Menopause & Sexual Health
Sexual dysfunction is more prevalent in women than men, and this tends to increase around the menopause and perimenopause with women reporting problems with libido, vaginal dryness and inability to climax. Painful sex can then lead to avoidance of sexual activity, and anticipation of pain prior to sex can lead to lack of arousal. Women who are going through their menopause transition, and women who are postmenopausal should be able to participate in an active sex life. Maintaining sexual health in the peri-and post menopause is an important part of menopause management by treating genitourinary syndrome of the menopause and addressing psychological problems which might also be contributing to symptoms.
The current recommendation is for women to continue with contraception for 1 year after the last menstrual period if aged 50 or older, and for 2 years after the last menstrual period if under 50 years of age. However, the last menstrual period is a retrospective diagnosis. Some women do not get menstrual periods with certain contraceptives, conversely, some contraceptives and HRT regimens will give women a monthly hormone withdrawal bleed. Hence it can be difficult to accurately determine the last menstrual period. Therefore, another recommendation is for women to continue with contraception regardless up until age 55 whereby most women will be postmenopausal. HRT (apart from the Mirena coil or IUS if used as the progesterone component of HRT), is not a contraceptive, and women are still advised to use a method of contraception until they are postmenopausal.
Safe sex principles still apply and it’s important to avail of STI screens if embarking on a new relationship and to use barrier contraception to reduce the risk of STIs.