Beginning in perimenopause, some women may experience a gradual decline in sexual desire (libido). However, 60 % of women experience no change in libido, 20 % experience a decrease and in 20 % of cases, the libido improves.
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Although no correlation has been found between oestrogen levels and libido, it appears that another hormone, androgen, may affect libido.
Other factors which may lead to changes in sexual function include:
Painful intercourse due to vaginal dryness (atrophy)
A woman’s perception of her changing body
Incontinence which could lead to sexual avoidance
Sleep disturbances from night sweats
Depression, stress and anxiety
Many medications including some anti-depressants
Reduced libido and impotence in the male sexual partner
What to do
Open communication with the sexual partner is of utmost importance to prevent resentment or feelings of rejection. It is also important to explore other ways in which one could be intimate.
If night sweats and insomnia interfere with sexuality, the doctor may prescribe HRT.
For the relief of vaginal dryness, short-acting, water-based vaginal lubricants such as K-Y jelly can be used immediately before sexual intercourse. Petroleum-based products such as Vaseline should be avoided.
It may also help to take a warm bath before intercourse. Regular sexual activity can help to improve natural lubrication and can keep the vagina moist and toned.
Counselling and support groups can provide useful strategies for coping with lifestyle stresses and poor body image, as well as with physical and emotional symptoms.
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