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Sexual Health

Sexual Wellness - Does Menopause affect it?

Sex and sexual health carries a taboo not just in the Indian culture, but worldwide. Hence not surprisingly, postmenopausal women fail to give their sexual and reproductive health the attention that it deserves.
Dr. Manish Mahajan
October 19, 2023

Ever wondered what was the life expectancy of women about a hundred years ago? It was about 40 years! Since then, we have seen a huge improvement in life expectancy due to the advancements in medicine and improved living conditions. Today, the life expectancy of Indian women on an average is about 70 years. So, what was the average age of menopause then, i.e. a century ago? 45 to 50 years. And what about now? The same i.e. 45 to 50 years!

So, while menopause was one of the terminal events of a woman’s life back then, the modern age women now spends about 1/3rd of her life in menopause. With such a huge chunk of life spent in this phase, it is but natural that it receives the attention it deserves! It is important for her to continue to stay healthy during and after menopause too!

As per the World Health Organisation, Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. And to this definition, in 1994, WHO added sexual well being by stating that right to sexual health is a fundamental human right.

Sex and sexual health carries a taboo not just in the Indian culture, but worldwide. And unfortunately this taboo deepens as women move towards menopause and they end up enduring the issues they face. Postmenopausal women fail to give their sexual and reproductive health the attention that it deserves. A study conducted in South India, concluded that the prevalence of sexual dysfunction in post menopausal women was as high as 86%.

Why is Sexual Health affected by age and menopause?

The reasons are as much medical as social. Let’s delve into the medical reasons first.

With menopause, the hormonal levels, especially that of female hormone estrogen, goes down and this results in lowered libido in women. There are high incidences of vaginal dryness, which ultimately lead to sex being a painful experience. This fear of pain itself may further affect the libido and end up resulting in an aversion towards sex.

There could be other medical conditions like orthopedic or joint related issues which may make intercourse difficult. Certain medications may also decrease libido and cause loss of interest in sex.

Social factors also play a huge role in inhibiting Sexual wellness. More often than not, a couple is undergoing some or the other stressors - whether related to family, work, finances or some other tensions. Marital discord in itself may hamper the intimacy between the couple. At times with joint families & grown up kids, there could be simple yet legit constraints of privacy and space. And the commonly existing notion that looks at sex, especially sex beyond a certain age, as a taboo. 

While we have been talking about lowering of libido with menopause, there is an exactly opposite possibility - Menopause resulting in increased sexual desire in the woman. Wondering how? There always exists a small amount of male hormone testosterone in a woman’s body. Earlier female hormone oestrogen was predominant. But now with menopause, as estrogen levels reduce, the hormonal ratio of female estrogen w.r.t. male testosterone gets deranged. This increased desire is a completely normal thing. But women might have problems either expressing it or discussing this with their partners considering the social taboos.

Let’s not forget, there can be varied understanding between the couple when it comes to expectations of sexual intimacy. And it is totally okay for both the partners in a relationship to be happy without sexual intercourse in a relationship. 

Bottomline - if something is affecting your sexual wellbeing, then discuss with your partner, and seek expert advice. Lack of awareness and fear of judgement often makes women suffer in silence without even discussing these concerns with their partner. It has been proven in multiple studies that a satisfactory sexual life even after menopause is one of the factors determining QoL i.e. Quality of Life. Look at it positively and take the appropriate medical advice from experts to overcome the limitations and to improve or even enhance sex life.