What can a doctor suggest if your love life runs into problems? GP Dr Rosemary Leonard gives her prescription…
In your 30s
By now, you should have overcome your insecurities about sex and know what you like. This, coupled with high hormone levels, should mean really good sex.
And the bad…
Problem one: You are desperate to have a baby, which means having sex stops being romantic and turns into a mechanical baby-making process instead. This can be a big turn-off, especially for men, who may have sexual difficulties under the pressure.
The solution: Try not to let your sex life be ruled by the calendar. Sperm can certainly live for a good three days inside a woman, so there’s no need to be at it every night! Good sex is romantic, not just a mechanical process.
Problem two: You’ve just had a baby. You’re tired, sex is at the bottom of your agenda and, when you do get around to it, your vagina is dry.
The solution: During breastfeeding, the ovaries usually ‘switch off’, which means oestrogen levels are very low. Don’t worry about it – once your baby is weaned and you start getting more sleep, oestrogen levels will rise and your body will get back to normal. In the meantime, vaginal dryness can be eased with topical oestrogen cream or pessaries from your GP.
In your 40s
Research suggests that libido peaks in women in their forties. There’s no need to be embarrassed about having a really high sex drive – enjoy it!
And the bad…
Problem one: Your family is complete, and you are desperate not to accidentally become pregnant.
The solution: Don’t leave contraception to chance. A good long-term option is a hormonal intrauterine device (IUD), like the Mirena coil, which has the added advantage of making periods much lighter, too.
Problem two: Sex – who has time and energy for that? You are just so busy, what with a job and looking after the kids, that when you get into bed, you are so exhausted you just want to sleep.
The solution: You may think it’s a bit cheesy and not for you, but ‘date nights’ really can work, even for long-established couples. Once a month, make your relationship your priority for an evening. If possible, palm the kids off on someone else – if you’ve no family nearby, a reciprocal arrangement with some friends can work well. Have a romantic evening together, don’t overdo the wine, and get to bed early.
Problem three: Your periods are all over the place and you don’t like the idea of having sex when you are bleeding, and when you do have intercourse, it feels uncomfortable. The menstrual chaos that can occur around the time of menopause can make having regular sex difficult.
The solution: There’s actually no medical reason to avoid sex during menstrual bleeding, but it’s something that you should talk about with your partner first. See your doctor to discuss treatments to control the bleeding.
You should also see your doctor if sex starts to become uncomfortable. You will need to have an examination and possibly a scan to sort out the cause. The forties can be a time when gynaecological problems, such as fibroids, can become symptomatic, which could lead to heavy bleeding and painful intercourse.
In your 50s
You no longer have to worry about an accidental pregnancy, so you really can enjoy sex without any worries. And, if you’re established in a long-term relationship, you don’t have to worry about infections either.
And the bad…
Problem one: You are forever throwing off the duvet and opening the window, so you’ve been banished to the spare room. Hot flushes and sweats that occur around menopause can be a real passion killer.
The solution: A good temporary measure is to use two single duvets on the bed – a lightweight one for you, and a heavier one for him. HRT can help, too, but if you don’t want to take that step, other treatments from your doctor, such as clonidine and SSRI antidepressants, can help control your erratic body thermostat.
Problem two: Your vagina feels dry and uncomfortable. Low oestrogen levels after menopause mean the vaginal tissues become thinner and less moist.
The solution: Special lubricants available from chemists, such as GynaGuard, can be used on a daily basis to help plump up the vaginal tissues. Better still is oestrogen, either as a cream or pessaries, in the vagina. This is only available on prescription, and the good news is that it doesn’t have the risks associated with standard HRT, and can be used long-term.
Problem three: You just don’t feel like sex any more. Your libido seems to have disappeared. This is a common problem after menopause and, again, low hormone levels are to blame, especially the low levels of testosterone, which is produced in small amounts from the ovaries before menopause.
The solution: Being honest, this one’s difficult. HRT can certainly restore your sex drive, but brings with it a slightly increased risk of breast cancer and blood clots, especially with long-term use. Some women may benefit from testosterone-replacement therapy in the form of a cream, although it’s often prescribed in low doses for short periods. In the end, it should be your choice, but you’ll have to confirm with your doctor that you understand the risks involved, as side effects can include acne and hair growth.
In your 60s
Life is less busy and pressurised, and you finally have the time to enjoy sex and romance with your partner.
And the bad…
Problem one: You can’t feel anything anymore. Your vagina and pelvic floor just feel slack. The muscles that support the pelvic floor become weaker and thinner with age, and the stretching that occurred during childbirth often only causes symptoms a couple of decades later.
The solution: Exercise and more exercise! It’s never too late to start doing pelvic-floor exercises. Join a Pilates class, which will also help to strengthen your all-important ‘core’ muscles, and practise regularly at home. More severe vaginal slackness may require surgical correction.
Problem two: Your partner can’t get an erection or can’t maintain it for long enough to have sex, and he’s too embarrassed to see the doctor. Erectile dysfunction becomes much more common with increasing age. It’s not just a sexual problem, though, as it can be a sign of a more serious underlying health problem, such as heart disease or diabetes.
The solution: Nag him until he sees the doctor, explaining that this has more to do with his general health and well-being than with sex. Even if there’s nothing serious wrong, it’s better for him to get proper treatment from his doctor, rather than from a dodgy Internet site.
By Health Writer Belinda dos Santos