Improved Sex for Couples after Menopause: Here's the Secret

According to a recent study published in the journal Menopause, many women and their sex partners suffer needlessly from a lack of sex following menopause. The chief reason behind this lack of sex is due to a condition called “vulvovaginal atrophy” (VVA)--the drying and thinning of vaginal tissue resulting from hormonal changes initiated by menopause. However, before menopause, hormonal changes do just the opposite and make women more sexually receptive.

Vulvovaginal atrophy is a well-studied medical condition that is typically remedied in some cases with hormone replacement therapy (HRT), but more often with vaginal lubricants and moisturizers. In some cases women also use a female Viagra pill to increase blood flow to their vaginal tissue. Loss of feelings of intimacy and loss of libido are typically associated with discomfort or pain during sex due to the vulvovaginal atrophy.

However, what is less studied is the emotional and physical impact of vaginal atrophy on postmenopausal women and their male sex partners—a quality of life issue that may adversely affect many marriages as well as feelings of esteem and self-worth.

In the study, researchers commissioned by Novo Nordisk--the maker of a vaginal estrogen products--created a survey titled “Clarifying Vaginal Atrophy's Impact on Sex and Relationships” (CLOSER). The goal of the survey was to gather information from both postmenopausal women and their sex partners about how they personally felt vaginal atrophy affected their sex lives and whether or not they found improvement following the use of a vaginal estrogen treatment.

The study participants consisted of 1,000 married or cohabiting North American postmenopausal women aged 55 to 65 years and 1,000 male partners of postmenopausal women aged 55 to 65 years. The participants completed questionnaires about their sex lives both before and after the female participants underwent vaginal estrogen treatment.

Before Vaginal Estrogen Treatment

For the women what the study showed was that:
• 58% of the women attributed vaginal discomfort to their avoidance of intimacy with their partners.
• 64% reported experiencing a loss of libido.
• 64% reported experiencing pain associated with sex.

For the men what the study showed was that:

• 78% believed that vaginal discomfort caused their partners to avoid intimacy.
• 52% believed that vaginal discomfort accounted for loss of libido
• 59% believed that their partner found sex painful

After Vaginal Estrogen Treatment

• 56% of the female participants who used local estrogen therapy to treat their vaginal discomfort reported less pain, more satisfying sex (41%), and an improved sex life (29%).

• 57% of the male participants reported looking forward to having sex because of their partner's use of local estrogen therapy.

The authors of the study concluded that the use of vaginal estrogen therapy improves the sex lives of postmenopausal women and their male sex partners, and that education and awareness efforts about the symptoms of and available treatments for vaginal atrophy will benefit many couples seeking an improved sex life.

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Reference: “Clarifying Vaginal Atrophy's Impact on Sex and Relationships (CLOSER) survey: emotional and physical impact of vaginal discomfort on North American postmenopausal women and their partners” Menopause Published Ahead-of-Print 3 June, 2013; Simon, James A. MD, CCD, NCMP, FACOG; Nappi, Rossella E. MD, PhD; Kingsberg, Sheryl A. PhD; Maamari, Ricardo MD, NCMP; Brown, Vivien MD, CM, CCFP, FCFP, NCMP.