Last week, I participated in a live Ask the Sexpert event at a conference up north. As several of the attendees were (self-identified) women in their early 50s, I was delighted (but not surprised) to get a bunch of questions about staying sexy as the body changes with age. A person is said to be “in menopause” once they haven’t had a period for 12 months. This happens because the body is making far less estrogen and progesterone, and has stopped ovulating each month.
Because the production of these hormones slows down a little at a time, these changes can start a decade or so before menopause. This period of time is known as perimenopause. During perimenopause, many people have irregular menstrual bleeding caused by erratic ovulation. They may also have many of the well-known symptoms of menopause, including hot flashes, night sweats, change in libido, vaginal dryness, and others. All of these perimenopausal and menopausal changes can impact a person’s sex life. And this is often exacerbated by our cultural belief that older folks don’t want/don’t like/don’t have sex.
As a sexuality educator who works folks of all ages, I can assure that older people do still have sex—lots of it! Still, there’s a taboo surrounding sex and aging. We don’t think about it much, and we really don’t talk about it enough! Well, today we’re talking about it.
Q: About 10 years ago, I started using a progesterone cream to help deal with unwanted symptoms of perimenopause. I’m now almost 50 years old. Should I continue using this medication? I’m not sure I’m getting much of a benefit anymore. I have a lot of hot flashes and night sweats again, and everything is changing!
A: Though we know that oral progesterone supplementation can relieve menopausal symptoms, there’s a lot of debate about whether or not progesterone creams are effective. Anecdotally, many people report feeling better while using the cream, but research remains inconclusive. If progesterone cream has helped you, that’s what matters. If you feel like it’s no longer helping, you can wean yourself down and see how you feel. If your symptoms become much more pronounced, you could resume the cream.
It’s important to note that 10 years is a long time to use any kind of medication or supplement. If you’re not getting much out of this one, you might take this opportunity to talk with a healthcare provider about other options as well.
Q: I am in the throes of menopause and it seems like nothing is the same anymore. I now have a lot of vaginal dryness throughout the day. My vagina just kind of feels sticky all the time. Also, I am definitely not lubricating well before or during sex. We’ve tried a few lubes from the pharmacy, but nothing seems quite right. Is there anything I can do about the all-the-time dryness? And is there a lube you recommend for sex after menopause?
A: When people ask this question, they want a specific answer. “Buy ABC lube! It’s perfect!” Unfortunately, it doesn’t really work that way. There is no best lube. There’s only the lube that’s best for you. (Additionally, that can change over time, so you may have to figure this out again in the future.) Silicone lubes are very slippery, and generally last a long time. As a matter of fact, it can be kind of hard to wash them all the way off your skin, and they can stain fabrics. But they’re very effective! If ongoing vaginal dryness is complicating your sex life, a silicone lube might really help (as long you’re not using silicone sex toys). Water based lubes are safe for everything, including sex toys, so they can also be a great option for folks. Unfortunately, they don’t stay slippery very long, and you’ll probably have to apply more during sex. Hybrid lubes are a great middle ground. They’re safe for sex toys; they wash up well and don’t stain; and they last longer than water-based lubes.
To deal with the all day dryness, try one of the water based lubes or hybrid lubes. If you apply it with something like this Lube Launcher, you can get it all the way up to the top of the vaginal vault. Then it will work its way down and out throughout the day, more closely mimicking the action of your own vaginal lubrication.
Q: Do you have any suggestions for talking to your partner candidly about peri and post menopausal changes in arousal?
A: Yes, there are a couple of things that might be helpful. The first is try to plan this conversation for a time when you’re not already in the midst of sexy activities. If possible, pick a time that is typically comfortable for both of you. For some folks, that might be on a longer drive or over coffee in the morning. When you bring up the topic, start by talking about the things that are working well for you. Or maybe there’s a not-too-distant example you can point out, like, “The sex we had after lunch last weekend was great!” And then you can transition into talking about the things you need to make sex better (or even consistently enjoyable). For most menopausal and perimenopausal people, it takes a little longer to get really turned on. Whatever it is that lights your fire—you’re probably going to need more of that! That might be certain kinds of kissing or touch, or it might be more flirtation in the hours leading up to sex (talking on the phone, dropping sexy thoughts into text messages, leaving notes for each other). If you’re a person who enjoys watching porn or reading erotica, you can build time into your pre-sex routine to do those together or separately.
Also, there are several good books about sex and aging that you might share with your partner. My favorites are written by Joan Price, one of the country’s most knowledgeable experts on the topic. The Ultimate Guide To Sex After 50 is a great guide to the changes we go through as we age and how to make the best of them. Ageless Erotica is a wonderful anthology of erotica that Ms. Price edited.
Curious about cunnilingus? Anxious about anal? Do you have questions about queefs or problems with your prostate? Lucky Tomaszek is the education coordinator at The Tool Shed: An Erotic Boutique, Milwaukee’s only mission-driven, education-focused sex toy store. Send her an email at firstname.lastname@example.org and she’ll get back to you with an answer.