Perimenopause and menopause can mark a difficult period for women and people with a uterus, and many find that hormonal changes and fluctuations affect sexual desire and function as well as relationships.
The transition through perimenopause and into menopause most often takes place between the ages of 45 to 55, though this can vary. Some individuals are “forced” into menopause early, either via a complete hysterectomy, as part of a treatment regime for certain cancers, or if they undergo hormonal gender reassignment.
Many people find themselves experiencing these hormonal changes alongside other life stages and changes, and the impacts of perimenopause and menopause are exacerbated by caring responsibilities, relationship breakdown, having teenage children, career and financial stress, and retirement planning.
If you are struggling with perimenopause or menopause, please see your GP. Symptoms can be managed so that their impact on your life is minimised.
Watch a great video about talking to your GP about menopause.
Perimenopause is a period of transition that can begin many years before menopause is complete and marks the time when your body begins to go through a natural transition to the end of your reproductive years. Perimenopause can last anywhere from five to 10 years and usually starts in your 40s, though this varies.
Menopause is said to take have taken place when 12 months have passed since your last period, and tends to happen between the ages of 45-55, with an average age of 51.
The symptoms experienced during perimenopause are hormonally-based, as oestrogen levels start to drop, cortisol levels (the stress hormone) start to rise, and the balance of progesterone and testosterone changes. These changes affect everyone differently, and the most common symptoms include:
- Irregular periods
- Headaches
- Mood fluctuations
- Fatigue
- Sleep disturbances
- Hot flushes
- Chills
- Weight gain
- Bladder control problems.
These symptoms can influence interest in sex, with many people reporting less interest in sex as a result. The lower levels of oestrogen and testosterone can also directly impact your sexual health, by causing you to experience:
- Pain during sex
- Less sensitivity to touch
- Lower Libido
- Increased difficulty getting aroused
- Increased risk of urinary tract infections
- Anorgasmia (inability to achieve orgasm)
- Delayed orgasms.
Some things that can help include:
- Masturbating more
- Extending time for foreplay
- Using a lubricant or regular vaginal moisturiser
- Talking regularly to your partner or partners about what is comfortable and what is not
- Experimenting with erotic videos or books to boost arousal
- Improving your diet and exercise routines
- Reducing stress by engaging in self-care, yoga, meditation, counselling, etc.
- Exploring other forms of intimacy and pleasure
- Seeking formal treatment.
You do not need to suffer in silence, and there is no victory in trying to battle menopause without support. There are many treatments available to reduce the symptoms of menopause, including:
- Diet and Lifestyle changes to help your body cope with changes and reduce symptoms
- Hormone Replacement Therapy (HRT) or implants to help with hot flushes, night sweats, vaginal dryness, vaginal elasticity
- Testosterone patches or implants to increasing libido
For more information, visit your GP as a first point of action. They might do a blood test, or they might start experimenting with treatment options simply based on your age and symptoms.
Pregnancy is possible during perimenopause, although periods might become less frequent or even stop temporarily. However, this does not mean that ovulation is not taking place, which means you can still get pregnant.
If you are having any sort of sexual contact where a sperm can come into contact with an egg, and you want to prevent pregnancy, you should use a form of contraception until you are absolutely certain that the menopause has taken place.
There are many different types of contraception. For information about your contraceptive options, we recommend reading through the following information provided by the NHS, and then visiting a trusted healthcare provider to discuss your preferred option. Different types of contraception are suitable for some individuals and not others, and your healthcare provider will help you determine which is best for you. You might need to trial one or more method before finding a suitable fit.
Condoms are the only form of contraception that also protect against STI transmission.