Singing the Menopause Blues

Upset couple sitting on opposite ends of bedDoes menopause or a hysterectomy quash or quicken your sex life? This question applies not only to those of us who might face these, but also to the romantic partners who love and live with many of us. Since our most important sexual organ is between our ears and not our legs, I believe our interest in sex (libido) is largely dependent on our beliefs about sex and what we can and should expect.

In my practice, I work with many older women who have read about increasing their estrogen levels in order to improve their sexual experiences and increase their sexual desire. Some swear by bioidentical hormones, while some declare that testosterone (T) is their favorite “hormone of desire.” (Susan Rako’s popular book bearing this title swears by T, but she backs her theory with personal anecdotes and no scientific data whatsoever.)

In 1985, researcher Barbara Sherwin wondered if lack of testosterone caused problems with libido. She discovered that administering T to women who had undergone hysterectomies enhanced the intensity of their sexual desire and increased frequency of sexual fantasies. But there was no evidence the hormone had affected their physiological response, so its effect was more motivational than physical.

There have been few well-designed studies of sexual interest in healthy people. Most studies of sexual problems have come from women who consulted their physician because of some health concern and thus had issues of some kind already. When well-known sexologist Alfred Kinsey and his colleagues spoke to women throughout their life cycles, they found that as age increased there was a distinct decline in the frequency of intercourse. But there was no decline in solitary self-pleasuring until well after age 60.

Among people I’ve talked to about sex, I’ve found over the years that men report a greater loss of sexual interest between 45 and 55 than women do; perhaps that’s why some of these women are masturbating! Many women over the course of menopause do report some decrease in intercourse and vaginal lubrication, but not in solitary sexual enjoyment when utilizing one of the many intimate lubricants available. Hooray for the slippery stuff!

A high percentage of our feelings about sex are determined by the culture that surrounds us. I once read about a study of aging women in a small village in Thailand. Some of them experienced a decline in libido, but they celebrated this, perceiving it as a welcome release from having to worry about sex. So while uterine changes may cause some lessening of sexual desire, not everyone experiences it and not everyone who does experience it considers it a problem.

I once worked with a young, single woman who underwent surgical menopause when she was in her late twenties. (I don’t recall whether her ovaries were removed.) She initially lost interest in sex, but when she regained her libido she began to lament that men were no longer interested in dating her. She would sit in my office and weep: “I’ve lost my mojo!” I scoured professional journals and spoke to colleagues about how the surgery might have affected her level of sexual attractiveness or desirability, and finally read about a study of monkeys that showed that males were no longer attracted to females who had hysterectomies. But when vaginal secretions containing pheromones from “intact” females were rubbed on the ones who had hysterectomies, males regained interest.

Pheromone secretion aromas are sexually stimulating, and after hysterectomy they are no longer produced in females. We do, of course, need to be careful about drawing conclusions about human sexuality from animal studies such as this, since so much of our sexuality is psychological and sociological. But popular magazines have recently published findings that seem to show that men “rate” women they’re watching on video who are ovulating as “more attractive” than women of a similar age and appearance who are in other stages of their menstrual cycle.

However, it isn’t as simple as no womb, no pheromones, no sex. Many older women are seen as sexy and are enjoying as much sex as they want. I guess we’re more complicated than monkeys!

© Copyright 2013 GoodTherapy.org. All rights reserved. Permission to publish granted by Jill Denton, LMFT, CSAT, CCS, therapist in Los Osos, California

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Erica

    Erica

    July 23rd, 2013 at 11:46 PM

    Relationship and companionship is more than just sex and physical relationship.There is much more to it.while I do understand that lack of sex may play a role in other forms of connections well,it can be overcome with some work.That is the same reason why old couples can still be happy even when there is no sex.They find ways to work it all out and I think that is a lesson all of us not-so-old folk need to learn.

  • Meg

    Meg

    July 24th, 2013 at 4:15 AM

    SSSOOOO not looking forward to menopause but I guess all I have to go by as far as what it will be like are stories from my mom. This gives me hope that it can be good too!

  • brenda s

    brenda s

    July 25th, 2013 at 4:24 AM

    I actually am more energized and interested in having sex now that I am older than I ever did when I was younger. I think that in large part this is because I have grown into who I am, I know what I like and dislike and I guess I am not afraid to show it or say it anymore. That’s one of the greates things about getting older. You start to realize that it is far more imprtant to look out for yourself and please yourself than it is to worry about what other people are doing or thinking.

  • Chelsea

    Chelsea

    July 30th, 2013 at 7:26 PM

    Menopause can be a very difficult time in a women’s life. For me, having an open discussion with my doctor and my husband has made it a bearable experience. Even with my hot flashes, insomnia, vaginal dryness and mood swings my husband has been extremely supportive. His loving support has naturally kick started my libido and our sex life is wonderful. Sex does get better with age!

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