Let's Talk About Sex in Menopause

This week, I planned to write about protein, but then I took a day off in the Texas wilderness with my fellow Austin menopausers, and we started talking about sex–and I’m sure you’re tired of being told to eat more protein, anyway! So let’s talk about sex and menopause, two words not often seen in the same sentence, although they should be. If we don’t start this conversation, we don’t have much to work with but prevailing myths, such as the one that says at a certain age, sex stops. What a crock of 💩. Our world is full of sex talk, images, information and misinformation. It's not as if we're a nation of prudes--except for the subject of sex for women in menopause, which seems to be the ultimate taboo.

I first realized the importance of this subject when a woman I’d never met approached me at the World Fitness Convention just after my lecture on “Training the Menopausal Client.” I’d discussed how little trainers (and their clients) seem to know about menopause symptoms. I’d mentioned genitourinary syndrome (GSM), a catchall term for symptoms related to the vagina, clitoris, labia, urethra, and bladder. This woman, presumably a fitness professional, told me she hadn’t known that vaginal dryness was “a thing” and that she’d thought it was her fault. Presumably, my lecture had explained the hormonal forces at work, but NOW WHAT? The more I thought about this brief conversation, the more I felt shocked and sad. This woman now knew why she was suffering, but no one, seemingly, had suggested that she experiment with different lube products or, if frequent UTIs were a problem, a prescription vaginal ring that’s safe even for breast cancer survivors. She said no medical doctor had mentioned that product or any other.

And yet vaginal dryness appears on every list of sexual symptoms related to menopause. So does “low libido,” with 40-55% of women reporting losing the desire to have sex and 12-45% reporting dyspareunia (pain during sex). It’s not as if these issues are unusual or mysterious, but there sure didn’t seem to be any non-bleak information out there, and certainly nothing nuanced enough to make a woman question why she would think “it’s my fault!” If you know me, you know I love science, but sometimes the actual human being gets lost in the data. No study I could find was talking about too-tired-for-sex syndrome, for instance. I’m a human being, and this is something I want to talk about!

My current menopausal roller coaster is stalled out in Insomnia Land, where all motivation and energy go to die. I haven’t had a good night’s sleep in weeks, and although I think about having sex, the thought of actually doing it is exhausting. For me, this is a big change. At times, it’s felt like a genuine identity crisis. And at first, like most women in the early stages of the menopausal tradition, I searched frantically for fixes, tips and hacks, in the name of getting back to my old, pre-menopause self.

But the Texas wilderness retreat changed my thinking. I began to question why so much menopause “help” centers around trying to rewind menopause, especially since no one has figured out how to actually do that! This prompted me to reevaluate the whole subject of sex. Do I have a preconceived notion of what it has to be?  Does it have to always end in everyone having an orgasm? Do intimate moments count? What about quickies? What about masturbation,  alone or with a partner? Does it have to happen right before bedtime? Who sets these standards, anyway? I discovered that my definition of sex had become fairly rigid, which in turn, made me shy away from it because of my lack of energy. But this experience has helped me see sex in a broader way, which feels like a heavy weight was lifted off. I feel less constraint and pressure.   

Is it obvious that I consider satisfying sex to be part of fitness in menopause? Well, I do, with the understanding that every woman gets to define what “satisfying sex” is for her. We’re at the very beginning of this conversation. Now, I want to hear from you. I’ve always wanted to create a space where women can share freely, without judgment, and this topic seems like a great place to start. EMAIL ME AT: [email protected]