SEX AND SEXUALITY AT THE MENOPAUSE
Depending on what newspapers and magazines you read, you might have seen headlines like those above. Certain parts of the press seem obsessed with the idea that taking HRT is about nothing more than having the looks and sexuality of a TV star. Every year, dozens of interviews are conducted with television and screen personalities who are now in their fifties and sixties ‘and look twenty years younger’.
In some ways, this can be a thoroughly good thing. For too many centuries, the older woman has been neglected, and treated as almost invisible. As far as The Real World is concerned, she just doesn’t exist. Newspapers and magazines seldom feature older women in their own right; if they are mentioned at all it is usually as the wife or mother of a man who is making the news. Books end when the beautiful heroine marries the hero; sometimes the story extends to the years of bringing up children, but how many novels can you think of in which the principal character is a woman of 50 or 60? It has been said that ‘Sensitive treatment of the ageing woman … is not a dominant theme in Anglo-American literature.’ Too true! Once you are past child-bearing years it is almost as if you move, in one swift step, to being an unimportant old crone.
Now all this is changing, and HRT can take some of the credit. Suddenly many older women look and feel younger. They don’t mind giving their age, because it provokes the response, ‘Goodness, are you really? You don’t look a day over 45,’ and that makes them feel good. Well, it would, wouldn’t it? Being more energetic, more confident and still looking youngish, they are visible once more, and that has got to be a good thing. Good for the individual woman and her own self-esteem, and good for womankind in general.
However, this book will not be plugging hormone replacement as an elixir for eternal youth. You will not read in these pages that you, too, can be a sex-kitten forever. If your husband is glancing sideways at younger women, your elderly parents are driving you mad, and your daughter looks how you would like to look, HRT will not magically put your world to rights. It may help mend a breaking marriage, or increase your sex drive, or make you feel 10 years younger, or it may not do any of these things. But it will make you feel better able to cope with what the world is throwing at you, and give you a better feeling about yourself.
One of the problems of the ‘sex kitten’ image is that it actually puts many women off taking HRT. Or they become reluctant to tell their friends they are on it in case they get comments like, ‘Oh, is your husband going off with someone else?’, as if the only reason a woman takes HRT is to keep her husband in her bed. And many doctors wonder if a woman is enquiring about taking it just so that she can remain ‘youthful’. Yes, there are reasons why it can help you maintain a satisfying sex life for many years but, as you will have read so far, it has many other advantages, too, and to concentrate on the Eternal Youth image is to trivialise HRT and to diminish women.
“I finally plucked up courage to see my doctor. He seemed surprised that a woman of my age (I’m 53 and happily married) should be reluctant to stop having sexual intercourse. He made me feel a freak, the female equivalent of a Dirty Old Man”.
The menopause is thought of by many (especially by men and by younger women) as ‘the beginning of the end’, a time of decline and degeneration, especially sexually. But it needn’t be like that. The end of fertility doesn’t mean the end of sexuality, let alone the end of femininity. With 30 years or so left, that’s just as well! The woman reaching the menopause now is unlikely to view this time as the end of her sexual years, and nor should her doctor, nor society in general. If she has sexual difficulties, they should not be pushed aside.
Many men and women are reluctant to talk to their GPs about sexual problems, as he is quite likely to dismiss it as an unimportant matter in older people. The average young doctor might be quite surprised that a couple in their sixties should still be having an enjoyable sex life, and wanting to continue for many more years. Even couples in their fifties are often considered ‘over the hill as far as all that sort of thing is concerned’.
As you have read at various points in this book, one of the symptoms of the menopause is vaginal dryness. Reduced levels of oestrogen diminish the sexual response and cause the cervix to secrete less mucus, so the vagina becomes dry, intercourse is more painful, and you get less pleasure from it.
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