anonymous on August 29, 2011

As my wife goes through menopause, we’re trying to keep a good sex life. What can we do?

I am a 44-year-old male, and my wife and I have enjoyed a very good and regular sex life for about 14 years. However, I’ve had intermittent erectile dysfunction for the past four months...and I think it’s because my 50-year-old wife is going through menopause. It seems like sex is a chore for her and this puts me off. Then I get anxiety and I can’t keep an erection. What should I do? I don’t want to stop having sex with my wife as we get older.

answered by Annette Fuglsang Owens, MD, PhD on August 29, 2011

I’m glad that you wrote and shared your concern with us.

First, it’s understandable and normal that you and your wife are experiencing some changes in your sex life as you both age. The major hormonal change that occurs during menopause can, indeed, change the way a woman enjoys and engages in sex…so it seems you’re both in the process of discovering new ways to enjoy sex.

I’ll do my best to address some of your concerns here, but I would also encourage you to see your doctor or urologist to discuss your erectile dysfunction (ED) more thoroughly.

Going through menopause by no means implies the end of your sex life.

What you are describing sounds like performance anxiety, which is a common type of ED. Sensing your wife’s struggle during lovemaking makes you anxious and most men will encounter erectile problems in such a situation. It’s a simple physiological process where the increased release of stress hormone (even in tiny amounts) will counteract your erection. When your body reacts to stress, an erection is the last thing it needs...but, rather, more blood to your muscles. Performance anxiety can often be helped by taking medication to enhance erections, at least while you’re regaining confidence. Again, I encourage to discuss your erectile problems with your doctor or urologist.

Remember, ED can have both psychological and/or physical causes. You seem to attribute your intermittent ED to the anxiety you feel due to your wife’s decreased interest in sex…and that’s certainly one possibility.

However, there are many other possible causes of ED, including some medications that lower blood pressure; additionally, other health problems – from heart disease to diabetes – can also cause problems with erections. Your doctor will be able to determine if your ED is due to a medical condition, and whether treatment or therapy makes sense in your case.

As for your wife’s decreased desire...yes, this could be aside effect of menopause. The good news is that your wife can address changes in libido (sex drive) with her doctor.

For example, some women benefit from short-termhormone replacement therapy to aid with menopausal symptoms, particularly hot flashes. As menopause often causes vaginal dryness, your wife may also want to talk with her doctor about vaginal moisturizers and lubricants to find out whether they would make sex more comfortable and pleasurable for her again.

Patience, understanding and communication go a long way. From your description, it sounds like the issues you describe are relatively recent. With a little time, effort and willingness on both sides – and perhaps with the support of a counselor or therapist who specializes in sexuality – I hope that you’ll explore new ways to enjoy sex and intimacy over time.

Related info:
    Suggested Reading:
      The Pause. Positive Approaches to Perimenopause and Menopause by Lonnie Barbach, The Wisdom of Menopause by Christine Northrup Better Than Ever: Love and Sex at Midlife by Bernie Zilbergeld. Women’s Sexuality Across the Lifespan by Judith Daniluk Women’s Sexualities by Carol Rinkleib Ellison Getting the Sex You Want. A Woman’s Guide to Becoming Proud, Passionate and Pleased in Bed by Sandra Leiblum and Judith Sachs.

Annette Fuglsang Owens, MD, PhD

Dr. Owens is an AASECT-certified sexuality counselor. Her areas of expertise include the medical aspects of human sexuality and sexual problems, as well as the impact of STDs ⎼ and other diseases, illnesses and disabilities ⎼ on sexuality. Dr. Owens was educated at the University of Copenhagen in Denmark.

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