More than two thirds of women between the ages of 50-70 have suffered from symptoms that affected their ability to be intimate with their partners, and the majority of those woman say they never anticipated physical changes would occur, according to a newly released “Sex, Menopause & Relationships” survey, sponsored by Duramed Pharmaceuticals, Inc., and conducted by Harris Interactive.

The survey also revealed the menopause-induced sexual issues women in that age group, and in partnered heterosexual relations, were most likely to face. Of those who reported experiencing physical problems that diminished sexual frequency and enjoyment, 72 percent said that they suffered from vaginal dryness, 70 percent from low libido, and 34 percent from pain with sex.

The question is, with so many women facing menopause-induced sexual challenges, why is there so little discussion about it? “There seems to be a lack of knowledge about the vaginal symptoms of menopause in women and the treatments available,” says David B. Schwartz, M.D. practicing Obstetrics & Gynecology at Christ Hospital in Cincinnati, Ohio, who believes that male sexual issues take center stage because of widely advertised erectile dysfunction drugs. “Sadly, we still live in a male dominated society when it comes to sexual issues. Women’s challenges are taboo, and they should be discussed just as much.”

Dr. Schwartz believes that a woman should start gathering information when she is in her early forties, before menopause begins. Since her estrogen supply will likely begin to diminish at this point, he recommends asking her gynecologist: “What is going to happen to my body as I transition to the menopause? How will the lack of estrogen affect my ability to maintain a healthy relationship with my spouse?”

We suggest that a woman discuss the physical changes of menopause with her partner as well. Of the men and women with symptoms who have discussed those symptoms with their spouses, a majority (75 percent) reported overall satisfaction in their relationships. That is not surprising to us, as we so strongly believe that honest, compassionate communication is the foundation of a relationship that keeps improving over the years. If a couple wants to continue having a good sexual relationship as they age, it is imperative that they are open with one another about any physical challenges they are currently experiencing or think they may face in the future. This dialogue is more important now than ever before, because there are simple and effective things that can be done.

Dr. Schwartz says that an over-the-counter lubricant may help with vaginal dryness. However, he cautions vaginal dryness and pain with sex are probably related, and a lubricant will do nothing to help the later. That is because the pain is caused by vaginal atrophy, something all women will eventually develop but only those who remain sexually active will ever notice. He recommends very low dosage estrogen in the form of a small pill inserted into the vagina or, perhaps even better, a locally applied cream to the area where it is most needed - in other words, something that gets right to the problem. This, he says, is a very effective way to reverse vaginal atrophy.

Clearly, if sex becomes painful, no matter how much a woman may love her partner, the frequency of sexual relations will decrease. Indeed, the “Sex, Menopause & Relationships” survey found that women cite discomfort as the primary reason for avoiding sex as they age. Low dosage estrogen will not restore libido, (which as mentioned, 70 percent of the women who had menopause-induced sexual symptoms said they were experiencing) and there is no scientific based evidence that anything else will either. However, when sex becomes pleasurable again, a woman’s libido is usually restored. After all, if sex is painful, why would you want to have it? But if it is wonderful again, your passion may well come roaring back.

That is not to suggest that sexual frequency will remain constant as you age, and the majority of male and female survey respondents agreed that a decreased frequency or desire for sex is to be expected. However, more than half believed that a good sexual relationship is important to their overall relationship satisfaction, and nearly half said that they would prefer to have sex more often.

Of the women who reported symptoms, nearly two thirds (63 percent) sought help. However, it was often in the form of over-the-counter products, such as herbal supplements. Dr. Schwartz cautions that there is no scientific proof that any of these products are effective, and also recommends that any medicine you take, including supposedly “harmless” alternative remedies, be discussed with your physician. Black cohosh, for example, can elevate blood pressure in some women. Perhaps even more important is that your healthcare provider may direct you to something that has been scientifically tested; FDA approved, and will work.

So, if you haven’t talked about all this with your gynecologist, now is the time. You don’t have to wait for your next yearly checkup, either simply call and make a phone appointment to discuss the issues. And then, sit down with your partner, tell him how much you love him, and explain the physical changes you’ve been experiencing along with the possible solutions. And remember - you are unique, but your menopause-induced sexual symptoms are not.

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