Why Are Women Over 40 Enjoying Sex More? Midlife Sexuality and Women

Why Are Women Over 40 Enjoying Sex More?
Midlife Sexuality and Women — Getting better with age

You've reached midlife and found a new sense of freedom. Your children are grown and perhaps on their own. You may no longer worry about an unplanned pregnancy or having to use contraception.

Your maturity has given you experience and confidence about many of life's aspects. Yet midlife also ushers in the transition to menopause — traditionally a time when women have been stereotyped as being beyond feeling sexual desire or being desired.

You may not have all the answers about what lies ahead. But don't let change shake your confidence. If you relate midlife and menopause with self-development and personal growth, you're likely to find that sexuality, like other aspects of your life, gets better with age.

What determines sexuality?

You remain a sexual being long after you lose your ability to bear children. Sexuality is more than the biological urge to procreate. It involves the timeless desire for both physical and emotional intimacy, to feel and give affection or pleasure. If you're healthy, your interest in sex can last your entire life.

As estrogen wanes

Menopause and the 5 to 10 years leading up to it, called perimenopause, can cause physical changes that may present new challenges to your lovemaking. Estrogen made by your ovaries declines gradually during perimenopause, then drops off precipitously at menopause. As a result, you may experience:

Vaginal changes — The opening to your vagina becomes narrower, especially if you're not sexually active. Lubrication occurs more slowly during arousal. Even when you feel sexually aroused, your vagina may stay tight and dry. These factors can lead to difficult or painful intercourse, called dyspareunia (DYS-pa-ROO-nee-ah).

Diminished or slowed response — Blood flow to your genitals lessens, increasing the time for your tissues to engorge (swell with blood) during arousal. Because sexual arousal begins in your brain, you can have an orgasm throughout your life. Yet your response may be slower or less intense.

Changes in sensitivity — Thinning and shrinking of vaginal tissue expose more of your clitoris. Greater exposure may reduce your sensitivity or cause an unpleasant tingling or prickling sensation when touched.

Higher risk of infections — Thinning of vaginal tissue increases susceptibility of the tissue to damage and infection. Your vaginal area also becomes less acidic, making proliferation of yeasts and bacteria more likely.

Stress incontinence — Estrogen deficiency reduces support to your sphincter, the muscle that controls urine flow, and your urethra, the tube that carries urine from your bladder. With the increase in abdominal pressure that occurs during intercourse, you may leak urine.

Will you lose your desire?

If you're like most women, your desire for sex probably won't change. Sexual desire results from a complex interplay between your unique psychological makeup, social and cultural conditioning, and hormones.

Although estrogen affects sexual desire, the male sex hormone testosterone, made in small amounts by your adrenal glands, exerts greater influence. Typically, your testosterone level doesn't decline as quickly as estrogen.

A greater proportion of testosterone to estrogen after menopause may lead to an increase in your sexual desire. Anticipation of more time with your partner or having more time for intimacy also may boost desire. However, if intercourse becomes painful, or if you're bothered by symptoms of menopause, such as hot flashes, insomnia or irritability, your desire may wane.

Practicing safer sex

Until you've been without a period for a year, you may still be ovulating. That means you still need to use contraception. Although the risk of pregnancy is low, some women opt for surgical sterilization. The contraceptive pill is also safe for many women as they approach menopause.

Sterilization as permanent birth control - His or hers?

Being of "a certain age" also doesn't protect you from sexually transmitted diseases (STDs), including AIDS. While abstinence from sexual relations is the only 100-percent-effective protection against STDs, use of a latex condom can significantly reduce your risk.

Enhancing sexual desire and pleasure

Whether you want to keep the sizzle in your sex life or add spark to a flagging relationship, these suggestions may help:

Stay sexually active — Regular sexual activity improves vaginal lubrication and elasticity after estrogen declines. This regular sexual activity can include self-stimulation, especially if you have no partner.

If vaginal dryness persists, try using a water-based lubricating cream designed for genital use, such as K-Y Jelly or Astroglide. Also, ask your doctor about a prescription estrogen-based cream such as Premarin or Ogen. When applied to your genital area several times a week, it can help prevent dryness and thinning of vaginal tissue. The estrogen-filled vaginal ring (Estring) also slowly releases a low dose of estrogen in your vagina to prevent dryness and tissue thinning.

Develop a good attitude — Your attitude and expectations about sex after menopause may have as much or more to do with your sexual satisfaction than declining hormone levels. Tossing away the stereotype of the "frigid midlife woman" may free you to become vital and sensuous.

Evaluate your priorities — Something as important as your relationship with your partner deserves high ranking on your list of "must dos." Don't let your home or career responsibilities take time away from each other. Spending time together is what makes you feel connected and cared for.

Be explicit about your desires — Tell your partner exactly what you want. If you become sexually aroused when spoken to or touched in a certain way, say so. Or, if it's easier, guide your partner's caresses over your most sensitive areas.

Change the script — Many couples who've been together for years get "in a rut." If your sexual script has been to spend two minutes on foreplay, then assume the missionary position and have intercourse, why not try something more playful and less predictable?

Talk about what each of you finds sexy. Remind each other that sex doesn't always have to lead to intercourse. Then go ahead, experiment with new, more exciting ways to prolong each sexual experience.

Touch each other in places you've not taken the time to explore. Take turns massaging each other with warmed scented oils. Read erotic passages to each other. Try using a vibrator. And when you do have intercourse, be more creative with position and location.

Consider hormone replacement therapy — Estrogen helps vaginal dryness that may interfere with sex. It also helps hot flashes, and may improve urinary incontinence. Restoring your estrogen level can also improve touch perception and skin sensitivity, which will improve your response to physical affection and caressing.

If you experience a loss of sexual desire, HRT may help. But some women also may need small amounts of the male hormone testosterone. To find out if HRT is right for you, including supplementation with testosterone, talk to your doctor.

HRT also reduces your risk of osteoporosis and may help protect against cardiovascular disease. Starting HRT at menopause and continuing indefinitely offers the greatest protection.

How talking helps

For many women, emotional intimacy is an essential prelude to sexual intimacy. Talking regularly and openly about your feelings with your partner helps you reconnect and discover each other again.

If intercourse becomes painful or your desire fades, you may become angry or feel alienated. Rather than endure intercourse or reject sexual advances, try talking about your concerns during a nonsexual moment in neutral territory. A long, relaxing car ride or quiet dinner may offer just the environment for frank discussions.

At all costs, avoid prolonged silence. Repressed feelings, especially anger, can be hazardous to your immediate well-being and long-term health. If necessary, discuss your problems with your doctor or counselor.

Taking care of yourself

It's difficult to have satisfying sex when you don't have a healthy self-image. To increase your energy and preserve confidence in your sexuality:

Eat a low-fat, high-fiber diet, rich in vegetables, fruits and grains.

Avoid excessive amounts of alcohol and don't smoke.

Exercise for a total of 30 minutes a day on most, if not all, days. Include 10 minutes of pelvic muscle (Kegel) exercises to tighten and tone your vaginal area.

Control stress and regain your sense of self by setting limits on demands from grown children and aging parents.

Schedule annual visits to your doctor.

Getting better with age

Now that you're older, you're probably more in touch with your feelings and comfortable with your body. You and your partner may be more caring, nurturing and patient - perhaps even more daring. Yes, there will be changes. But knowing what you can expect and talking frankly about sex can free you to discover a deeper, more satisfying intimacy.

Source: http://www.mayohealth.org/

September 21, 2000