Sexual Health - Perimenopause

<html><head></head><body><div data-rte-type="old"><p>There are no more periods to deal with every month, so sex should be fantastic...right? Women nearing <a title="menopause" href="http://www.babymed.com/menopause">menopause</a> years or those in menopause often find this dream of a renewed sexual energy and vigor depressed by the realities of menopause. When estrogen levels drop, so does libido; vaginal dryness can make intercourse painful, and mood swings beat out intimate feelings many days of the week. Menopause and sex do not have to be strangers, however, just bed partners that must learn to live together.</p>
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<h2>Arousal Takes a Bit More Time and Effort</h2>
<p>Many women who are in menopause claim they want to have sex more often, but simply don't think about sex as often as they should. Sexual peak for women is age 35, but that is the time when most women are neck deep in career and home life. By the time they reach menopause, estrogen levels have dropped dramatically and that itchy feeling to hop in the sack is all but gone.</p>
<p><strong>Tips for Her Partner</strong></p>
<ul>
<li>Help her warm up with a gentle massage and intimate touch. It isn't that a woman in menopause doesn't want to have sex, its just that her hormone levels make it almost impossible to think about. Remember, women are genetically made for reproduction. When they lose the ability to reproduce, there is no instinctual reason to have sex.</li>
<li>Partners who work together can learn to read the sexual signs in a household. Actions, loving words, or even a subtle look could all be signals that she is feeling a little more aroused than normal. The key is to go slow and let things happen.</li>
</ul>
<h2>Vaginal Dryness Can Account for Painful Sex and Irritation for Him and Her</h2>
<p>Estrogen is again responsible for vaginal dryness during menopause. Without a basic need for sex, the vagina doesn't need to stay lubricated. There are numerous vaginal lubricants on the market that care completely safe for external and internal (in the vagina) use. Some are flavored and others cause tingly sensations – so pick one or many and stock up to prevent vaginal irritation during sex.</p>
<p><strong>Tips for Her Partner<br></strong></p>
<ul>
<li>When wearing a condom, men often lose sensation and feeling. If your partner has had trouble with vaginal dryness before, there is a good chance she may be suffering again. Take your time during intercourse and reapply vaginal lubricant often. There can never be too much lubrication for a woman in menopause.</li>
</ul>
<p>Women in menopause alone cannot be held responsible for lacking libido and drive to have sex. Nature has a way of changing a female's reaction to sex as she ages. Working through the problems as a couple is the best option for everyone involved.</p></div></body></html>

There are no more periods to deal with every month, so sex should be
fantastic...right? Women nearing menopause years or those in menopause
often find this dream of a renewed sexual energy and vigor depressed by
the realities of menopause.

How Sex Changes with Menopause

<html><head></head><body><div data-rte-type="old"><div data-rte-type="old"><div data-rte-type="old"><p>As women age, they often anticipate menopause. After 40 years of monthly cycles, there is little reason not to want menopause to start and get it over with ASAP. Going through menopause can take several years, but once the change has happened and all eggs are released and passed – life does change.</p>
<h2>What happens post-menopause?</h2>
<p>After the body has passed all eggs, the ovaries cease to function. <a href="https://babymed.com/womens-health/estrogen" target="_self">Estrogen</a> and other reproductive hormone levels fall to near non-existent levels. While periods stop, so does libido, vaginal moisture, and ability to control fat stores, in some cases. Natural menopause progression and hormone changes are subtle, which often means symptoms may appear gradually.</p>
<p>If surgical menopause pushes women immediately into post-menopause, symptoms may appear quickly and hit her like a brick wall. Gynecologists will often start hormone replacement therapy in the recovery room to prevent symptoms during recovery.</p>
<h2>Sex post menopause</h2>
<p>Just because a woman can no longer have children does not mean sexually transmitted diseases cannot be passed from one sexual partner to another. Having sex post-menopause is just as unsafe as having sex without protection before menopause. The same <a href="https://babymed.com/std-recommended-screening" target="_self">STDs</a> are out there.</p>
<h2>Pelvic exams post menopause</h2>
<p>Women who pass into menopause naturally need to continue yearly pelvic exams and&nbsp;<a href="https://babymed.com/node/4605" target="_self">Pap smears</a> until the age of 65 to 70. Some experts believe women over the age of 65 with no history of abnormal Pap smears can move to pelvic check-ups every three to five years.</p>
<p>Surgical menopause is a bit different. If a total hysterectomy was performed, there are no female organs left to check during the yearly Pap smear. Pap smears are used to check cervical health and screen for cervical cancer. Women who have undergone a complete or total hysterectomy have no cervix in most cases. Pap smears only need to be performed when women have received a hysterectomy because of cervical illness or disease.</p>
<h2>Bone density, HRT and more</h2>
<p>As soon as hormone levels drop, <a href="https://babymed.com/menopause/menopause-exercises" target="_self">bone density will suffer</a>. Most often, women who are Caucasian and thin have trouble with bone density more often than women who are larger or of a different heritage. Bone density scans can be used early in post menopause to set a baseline for future scans. Increasing calcium and vitamin D intake is crucial during post-menopause.</p>
<p>HRT or hormone replacement therapy comes with risks, but also rewards. HRT can reduce menopause symptoms and slow bone loss.</p>
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As women age, they often anticipate menopause. After 40 years of monthly cycles, there is little reason not to want menopause to start and get it over with ASAP!

Post-Menopause – After the Change of Life

<html><head></head><body><div data-rte-type="old"><div data-rte-type="old"><div data-rte-type="old"><p>Vaginal bleeding following sexual intercourse can be a scary experience and at times there is reason for concern. Bleeding after intercourse, also referred to as postcoital bleeding, describes vaginal bleeding or spotting experienced during or after sex which is not related to your menstrual period. Postcoital bleeding also refers to bleeding from other genital areas, as well as the urinary system. It is important to note that bleeding can be caused by varied physical conditions. <br><br>Premenopausal women who experience postcoital bleeding generally experience the bleeding from their cervix, which can be caused by friction/trauma during sex. However, this kind of bleeding can also signify the presence of a sexually transmitted disease. <a title="menopause" href="https://babymed.com/menopause">Postmenopausal</a> women (women who no longer get their menstrual periods) may also experience postcoital vaginal bleeding which my come from the urethral meatus, the labia, uterus and/or cervix.<br><br>While there are several causes of postcoital bleeding, it should be noted that some are serious and some less concerning. The most concerning cause of postcoital bleeding is cancer, evidenced by 11% of women with cervical cancer presenting to their healthcare provider with postcoital bleeding.</p>
<p>Other causes of postcoital vaginal bleeding include the presence of non-cancerous conditions such as:</p>
<ul>
<li>Cervical ectropian</li>
<li>Benign cervical growths referred to as cervical polyps</li>
<li>Inflammation of the cervix referred to as cervicitis</li>
<li>Genital sores related to sexually transmitted diseases such as the presence of herpes or syphilis</li>
<li>Decreased vaginal lubrication</li>
<li>Uterine lining injury, especially present in women who are on <a title="birth control pill" href="https://babymed.com/contraception/all-about-birth-control-pill">oral contraceptives</a></li>
<li>Menses</li>
<li>Trauma (related to sexual abuse)</li>
<li>Vaginal atrophy, dryness or vaginitis</li>
<li>Other sexually transmitted diseases</li>
<li>Prolapse of the genital organs</li>
<li>Lesions of the vagina and/or lining of the uterus</li>
</ul>
<p>If you are experiencing postcoital bleeding, you should speak with your healthcare provider to determine if you are in need of an evaluation based on your individual circumstances. If you have been recently exposed to a <a title="sexually transmitted diseases (STDs)" href="https://babymed.com/love/std-sexually-transmitted-infections-diseases">sexually transmitted disease </a>or have concern that you may be experiencing an infection, you should speak with your healthcare provider for an evaluation. In most cases, premenopausal women who bleed infrequently after intercourse and who have normal <a title="pap smear" href="https://babymed.com/womens-health/all-about-pap-smear">Pap Smear</a> and sexually transmitted disease screenings will not require an evaluation however if the bleeding is concerning to you, it may benefit you to speak with your healthcare provider for guidance. Postmenopausal women who experience any vaginal bleeding at any time should be evaluated regardless of the likely cause.</p>
<p>During evaluation, your healthcare provider may utilize varying approaches to further evaluate the bleeding and may include:</p>
<ul>
<li>History and physical exam, including an exam of the vagina and cervix</li>
<li>Sexually transmitted disease testing</li>
<li>Biopsy of any abnormal findings</li>
<li><a title="colposcopy" href="https://babymed.com/womens-health/what-is-colposcopy-and-why-is-it-used">Colposcopy</a></li>
<li>Evaluation of the uterine lining</li>
</ul>
<p>If you are experiencing postcoital vaginal bleeding, speak with your healthcare provider to determine your individual need for evaluation.<br><br></p>
<p>Sources:</p>
<ol>
<li>Shapley, M. Post Coital Bleeding in Women. <a title="UpToDate" href="http://www.uptodate.com/contents/postcoital-bleeding-in-women" target="_blank">Up to Date</a>.&nbsp;</li>
<li>Vaginal Bleeding After Sex. <a title="Mayo Clinic" href="http://www.mayoclinic.org/symptoms/bleeding-after-vaginal-sex/basics/definition/sym-20050716%20" target="_blank">Mayo Clinic</a>.&nbsp;</li>
</ol></div></div></div></body></html>

Bleeding after intercourse, also referred to as postcoital bleeding, describes vaginal bleeding or spotting experienced during or after sex which is not related to your menstrual period.

Postcoital Bleeding (Bleeding After Intercourse)

<html><head></head><body><h2>The Hidden Impact of Menopause on Sexual Health</h2><p style="line-height:1.38;margin-bottom:12pt;margin-top:12pt;" dir="ltr">Menopause marks a significant transition in a woman’s life, bringing about hormonal changes that can affect overall well-being. One of the most overlooked yet impactful aspects is genitourinary syndrome of menopause (GSM), which is characterized by vaginal dryness, discomfort, and changes in sexual function. Declining estrogen levels primarily drive these symptoms and can significantly impact a woman’s quality of life and intimate relationships. Fortunately, these studies, among others, explore various available treatments to help manage these changes effectively.</p><h2>What is Genitourinary Syndrome of Menopause (GSM)?</h2><p style="line-height:1.38;margin-bottom:12pt;margin-top:12pt;" dir="ltr">GSM refers to a collection of symptoms affecting the vagina, vulva, and lower urinary tract due to estrogen loss during menopause. Common symptoms include:</p><ul><li>Vaginal dryness and irritation</li><li>Pain during intercourse (dyspareunia)</li><li>Decreased libido</li><li>Increased risk of urinary tract infections</li></ul><p style="line-height:1.38;margin-bottom:12pt;margin-top:12pt;" dir="ltr">These symptoms occur because estrogen plays a crucial role in maintaining vaginal tissue elasticity, moisture, and blood flow. As levels decline, the vaginal walls become thinner and less lubricated, leading to discomfort and an increased risk of infections.</p><h2>The Role of Androgens in Female Sexual Function</h2><p style="line-height:1.38;margin-bottom:12pt;margin-top:12pt;" dir="ltr">While estrogen is widely recognized as a key hormone in female reproductive health, androgens (such as testosterone) also play a role in maintaining sexual function. Research suggests that androgens contribute to sexual desire, arousal, and overall well-being. Some studies indicate that androgen therapy may be beneficial for women experiencing low libido or other sexual dysfunctions related to menopause. However, further research is needed to understand the long-term benefits and risks of androgen supplementation fully.</p><h2>Managing GSM: Treatment Options</h2><p style="line-height:1.38;margin-bottom:12pt;margin-top:12pt;" dir="ltr">There are several effective strategies for managing GSM symptoms:</p><ul><li>Vaginal moisturizers and lubricants: Over-the-counter options can help reduce dryness and improve comfort during intercourse.</li><li>Hormone therapy: Local estrogen therapy (such as creams, rings, or tablets) can restore vaginal tissue health and alleviate discomfort.</li><li>Androgen therapy: In some cases, testosterone therapy may be considered for improving sexual desire, though this remains an area of ongoing research.</li><li>Lifestyle modifications: Staying sexually active, maintaining hydration, and using gentle, non-irritating products can help maintain vaginal health.</li></ul><h2>The Importance of Seeking Help</h2><p style="line-height:1.38;margin-bottom:12pt;margin-top:12pt;" dir="ltr">Many women feel hesitant to discuss sexual health concerns, but GSM is a common and treatable condition. Consulting a healthcare provider can open the door to effective treatments that improve comfort and overall quality of life. Understanding the biological changes of menopause and seeking appropriate care can help women maintain intimacy and confidence during this stage of life.</p><p><strong>Sources</strong>:</p><p style="line-height:1.38;margin-bottom:12pt;margin-top:12pt;" dir="ltr">Davis, S. R., Worsley, R., Miller, K. K., Parish, S. J., &amp; Santoro, N. (2016). Androgens and Female Sexual Function and Dysfunction—Findings From the Fourth International Consultation of Sexual Medicine.&nbsp;The Journal of Sexual Medicine, 13(2), 168–178. https://doi.org/10.1016/j.jsxm.2015.12.033</p><p style="line-height:1.38;margin-bottom:12pt;margin-top:12pt;" dir="ltr">Mitchell, C. M., Larson, J. C., Reed, S. D., &amp; Guthrie, K. A. (2023). The complexity of genitourinary syndrome of menopause: Number, severity, and frequency of vulvovaginal discomfort symptoms in women enrolled in a randomized trial evaluating treatment for genitourinary syndrome of menopause.&nbsp;Menopause, 30(8), 791-797. https://doi.org/10.1097/GME.0000000000002212</p></body></html>

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<p>Menopause-related hormonal changes can lead to genitourinary syndrome of menopause (GSM), affecting vaginal health and sexual function. Symptoms such as dryness, pain, and reduced libido result from estrogen loss, but treatments like hormone therapy, lubricants, and lifestyle changes can help. Understanding GSM and seeking proper care can improve quality of life and intimacy post-menopause.</p>