Menopause can affect a woman’s sex life dramatically for several reasons. But here’s the good news: There are solutions for feeling like yourself again—and ways to put the sizzle back into your intimate life.
Sex remains a sensitive topic for many women, often causing unspoken concerns in relationships. As an OB-GYN with 30 years of experience, I've found that issues like decreased libido, body image concerns, new relationship dynamics, and pain during intercourse can complicate post-menopausal sex lives, potentially straining even strong relationships.
A woman I’ll call Jane is an example of someone who suffered needlessly and thankfully sought help. She came to see me because of pain from intercourse and explained that she and her husband had experienced a good sex life for many years, but now the pain was keeping her from wanting to be intimate.
Jane found herself doing anything she could to avoid the topic of sex, including steering clear of romantic movies, music or opportunities where they might have the chance to have sex. She would stay up late, fall asleep in a chair while watching television, or wake up much earlier than her husband. Jane didn’t want to have to say no or make him feel inadequate or rejected, but she was afraid to have sex and even more scared to tell her husband it hurt. She didn’t know how to start the conversation with him.
Jane’s dilemma was something I had heard many times, so I started by asking her specific questions and learning more about her recent medical history.
Overall, she was feeling healthy. She told me her transition into menopause had started about five years earlier, and her periods had stopped entirely about two years ago. Her hot flashes had not lasted long, and she was now sleeping well and not experiencing any other symptoms. Although Jane had gained some weight during menopause, she was still very active, ate a balanced diet, and consumed very little sugar or alcohol.
This was all good news.
In addition, she had a job she liked and a strong group of friends. With her kids all grown and established, she and her husband looked forward to spending quality time together. So, this sex issue was really throwing a wrench in their plans.
Further discussion with Jane revealed she had decided not to take hormones because her symptoms weren’t that bad, and she had concerns about taking them. She was not on any other medicines. Her only complaint was the pain during sex and very mild bladder urgency.
Next, I performed a physical exam to look for the cause of her pain and found good news that she was clear of bacterial vaginosis, which is very common, or a skin condition called lichen sclerosus (also common). However, as I expected, she had Genitourinary Syndrome of Menopause (GSM), also known as vaginal dryness. Her skin was dry, and the normal structures almost looked shrink-wrapped.
After the exam, we discussed Jane’s options. I explained that her condition was common and fixable. Her symptoms were due to a lack of estrogen in the skin, which caused skin thinning, less blood supply for arousal and loss of the ability to make lubrication. The changes in estrogen were leading to bladder urgency. Also, the pH or acid level was increased, which would lead to an increased risk of vaginal and bladder infections. This condition affects more than 90% of women with untreated menopause.
We then discussed all of her options for treatment, including the pros and cons of each. One option was a series of three MonaLisa Touch® fractional laser treatments over three months. I explained that the MonaLisa Touch® laser therapy offers a gentle and quick solution for women experiencing symptoms of GSM. In just three to five minutes, this innovative treatment can:
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Increase vaginal moisture without hormones or creams.
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Decrease pain with intercourse.
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Treat mild stress urinary incontinence.
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Improve vaginal tone and laxity.
We also discussed how systemic or vaginal estrogen were also safe options to treat her GSM. I explained that vaginal estrogen cream, tablets or a vaginal ring didn’t boost blood levels of estrogen significantly. Even women with unique risks, like a cancer diagnosis, have used vaginal estrogens without problems. If she wanted to discuss systemic estrogen with pills or patches, we could do that as well.
By the end of her visit, Jane said she was encouraged about her treatment options and decided to schedule an appointment to have her first Monalisa Touch® treatment the following week.
I am happy to share that almost immediately after her first treatment, her moisture levels improved, and after her second treatment, Jane said her vagina felt normal during intercourse. Before, she felt forced to imagine a life without intimacy, suffering from the painful symptoms of GSM. Now, she was very grateful for the significant improvements and the restoration of her intimate life with her loving husband.
After eight months, Jane is still reaping the benefits of this non-hormonal and chemical-free laser technology. At her check-up, Jane told me that she felt good about the direction of her intimate relationship with her husband; she felt closer to him and did not have to avoid being alone with him anymore.
Join us on Tuesday, September 17, 2024 at 5:30 p.m. at the true. Women’s Health clinic to learn more about MonaLisa Touch® and explore options for managing GSM symptoms. Discover how this treatment can help you reclaim intimacy and comfort without hormones. Attendees will have a chance to win a free MonaLisa Touch® treatment and exclusive discounts on treatment packages. Visit truewomenshealth.com/monalisa-event to learn more and RSVP.
If Jane's story resonates with you, take the first step towards reclaiming your intimate health at true. Women’s health.
Written by Diana Bitner, MD, MSCP, FACOG, Chief Medical Officer & Co-founder
true. Women’s Health.
Courtesy of true. Women’s Health.
Photo courtesy of Chase Loreto, Leverage Marketing, Grand Haven.
