As women approach midlife and as they go beyond 50 years of age, it is normally presumed that sex would not be a part of their lives. In the past women were shy, too tied up with children and household chores, did not have privacy of a bedroom or probably were still sexually active, but did not speak about it, nor did their doctors talk to them about it !
But today, we know that women are sexually active much beyond that age! They are more expressive, more demanding and more vocal. They speak to us about their difficulties, and their frustrations. The problems commonly seen are due to estrogen (female hormone) deficiency which reduces drastically at menopause or problems which their husbands may have, mainly due to Erectile Dysfunction. Estrogen deficiency causes vaginal dryness leading to pain during sexual activity, besides reducing their desire to have sex which also reduces lubrication. Many men do not understand what their partners are going through and this can cause difficulties in their marriage, so a large number of women go through their sexual life being uncomfortable and sometimes in pain, whilst a small percentage come to us for their problem and talk about it, which we correct quite effectively. This therapy helps them to enjoy sexual activity again and also increases their desire which matches with their partners.
On the other hand, a woman may continue to have the desire, but her husband has a physical problem, which fails satisfy her which she does not communicate to him. The husband does not feel that it is not necessary to seek medical advice because he himself remains satisfied or is too embarrassed to see a doctor.
This lack of dialogue which exists between the couple related to this part of their lives can lead to the straying away of couples from each other. In a study carried out in South America, about 400 women were evaluated for sexual dysfunction with 33% being menopausal between the ages of 40-59 years. 55% of the women complained of sexual difficulty due to vaginal dryness and their problems got worse when their husbands had associated erectile dysfunction, yet all of them continue to remain sexually active!
Sexual wellbeing is an integral part of living and there is a stereotyped view on sexual activity and ageing. Many false beliefs exist of sexuality in older age. Even though scientific studies have shown that there is a decline in the frequency of older women’s sexual activity, there is almost no evidence to suggest that older women have a decrease in sexual interest and desire.
Some studies have shown that 70% of women between 50-90 years are sexually active, whilst most of the studies indicate that 50% of women are sexually active, with 40% reporting activity at least once a month. It is also well known that women who are sexually active at an older age, have better physical and emotional health, as compared to women who are not active.
Hence it is important for us to revise our thoughts on this subject and try and see that these issues are addressed at every age. The Sexual difficulties which occur following menopause, can be minimized by the use of oral or vaginal hormone therapy and or the use of virginal lubricants. There are many doctors who do not address this issue by not asking a direct question on this subject, whilst women may feel embarrassed to open the discussion with their doctors especially if they are from the opposite gender. There have been very few women who have voiced their difficulties to me on their own, but when I ask them directly, they definitely tell me their problems and how they are coping with it.
Usually they were just pretending to enjoy sex and now they were enjoying it to their fullest!