Relate Guernsey

MENOPAUSE & RELATIONSHIPS

Women will experience menopause at different times in their lives, but if it arrives early then some women can feel quite cheated, and have many questions. Some may never have even considered that this could be a possibility which would make it even more difficult for them to seek help or talk to their partner.

“I experienced an early menopause at 37. At first I didn’t know what was happening – I think the hot flushes were the worst to handle. It got to the stage where even my ankles were sweating, it was awful. It is really embarrassing - you just have to get cool, it literally pours off me. I tried herbal remedies to begin with and they helped for about three years, I’m now on HRT and feel much, much better and don’t have sweaty ankles now!”

There is an expectation for women between 45 and 55 to go through the menopause, and at last it is being spoken about publicly but it still remains a ‘taboo’ subject for many women and their partners.

If a women doesn’t go through the menopause in the ‘normal’ timeframe, then she can often become fed up, tired and agitated, feeling at odds with.

Self image

“I went through an early menopause and thought I’d turned into an old hag over night.”

Many women, more so now, struggle with the idea of ageing. We are a society that values youth, supple, smooth skin and fitness above experience, slightly less elastic skin and maybe a bit slower to run the ‘Race for Life.’

Body shape alters with age and women need to be able to accept this rather than fight it. However, try not to give into it – keep (or start) exercising and make sure you eat a healthy diet. Don’t feel influenced by unrealistic expectations. The pressure to remain young comes from both inside and outside the person and being able to share your thoughts with a non-judgemental, supportive partner really helps. However, no matter how many times you hear “you look lovely”, you have to believe it for herself.

Many perimenopausal and menopausal women experience a loss of sexual desire and this can be the result of multi-hormonal problems related to oestrogen as well as androgens. This combination of oestrogen deficiency leading to vaginal atrophy and reduced clitoral sensitivity, and androgen deficiency leading to loss of libido, can obliterate sexual satisfaction and cause the woman to feel she is no longer sexually attractive.

Attitude to menopause

These days most women can expect one-third of their life to be post-menopausal.

So it’s essential for them to be able to explore attitudes and their own beliefs regarding menopause if they are to enjoy a full, healthy and respectful relationship. The idea that the menopause signals the end of women’s sexually active years is losing ground.

The notion of sex as a purely procreative activity has all but disappeared from society but many women can still feel that sex is only about procreation and the idea of indulging in a purely recreational sex life is alien to them.

Vaginal dryness, atrophy, fear, hot flushes

Biological problems account for the majority of sexual problems in menopausal women. It is important to recognise that these problems hardly ever exist in isolation. Psychological, sociocultural, and/or relationship issues may also contribute to difficulties experienced by women and therefore it’s important that a thorough assessment is made to address these and other non-physiological factors.

Effects on men/partners

Knowledge of menopause and HRT

Some men may feel that the menopause is ‘women’s business’ and that there is no need for them to be informed or even involved. This is insensitive, not even trying to understand can isolate both partners and a mutual protection racket can exist. One partner may collude with the other not to address the changes that are happening at this meaningful time in a woman’s life.

Women may want sex more/less often

For some women, the menopause brings with it a sense of sexual liberation, not having to concern themselves with unwanted pregnancy, or worries about when they can have sex (due to menstruation).

More than 50% of menopausal women report no decrease in desire at all in sexual desire, and fewer than 20% report a significant decrease.

For other women, the declining levels of oestrogen result in less vaginal lubrication which can result in intercourse becoming painful (dyspareunia) and in anticipation of pain some women may also cause women to develop vaginismus, (a reflex where the muscles of the vagina contract such that penetration isn’t possible).

Dyspareunia is relatively easy to treat but vaginismus is more difficult to correct and often a sex therapist must be consulted. These conditions could cause a woman to want sex less, coupled with a low appreciation of her body image, or the perception that her partner is less interested. Partners can feel rejected and this can cause them to give up initiating sex, thus creating a physical distance between them. It’s also possible that situations can be equalised in terms of libido: if one partner has had a higher need for sex than the other, they may also be feeling the effects of age, beginning to suffer performance, age-related problems.

“I’ve always had a higher sex drive than my partner, but as I’ve aged I have found my need for sex to be less, I don’t fancy my partner any less, but now it feels as if we are at the same place regarding desire and frequency of sex.””

The menopause can mask other sexual problems. If a man is experiencing difficulty with his erections he may have withdrawn from sexual contact and could feel relieved that his partner requires less sex than before – more collusion.

“I think I actually enjoy our sexual relationship more now than when we first met, it’s more about the emotion, knowing one another’s likes and dislikes than performance, which is really good because I’ve found getting and maintaining erections more difficult as I’ve got older. The fact that my wife takes longer to become aroused since reaching the menopause suits me just fine as we have found ways of pleasuring each other which doesn’t always include penetration.”

How s/he views her/him

Shy conversations and secret fears may not get talked about. So if there are any other sexual, marital or relationship problems they can get ignored leading to assumptions being made and misunderstandings becoming more common, which in turn can lead to arguments. Low self-esteem then becomes a problem as neither partner feels supported or able to give voice to their emotions.

Coping with mood swings and other menopause symptoms

This is a time when real amounts of understanding and patience can be tested. It’s useful for partners to recognise that the mood swings, distress, anxiety etc are not really anything to do with them. Being there emotionally is a skill that requires individuals to suspend their own emotional needs, not to try and ‘fix it’ but to simply be there. It’s more than empathy.

Sleeping apart

Many couples enjoy going to bed together at the end of the day and for many couples it is a time to catch up, chat and cuddle, it may be the only time they have to be close and physical. If night sweats or insomnia have become problems, then sleeping apart may be an option that the couple take. This can mean that a physical distance develops and couples can feel isolated if there isn’t any other form of physical intimacy in the relationship.

Effects on family/friends

Coping with mum/friend and how she feels

It’s useful if friends and family can be supportive at this time, and to do this they need to be informed, sympathetic and supportive.

““I had a hysterectomy 15 yrs ago and was put on HRT for a short time – then the doctor stopped it. After some time I was crawling up the walls, my family hated my mood swings and I begged my GP to put me back on HRT. He eventually did and now I have enough energy to play with my grandchildren and my husband likes me again.”
“I’m 49 yrs old and started with hot flushes. When they come, I get 4-5 a day and if I’m at work I have to get my little fan out which annoys my colleagues; I just have to get cool ...”

Is it different for sons and daughters?

It’s clearly gender normative, but daughters may be able to show more understanding and learning, as they’re often conditioned to feel more empathetic. Sons may not even want to acknowledge their mother’s sexuality (let alone the end of it) and may be less able to empathise, but might be able support their fathers.

Neither sons or daughters may be able to cope with mum changing, as she has always been there for them and to let go of their perception can be challenging, plus they also have to acknowledge that their mum is getting older and this causes them to consider mortality.

Impact on couple relationships

Day-to-day/sexual relationships

The daily relationship can be adversely affected by lack of sleep and intimacy, a lack of understanding and no little or no communication. This will have a knock-on effect to the sexual relationship. It is hard to get close to someone who is being moody, anxious, short tempered and non-communicative.

“I’m happy to continue HRT, without it my life is a nightmare. I'm moody, angry, arguing over anything and everything. Not sleeping because of night sweats made me really horrible to be around.”

Talking about menopause

It’s important for women and their partners to remember that menopause is natural and normal. It is an important milestone in a woman’s life which can mark the beginning of a fascinating new era. Each woman will experience menopause differently and it is important not to use comparison to other women at this time.

Fear and anger...life stages

These are just two of the emotions felt by both partners at this time in a relationship. There may be other contributory factors adding to these emotions, such as empty nest, retirement, ill-health and also many women may be looking after elderly parents as well as dealing with their own fears.

“I didn’t know what was happening to me….I wanted to get out of my skin.”

Renegotiating the daily and sexual relationship

The couple may have to re-negotiate who does what as energy levels and motivation alter – especially if depression is an issue. The couple may also have to discuss and experiment with different sexual positions that would make intercourse more comfortable.

“I was on HRT and because of all the scares I came off it, my life became a total misery with mood swings, night sweats and depression. I tried all sorts of natural remedies, checked my diet and continued to exercise, but just felt really down. Recently I went back to my GP and he put me back on HRT. I’ve got my life back.”

Other areas for discussion and ongoing communication

Dual dysfunction

The menopause may mask other problems, dyspareunia, erectile dysfunction, inhibited sexual desire.

Is it all down to menopause?

Many women (and men) feel that their hormones must be responsible for the things that are going wrong in their sexual/daily relationships – this isn’t necessarily the case, but it’s easier to look at the menopause rather than at the underlying issues.

Knowledge of the menopause and its effects makes it easier for them to offer support at a time when their partner may need more reassurance.

Be aware of other influences that may need to be explored, such as:

  • The cost of HRT/natural remedies
  • Hysterectomy and menopause
  • Disability and menopause

Busting myths

“My sex life is over - complete and utter nonsense!"

There is no reason why you can’t continue to have a full and enjoyable sexual relationship.

"I'm no longer attractive to my partner."

This is unlikely to be the case, this may be more about you feel about yourself rather than a partner finding you less attractive.

"Menopause means I’m ageing and being post-menopausal means that I’m old - not any more."

Most women experience the menopause between 45 and 55, but women can look forward to an average of another 30 years of living, so enjoy, life isn’t over!

How you manage this ‘phase’ of your life together will colour how your relationship will be once the menopause is over.

Things to do

  • Listen to concerns, fears and frustrations; be there for your partner.
  • Research the menopause together; Useful websites include Health and Her, & Menopausematters & The Daisy Network
  • Be patient, with your partner and yourself, if mood swings occur or if forgetfulness is an issue.
  • Exercise can help reduce some symptoms of menopause so why not join an exercise class together, go for a swim or walk together more often?
  • Develop your sensual relationship
  • Talk about concerns and changes – it’s not just the woman who’s changing at this time of life.

How we can help

If you’re finding it hard to talk about any tricky issues, Relationship Counselling, offers a safe and confidential space where you can be open and honest.

To find out more and to arrange an appointment contact us today