Dear Mary: Sex is too painful since menopause – will I never enjoy it again?

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I don’t know where to turn with this one. Since hitting menopause three years ago, I’ve hardly had sex with my husband. I have a good marriage and I love him, but sex became painful to the point that we stopped having it altogether over 18 months ago. It has changed things between us, and I feel like I’m no longer the person I once was. He is being patient, but I don’t know how long he can be patient for. I have no answers – do I resign myself to never having sex again?

Mary replies: It seems to me that menopause often has very negative connotations – we hear lots about hot flashes, thickening waistlines and painful sex. But this should not be the case. Instead, I feel it should be seen as something positive, and, in some ways, a new beginning. After all, there are no more painful periods, no more worrying about getting pregnant and usually, with a family reared, more time to devote to the woman herself and her partner, if she has one.

While a woman is fully fertile and menstruating, the ovaries produce higher levels of the hormone oestrogen in the first half of her cycle to prepare the womb for a possible pregnancy. If the egg that she produces every month is not fertilised, the levels of oestrogen, and another hormone, progesterone, drop. But when she reaches menopause – which is when she has not had a period for a year – her ovaries produce less oestrogen and progesterone as no further eggs are being released. However oestrogen is what keeps the vagina moist, and so something has to be done to replace it. Otherwise a woman is very likely to suffer with dyspareunia, or painful intercourse, which is what you are experiencing.

There are lots of ways that you can replace the oestrogen, and the first thing to do is to consult with your doctor. Please do not be embarrassed by talking about this. Help is readily available and it is only a question of finding what is right for you. Some women find that an over-the-counter lubricant is all that they need, whereas others need an oestrogen replacement which can come in the form of a patch, or as a tablet that is put directly into the vagina. Your doctor will know what will be best for you as he or she has access to your complete medical history.

I am delighted you mentioned your husband, because very often they are forgotten in all the talk of menopause. It is also very important that your husband knows and understands what is going on, because he is an equal part of the lovemaking process. Just as he may be finding that it takes him a little longer to get an erection, or to ejaculate, he should understand that you will be taking longer to get aroused, and because of this, foreplay has greater importance than ever when you are having sex. And he won’t know about this unless you tell him.

Some women unfortunately let the painful-sex situation continue for too long without seeking help. They then find that they have become very tense as their body remembers the pain of previous attempts at having sex. In those cases, it would be necessary to seek professional psycho-sexual help for the dyspareunia.

A very good resource for anybody starting into menopause, or indeed having come through it already, is a website called My Second Spring. Some years ago, Aisling Grimley found that there was very little available in the way of information and support regarding menopause, so she started a website. It has grown into a very successful site over the seven years of its existence. In China, the menopause is referred to as the ‘second spring’ as women in middle age are respected for their wisdom and experience, which is such a lovely sentiment, hence mysecondspring.ie was born. On the website under the Treatments section, you will find a very good article by Dr Deirdre Lundy, which gives lots of useful information regarding different types of treatment available.

I hope that very soon painful intercourse will become a thing of the past for you, with many years of joyous sex ahead. l

You can contact Mary O’Conor anonymously by visiting dearmary.ie or email her at dearmary@independent.ie or write c/o 27-32 Talbot St, Dublin 1. All correspondence will be treated in confidence.

Mary O’Conor regrets that she is unable to answer any questions privately

Sunday Indo Living

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