“You lose about a third of your collagen at the time of menopause,” explains Dr Caoimhe Hartley, who set up the Menopause Health clinic in Dalkey, Co Dublin. She is also part of the multidisciplinary team in the new specialised menopause clinic in the Rotunda Hospital. Other menopause clinics have recently opened in the National Maternity Hospital and the Coombe and Nenagh hospitals, with two more due in Cork and Galway.
“[In menopause] you lose oestrogen, and you lose that collagen. The vaginal canal becomes shorter, so tightens a little, the walls become thinner, they’re drier, things tear much more easily. We see this constellation of symptoms happening where people lose lubrication, the area gets drier, but also people get recurrent urine infections, increased urinary frequency, they get new incontinence.”
Meanwhile, decreased blood flow to the vulva area can reduce the sensitivity of the clitoris, which can mean that some sexual activity that used to provide pleasure is no longer as effective. These factors, along with the mental and emotional impacts of menopause, can have a huge impact on women’s libido.While we often associate menopause with the body, reproductive organs and ageing, what is happening is actually a natural and impressive form of adaptation by the brain.
“If women are struggling with mood disturbance or sexual difficulties, they should speak to their GP who will address the issue sensitively and offer some management strategies that may significantly improve their quality of life,” says Dr Ciara McCarthy, the first ever clinical lead in women’s health for the Irish College of General Practitioners .
While for some women the idea of asking a GP about their sex life, libido or vaginal health might be “too much information”, rest assured that in medicine, there’s no such thing. Sex is not limited just penetrative intercourse, and women going through menopause might find that there’s greater pleasure in other sexual activities, such as enjoying oral sex, an erotic massage and using powerful vibrators which can still provide pleasure without causing any discomfort. Couples can use this time to experiment and try new forms of touch to discover what feels good for them.
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