Sex vs. Romance for the Menopausal Woman

Patient Expert

I'm sure it hasn't escaped anyone's attention that Valentine's Day is coming up. I remember when I used to like that day. I even looked forward to it. The romance. The anticipation. But in recent years, it's been The Dread.

Sometimes I feel like our bodies are just not made for sex anymore. In my case, my middle is decidedly unsexy. I feel like I swallowed a beach ball. Next, most of us are always tired. I don't know about you, but I could go to sleep at 9 every night.   Between my husband's snoring, my hot flashes and the dog moving around in the bed-well, I just don't sleep all that well. And last, but not least, for many of us, menopause has taken away our desire for sex and when we DO get in the mood, our lovemaking can be, well, painful. That is so cruel.

I get a lot of questions about why sex is painful for women going through menopause. I've asked a lot of questions of a variety of doctors and read just about anything I can find. It has to do with our decreasing levels of estrogen, which causes vaginal atrophy or essentially thinning of the vaginal wall. When that tissue is dry and thin, it can really be uncomfortable to have sex, and for some, it is downright painful.

A typical physician's response is to prescribe a topical or low-dose estrogen ring (inserted into the vagina) or gel or lotion.  I was scared of this at first. You know, estrogen has a bad reputation concerning breast cancer, and several of my family members have had breast cancer. But now I'm convinced it is safe for me and it works. If you are suffering in silence, bring it up with your health care provider. For many women, these treatments help with the physicality of sex anyway. But it doesn't help with the emotional part. I fear there's no drug for that.

It's easy to let the romance of our youth fade away. It just happens over time. We stop kissing as much, we stop gazing into each others' eyes. But I feel so strongly that we need romance now more than we did when we were younger. Holding hands, cuddling on the couch to watch a movie, or a simple touch can mean so much. It has taken me years to convince my husband that there's a big difference between romance and sex. I bet 99.9% of you agree.

So this Valentine's Day, I'm going to try to stay up past 9 and cuddle on the couch. Who knows after that? As for you, I wish you romance.