Menapause and Sexuality

Although the word menopause gives many meanings to women's life, it is actually defined as a woman's absence of menstruation for 12 months without any physical and pathological reasons. The transition to this period usually begins between the ages of 45-55, when the ovaries reduce their hormone secretion. This transition may occur slowly over time, or it may occur rapidly, especially in the case of surgery and/or chemotherapy and radiotherapy treatment.

Hot flashes, night sweats, insomnia, difficulty falling asleep, mood changes, anxiety disorders, dryness in the body and vagina, decreased sexual desire and painful sexual intercourse are the main effects of menopause.

Compared to the past, due to the prolongation of human life, today many more women spend a long period of their lives in menopause, and therefore they are in search of a healthier and higher quality life. Although most women experience impaired sexual function in menopause, which is an aging process, menopause certainly does not mean that a woman's sex life is over.

From a philosophical point of view, the absence of subconscious fear of getting pregnant may also have positive effects on sexuality.
Sexual problems that occur during menopause and their treatments can be grouped into several groups:

Decreased libido and sexual desire: It develops as a result of decreased hormone levels. Although we cannot say that estrogen / progesterone treatment directly increases sexual desire, estrogen has positive effects on sexuality indirectly by increasing vaginal blood supply, vaginal lubrication during intercourse and sensitivity of the vagina. Unlike systemic estrogen/progesterone treatment, the preparation called Tibolone is a different treatment option that shows positive effects on libido with weak estrogenic, weak progesteganic and androgenic effects in the body.

In this so-called estrogen levels, thinning and dryness develop on the walls of the vagina due to decreasing estrogen levels. This leads to the painful relationship we call dysparone. In addition to the systemic use of estrogen/ progesterone, low doses of vaginal estrogen tablets or gels can be used. However, vaginal lubricants and moisturizers are especially useful during intercourse. Increasing the number of sexual intercourses, especially exercising the pelvic muscles, has positive effects by increasing the blood supply of this area.

Ospemiphene, which has an estrogenic effect on the vagina, is also a treatment option. Quitting smoking also increases blood supply in the vaginal area.

Orgasm and arousal problems: Priorities are to apply local treatments to treat vaginal dryness, Kegel exercises, and sex therapy when necessary. In addition, vibrators, dilators and clitoral therapy instruments can be used. Although not FDA approved, Viagra-like (PDE-5inhibitor) gels in the clinic help orgasm by increasing blood supply, especially when applied to the clitoris area as gels. Apart from these, it promises hope in vaginal anti-aging treatments such as vaginal laser treatments and PRP (Platelet Rich Plasma) applications.