Fear of pain and UTIs cause women’s declining libido

Fear of experiencing pain during sex and urinary tract problems are key reasons women avoid intimacy as they age, a new report has found.

Concerns that intercourse will hurt was reported by two in ten postmenopausal women while one in ten say bladder issues put them off.

Researchers say their study shows that the typical decrease in sexual activity of women as they age is not necessarily because they are no longer interested in sex and that the problem for many is physical.

‘Our findings underscore the need to further expand the sexual history after a woman reports that she is not currently sexually active,’ says Dr Amanda Clark, lead author of the study from the Kaiser Permanente Center for Health Research in Portland, Oregon.

‘This study provides just one more reason why healthcare providers need to have an open and honest discussion with peri- and postmenopausal women so that appropriate treatments options can be evaluated,’ says Dr. JoAnn Pinkerton, NAMS executive director.

A study by Oregon researchers has found declining interest in sex in women as they age is caused by physical problems for many (stock photo)

Key findings 

More than 1,500 women completed a questionnaire about their love lives. 

Pain during sex was reported as a reason for avoiding or restricting activity by 20 percent while nine percent cited the deterrent as bladder problems, such as fear of wetting the bed or having to interrupt activity to go to the bathroom.

TREATMENT FOR GSM 

To treat genitourinary syndrome of menopause (GSM), your doctor may first recommend that you:

  • Try a vaginal moisturizer to restore some moisture to your vaginal area. The effects generally last a little longer than those of a lubricant.
  • Use a water-based lubricant to reduce discomfort during intercourse. Choose products that don’t contain glycerin because women who are sensitive to this chemical may experience burning and irritation. Avoid petroleum jelly or other petroleum-based products for lubrication if you’re also using condoms. Petroleum can break down latex condoms on contact.

Bothersome symptoms that don’t improve with over-the-counter treatments may be helped by:

  • Topical (vaginal) estrogen – vaginal estrogen has the advantage of being effective at lower doses and limiting your overall exposure to estrogen because less reaches your bloodstream. It may also provide better direct relief of symptoms than oral estrogen does.
  • Oral estrogen – estrogen taken by mouth enters your entire system.Ask your doctor to explain the risks and the benefits of oral estrogen.

Source: Mayo Clinic

This collection of symptoms is now referred to as Genitourinary Syndrome of Menopause (GSM), a term that has replaced that of vulvovaginal atrophy (or atrophic vaginitis), which was what doctors used to call vaginal dryness.

This is thought to affect about half of postmenopausal women, although few seek treatment.

When a woman goes through menopause, her estrogen levels decline along with the levels of other steroid hormones, according to the International Society for Sexual Medicine. These decreases can lead to changes in the vagina, vulva, and bladder.

Less estrogen makes the vaginal tissues thinner, drier, less elastic and more fragile.

For example, estrogen helps keep the vagina moist and flexible. But when estrogen levels drop, the vaginal tissue becomes thinner, drier, less elastic and more fragile, causing discomfort during intercourse.

GSM increases the risk of urinary problems, including increased frequency or urgency of urination or burning with urination. Some women experience more urinary tract infections or incontinence.

It also brings the risk of vaginal infections due to changes in the acid balance of the vagina. 

Women do not need to have all of the symptoms to be diagnosed with GSM.

The condition is considered chronic and progressive and it does not get better over time. However, symptoms can be managed with treatment. 

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