University of Colorado Anschutz Medical Campus – Winnifred (Winnie) Hunter, PhD, knows how menopause can trigger troubles in the bedroom.
A psychologist and sex therapist, Hunter has counseled middle-aged women through countless issues that were taking tolls on their sex lives during this final reproductive stage – from depression and vaginal pain to boredom and body shame.
“Sexual health is a fundamental aspect of overall well-being that is deeply connected to one’s emotional, physical, relational and social dimensions of life,” Hunter said.
Yet, for multiple reasons – including a persistent stigma around sex talk, a lack of training among healthcare providers and no clear pathway on where to seek care – few women receive help, she said.
Hunter expands on menopause and sexual health in the following Q&A.
How common is it for women to begin having sexual problems during the perimenopause years?
It’s quite common, but not necessarily exclusively for physiological reasons in perimenopause. It’s also just about that stage of life. When you think about women around the age of 45 moving into their 50s (common perimenopause years), they’re managing a lot of really complex psycho-social stressors.
For example, they might have kids at home that they are caring for, often teenagers that have their own hormonal landscape. Then, women are very often the primary caregivers for elder family members – both their own and their partner’s.
It’s also often a stage of life where people are taking on more responsibility in their careers, where they are maybe managing a lot. So, there’s a lot that contributes to fatigue, to stress. And we know that fatigue and stress are significantly going to decrease interest in sex.
At the same time, women’s hormones are often radically fluctuating, correct?
Yes, there is a changing hormonal landscape. The decrease in estrogen can contribute to a decrease in sexual desire. Fluctuating levels can also cause weight gain during this stage of life, particularly around the middle part of women’s bodies.
So, there’s that body image as well – internalized feelings of shame about one’s body, less feeling of one’s own sense of attractiveness or sexiness – that can then contribute to not wanting to be seen or to engage in a sexual way.
I also think that how we are socialized around middle age and sex is a problem …
