Symptoms That Impact Intimacy

Although the menopause transition is a natural phase of life, some symptoms can disrupt your physical and emotional well-being. Vaginal and urogenital symptoms in particular can have a negative impact on sexual wellness and physical intimacy. These symptoms and experiences are common: 

Vaginal Dryness
In a recent study, approximately 50% of women over the age of 50 reported experiencing vaginal dryness, one of the most common symptoms of menopause. Vaginal dryness occurs when the vagina does not produce enough natural lubrication. As levels of estrogen drop during menopause, the tissues of the vagina become thinner and stop self-lubricating as effectively. This can cause discomfort during sex and also lead to itching, burning, and painful urination.

Vaginal Atrophy
Painful sex is also common. The intensity can differ greatly among women, ranging from only feeling pain during penetration to burning or discomfort long afterward. The main reason for painful sex during menopause is a decrease in testosterone, progesterone, and estrogen, causing the vaginal walls to exhibit:

• Dryness

• Thinning

• Irritation

• ​​Tearing

This combination of symptoms is known as vaginal atrophy.

Genitourinary Syndrome of Menopause
As hormones decline during menopause, women can start to develop what is known as Genitourinary Syndrome of Menopause (GSM). GSM is a group of symptoms that can occur in the vagina and urinary tract due to a decrease in estrogen levels:

• Vaginal dryness

• Itching & burning

• Urinary urgency & incontinence

• Vaginal and vulvar atrophy

• Narrowing of the vaginal canal

These symptoms can make sex more painful, impacting your quality of life and relationships. In menopause, these changes are common. A U.S. survey of over 3,000 menopausal women revealed the following about vaginal discomfort:

• 80% said it negatively affected their lives. 

• 36% said it made them feel old. 

• 29% reported that it compromised their sleep.

• 26% said it lowered their self-esteem. 

• 85% reported it adversely affected sexual intimacy. 

• 68% said it caused them to be less sexual.

• 59% said it took away from the enjoyment of sex.

• 47% reported that it had negative consequences for their marriage or relationship.

Ways to find relief:
Promote natural lubrication by eating foods high in fatty acids, isoflavones, and vitamins A, B, and E.
Stay hydrated by drinking enough water daily.
Avoid douching or products that contain perfumes, dyes, and fragrance.
Consider hormone replacement therapy (HRT), which naturally restores hormone levels to treat 100+ menopause symptoms, including vaginal and urogenital symptoms. (Learn more under “Tips for great intimacy”.)

Understanding Low Libido and FSIAD
Not "in the mood" these days? Low libidio is a common symptom during the menopause transition. But sometimes, it isn’t just a feeling. It may be a sign of Female Sexual Interest/Arousal Disorder (FSIAD). 

What is FSIAD?
Female Sexual Interest/Arousal Disorder (FSIAD) is a condition in which a woman’s body does not respond to sexual stimulation, whether mental (fantasies, desire, enthusiasm) or physical arousal (touch, natural lubrication, sensation). 

The term FSIAD is used to refer to women, while for men, it’s usually referred to as erectile dysfunction (ED). Despite this condition being common, FSIAD is not as widely known. It’s particularly prevalent for women around 45 years and older, when hormone levels are affected during the menopause transition.

Common signs and symptoms of FSIAD include:

• Less motivation to initiate sexual activity and being unreceptive to a partner’s attempts to initiate sexual intimacy

• A decline in sexual arousal or enjoyment during sexual activity

• Little-to-no sensation in the erogenous zones

• Pain during intercourse

• Inability to orgasm

• Reduced vaginal dilation and wetness

Fortunately, these symptoms are treatable. Treatment for FSIAD often involves a combination of lifestyle changes and medications.

Lifestyle changes may include finding ways to reduce stress and anxiety, like light exercise, meditation, reading, and other self-care practices. Talking with a friend, loved one, or therapist can also help.

Medications can also be prescribed to help treat underlying conditions like depression or anxiety, which can contribute to FSIAD. Treatments like HRT can improve these symptoms and help support a healthy sex life.

It’s important to talk to your doctor or healthcare provider if you are experiencing symptoms of FSIAD.