Don’t give up on sexual happiness after menopause

Menopause only means the cessation of reproductive function, not the loss of female sexual function.

Menopause is a stage that every woman will inevitably go through in her life, but many people will inevitably have some anxiety when facing this stage. Not long ago, I met such a patient in my clinic: Ms. Wang, 50 years old, has been menopausal for 2 years. She has had repeated urinary tract infections and vaginitis recently, which made her uneasy. She thought that dancing square dance to exercise her body and improve immunity can resist inflammation. Who knows, as she said, “I don’t know until I dance, I leak urine when I dance, which is even more annoying.” She hesitated for a long time and whispered to me: “Doctor, you said that this menopause is always infected, and there is leakage of urine, and it is painful and uncomfortable to have sex. Can you still have sex after menopause?”

Menopause does not mean loss of sexual function

In fact, women like Ms. Wang are not uncommon during menopause. After menopause, due to the decline in estrogen levels, the vaginal mucosa loses the support and protection of estrogen, gradually atrophies, the epithelium becomes thinner, the physiological secretions in the vagina decrease, and vaginal dryness causes insufficient vaginal lubrication and pain during intercourse. At the same time, the glycogen content in the vaginal epithelial cells decreases, the ability to produce lactic acid decreases, the pH value in the vagina increases, and the vaginal defense function decreases, resulting in a decrease in the beneficial bacteria in the vagina – lactobacillus, and excessive growth and reproduction of other flora, which can easily cause vaginitis and urinary tract infections, resulting in frequent urination, urgency, pain, vaginal itching, burning sensation, and pain during intercourse.

Due to the influence of traditional cultural customs and other aspects, many women have problems after menopause, but are ashamed to talk about it and rarely seek medical treatment. They may gradually stay away from sex, gradually reduce the number of sexual intercourse between couples, and even gradually disappear. But the quality of sex life is an important part of people’s quality of life, especially for postmenopausal women.

Menopause only means that the reproductive function stops, and it does not mean that women lose their sexual function. Postmenopausal women can still have sex. And a harmonious and moderate sex life is particularly important for physical and mental health.

So, what factors will affect the sex life of postmenopausal women? How can we improve it?

After women enter the perimenopausal period, due to the fluctuation of hormone levels in the body, they often experience hot flashes, sweating, irritability, insomnia, etc. The symptoms of postmenopause often worsen, and in severe cases, they may also have psychological problems such as anxiety and depression. These will have a negative impact on sex life, leading to low libido and orgasm disorders. Therefore, it is very important to adjust your own impatient emotional state, relax your tension and fatigue through yoga and other exercises, and take the initiative to do regular fitness exercises. On the one hand, it can improve satisfaction with self-image, and on the other hand, it is also beneficial to improve the quality of sex life.

Recurrent urinary tract infection, the more you wash, the worse it is

For recurrent urogenital tract infections, you don’t have to be overly anxious, let alone blindly do vaginal douching. The view that “washing is cleaner” is wrong. Because the vagina is not a sterile environment, a certain number of lactobacilli is essential to maintain the normal microecological environment of the vagina.

When vaginal itching and abnormal leucorrhea occur, it is recommended that you go to the gynecology department for vaginal microecological testing to make a clear diagnosis. Do not arbitrarily label it as “senile vaginitis”. Different vaginal inflammations require the use of different antibacterial drugs under the guidance of a doctor; at the same time, local use of estrogen in the vagina can improve the atrophy of the vaginal mucosa and reduce the recurrence of inflammation. After the vaginitis is cured, lubricants can be used to relieve discomfort such as vaginal dryness and sexual intercourse pain.
Reduce urinary incontinence and recommend pelvic floor muscle training

We often compare the pelvic floor muscles to a “hammock”, which tightly hangs the urethra, bladder, vagina, uterus, rectum and other organs, and participates in controlling urination and defecation to maintain the tightness of the vagina. Low estrogen levels after menopause can cause the pelvic floor muscle fascia and ligaments to relax, which manifests as bulging of the anterior and posterior walls of the vagina, uterine prolapse, urinary incontinence, etc.

Epidemiological surveys show that the prevalence of pelvic organ prolapse in women over 60 years old in my country is close to 25%, and the incidence of urinary incontinence in postmenopausal women exceeds 50%. Strong and sensitive pelvic floor muscles can maintain vaginal wall tension and orgasm sensation. Relaxed and weak pelvic floor tissues and embarrassment of urinary incontinence during sex will inevitably affect the quality of sex. But people often think that this seems to be a common phenomenon after menopause, and few women are ashamed to talk about it, and few women get reasonable treatment. In fact, pelvic floor muscle relaxation, urinary incontinence and dissatisfaction with sex can be improved through pelvic floor training and rehabilitation.

First of all, it is recommended that postmenopausal women do pelvic floor muscle training, also known as Kegel exercises, on their own. It is not difficult to do Kegel exercises. There is no need to deliberately choose a location, and there is no need to practice in a big way. Whether you are standing, lying or sitting, it is fine. It is good to develop a training habit in daily life under the guidance of a doctor. In addition, adding Kegel exercises to sex life may bring you and your partner a better feeling due to “friction”.

However, in clinical practice, we also encounter some women who cannot learn Kegel exercises correctly, or cannot achieve obvious results by training themselves. In this case, we recommend that you go to the gynecological pelvic floor specialist clinic for evaluation and receive pelvic floor rehabilitation treatment in the hospital. Through standardized pelvic floor electrical stimulation and biofeedback treatment, a series of problems caused by pelvic floor muscle relaxation can be solved.

The most important thing is that we cannot wait until we enter menopause and have problems to think about pelvic floor muscle training. We should consciously exercise as early as possible. Now I will teach you a simple method: contract the pelvic floor muscles and hold for 5 seconds, then slowly release for 5 seconds. Repeat this action 10 times, and do 3 sets a day.

At present, the general age of menopause for women in my country is 45 to 50 years old. A recent survey showed that the incidence of sexual dysfunction in perimenopausal women in Beijing and surrounding areas reached 84.1%. However, due to psychological factors, social and cultural background, and cognitive differences, many women are ashamed to seek medical treatment. Everyone should know that in daily life, moderate sexual life can help release stress and is beneficial to physical health. After menopause, you need more sexual happiness.