Yes, you can still enjoy sex during and after menopause

It has been a while since Chama members invited me for a meeting. I was therefore pleasantly surprised when the chairperson called me to join them in a meeting last Saturday. As you may be aware, I am invited to meetings whenever the women want to discuss sexual issues. 

“A number of us are staring at the scary inevitability of menopause,” the chairperson said in inviting me to the stage, “we fear that with the onset of menopause we will go cold.”

“Yes, we fear for our men and wonder if they will cope,” a member pointed out, “can a man actually live without sex, or what is likely to happen once we hit menopause?”

“And what if they insist on having sex and yet we don’t want to?” the vice chairman asked, her voice full of emotions. “My friend who is undergoing menopause told me that sex became painful and unbearable the moment the phase set in, I am not ready to face such an experience.”

Well, there are many sex myths that come with menopause. A common one is that it is the end of a woman’s sex life. In fact, I have met couples who moved to separate bedrooms when menopause set it. In one instance, a man was advised by his wife to get another wife if he still wanted sex.

Scientifically, menopause is just another stage in the development of human sexuality and reproduction. It is marked by the cessation of menstrual periods. The period stops because of changes in hormones which come about once the ovary is depleted of eggs.

“You mean menopause is caused by a woman’s eggs getting finished?” A member shouted from the back rather rhetorically.

But yes, it is true that at a certain age, a woman’s eggs get depleted. Every woman has a predetermined number of eggs in life. Each month, one of those eggs is released and fertilisation can happen leading to pregnancy. If fertilisation fails, a woman gets her monthly periods. After some years, the eggs get finished and monthly periods cease. If a woman has not had periods for 12 months and the hormone tests show changes typical of menopause, the diagnosis is confirmed. 

“And what age are we talking about here? Can a 30-year-old woman get into menopause?” a member asked.

Menopause typically happens between the ages of 45 to 55 years. There are diseases that cause premature menopause, i.e. before the age of 45. A few women may also overshoot the 55 years.

But back to the issue of menopause and sex, it is important to note that the oldest woman reported in history to have had an orgasm was 114 years old. As such, menopause is not the end of a woman’s enjoyment.

For most women, desire for sex does reduce as menopause sets in. Before menopause, the normal sequence of events is that a woman desires sex, gets aroused and proceeds to penetrative sex. In menopause, the sequence is different:  a woman’s desire for sex in menopause comes only after foreplay starts; hence, arousal precedes desire. Understanding this change is important because it means that a woman in menopause may not have the inner drive to engage in sex but if she is willing to have the start the inner drive will follow.

“That is quite an insight, it means one needs foreplay to generate action,” the chairperson stressed the point.

Due to the hormone changes in menopause, getting lubrication may be difficult too. This calls for prolonged foreplay. If lubrication still fails such that coitus is dry and causes pain, use of lubricants is recommended.

In some cases, the menopause related dryness accompanied by pain during sex is further complicated by recurrent infections. At the same time, hot flushes - heat waves that run through the body as a result of the hormone changes, can be unbearable. Further, the woman’s moods may become unpredictable. The woman may also suffer severe fatigue. When these symptoms are unbearable, the woman may be put on hormone treatment that simulates the pre-menopausal period to have some level of well-being.

But on the issue of sexuality, as long as the woman is open to trying sex and getting care for vaginal dryness, sexual satisfaction is still realised. Even if sexual frequency goes down as is likely to happen, the woman and her partner can still satisfy each other’s needs.

The most unfortunate thing, however, is that most sexual partners of menopausal women may also be facing erection problems and other diseases that affect sexual function. They may not, therefore, be able to meet the changing needs of the woman. In fact, the availability of a functional man is the best predictor of the success of sex for a woman undergoing menopause.

“Our men must strive to remain healthy if we are to continue enjoying sex during menopause,” the chairperson said as she brought the meeting to a close.