’s play,’ or ‘No.’ I was strong and stood up for myself no matter the risk.”

Cynthia continued to enjoy her sexuality, with its power and pleasure, until her late forties when she became peri-menopausal. Menopause challenged not only her enjoyment of sex but her sense of self.  “I thought I’d be someone who’d have great sex into my 80’s.” Instead, sex got more painful as vaginal dryness and thinning worsened. “I felt out of control in an area where I’d always been so confident. But I couldn’t figure this one out on my own. And, I really wanted an answer.”

Certain symptoms, like hot flashes, have become more visible and normalized, especially with women in the workforce. No one can ignore the woman in a meeting fanning her face as sweat runs down her hairline. But while we can joke about our “power surges,” changes to our sexuality are much harder to talk about. We all want to be that woman who breezes through to menopause. We can feel isolated and even self-blaming if, instead, we suffer.

Cynthia turned to health care clinicians for answers, only to be disappointed. “They seemed so checklist oriented. They didn’t listen and were quick to tell me I just needed lube, which didn’t help much.” Although she had always considered herself very self-assured, with clinicians she felt vulnerable. Her lifelong confidence faltered. She blamed her inability to articulate her needs as the reason she did not get the help and information she sought. In fact, she felt more heard and validated at the local, female-owned sex shop than she did with her doctor.

Now, seven years since her last period, Cynthia has found satisfaction with her evolving sexuality. Here are some of the ways she got there.

First, a doctor eventually prescribed estradiol vaginal cream which helped address the vaginal pain and dryness.

Second, she talked with friends. She learned that she was not alone, neither with the problems of menopause nor with the inability to find answers. “Why do we have to work so hard to address these issues?” she lamented.

Third, she and her husband began to talk about the changes in their sexuality. “We are able to talk more, not just about my issues but about his.” She learned that his sexual functioning and desire were changing, too. “I can see how if we could not talk about it, that things could go another way and be detrimental to the relationship. But we do talk. I don’t know if I could have had these conversations when I was younger. I’m not sure I had the wisdom and the confidence that this kind of sexual communication demands.”

Fourth, she became more comfortable with her body. “When I am connected to my body, sex is better. Exercise is important. I had always felt fat and then, in menopause, I got heavier. I’ve had to shift from a number to how I feel. Overall, I am more comfortable with my looks now.”

Fifth, Cynthia recognized and accepted the changes to her sexuality. “It takes both of us longer to be ready for sex. And, sex is less focused on the big O and more on touching and cuddling. We have more oral sex and less intercourse.” Indeed, her orgasms are less powerful, but in their wake, she appreciates other aspects of being with her partner. “I think that I am more open to intimacy, the way the physical gives and takes with the emotional.”

As Cynthia talks about her current sex life, her eyes reveal an impish sparkle, her face grows younger, and she takes on the glow of a woman in love. “Talking about this stuff really helps. Now I feel all excited about my sex life!”

I think about the determination underlying her desire to explore her changing sexuality: “I really wanted an answer.” Cynthia seems to have followed the advice from this blog post. She made sex a priority, attended to her physical health (exercise) and mental health (acceptance and appreciation), addressed the issue of vaginal lubrication and above all… communicated, communicated, communicated.