Menopause: habits for a better sex life – 02/28/2024 – Balance

When talking about menopause, the first thing that comes to mind is sexual decline. But this process, which all women go through, should not be interpreted as such — but rather as a new stage to be discovered, a period of transition and self-care.

This does not mean that it is not interesting to resort to treatments to maintain sexual function, as we will see below.

A break on the way

Menopause, the cessation of menstrual bleeding for a continuous period of at least twelve months, is caused by a reduction in ovarian hormones, especially estrogen and progesterone. Sometimes it can also be triggered early by medical procedures, such as surgical removal of the ovaries or radiation therapy to the pelvic region.

Hormonal changes cause changes not only in genital anatomy, but also at a mental and emotional level. In the genitals, loss of elasticity and vaginal dryness due to reduced blood flow are evident. Women can observe these changes with the help of a mirror.

There are also changes that are not detectable with the naked eye. The microbiota of the vagina, made up of microorganisms that protect against infections, decreases and alters the vaginal pH, which is the main cause of recurrent candidiasis (yeast infection).

Desire, or libido, is also affected, probably due to difficulties in penetration. Symptoms such as dryness, irritation or burning form a vicious circle of pain.

All these genital changes and discomforts, together with urinary disorders, are called “menopause genitourinary syndrome” — and considerably impair the quality of life of the women involved.

So, does sex life have an expiration date?

Of course! The biggest problem is the lack of treatment, which requires knowledge of the symptoms and the impact on the quality of life of those affected. Until this year, professionals did not have a questionnaire to assess vaginal symptoms that cause sexual disorders.

To mitigate this problem, professors from the Faculty of Physiotherapy and Nursing at the Castilla-La Mancha University (UCLM), in Spain, developed an assessment tool to measure changes in vaginal penetration. The goal is for health professionals to be able to evaluate and offer specific treatments for each individual woman.

Once the problem is detected, what to do?

Let’s start with some simple habits that can help reverse symptoms:

• Take care of your intimate hygiene: this is vital. The perineum region should only be washed with water or intimate soap with an acidic pH. This type of product contains the same pH that the vulva should have, a factor that prevents increased dryness and itching. In any case, body hygiene soaps should be discarded.
• Dress comfortably: cotton underwear prevents the accumulation of moisture in the vulva and promotes the stability of the microbiota.
• Use vaginal lubricant: its main function is to reduce friction caused by vaginal dryness, which can relieve pain and irritation. The pH of the lubricant must always be between 3.8 and 4.5 — and the osmolarity (concentration of particles dissolved in the solution) below 370 mOsm/kg.

Two innovative therapies

There are also non-invasive treatments that are bringing about effective, long-term changes in the sexual health of menopausal women. Two of them stand out:

• Vaginal CO₂ laser: this has proven to be a revolutionary option. Its results are due to microablation, a medical procedure that destroys the tissue of the vaginal walls in a controlled manner. This technique stimulates collagen production and helps tissue regeneration, causing a true “anti-aging effect” in the vagina.
  Recent studies have shown that the laser can restore the vaginal epithelium, and improvements in the vaginal flora have also been observed, which favors the reduction of dryness. There is a limitation, however: at the moment, its high cost prevents it from being accessible to all women.
• Non-ablative radiofrequency: it is administered with a device that emits electromagnetic waves that generate heat. When the temperature reaches 40°C-41°C, cells called fibroblasts are activated to produce more collagen.
  This technique is less invasive than the vaginal CO₂ laser. The promising results of this treatment, administered by physiotherapists specializing in pelvic health, are currently being studied.

Not to forget

We need to remember that menopause is not synonymous with a decline in sex life. Knowing the symptoms to develop specific treatments is essential to allow us to improve it. Either way, this phase of a woman’s life offers the opportunity to explore new forms of self-care and sexual function.

This article was published on The Conversation and reprinted here under a Creative Commons license. Click here to read the original version.