Hot flushes aside, menopause is being branded a period of sexual liberation by experts everywhere. 

For some women, however, the discomfort and pain often associated with this transition make sex the last thing on their minds. One of the lesser-talked-about challenges of the transition –genitourinary symptoms of menopause (GSM) – is often to blame for the libido-squashing discomfort.

The physiological and emotional changes that come with menopause are so often cast in a negative light. But while the life stage may represent the door to a woman’s reproductive ability closing, it also signifies the beginning of our sexual and physical liberation.

Understanding GSM and how to overcome them

Like every major life transition – from puberty to pregnancy – every woman experiences menopause in their own unique way. And, as any woman experiencing menopause will tell you, the experience is far from peachy, usually defined by all-encompassing physical symptoms and hormone fluctuations. 

While GSM can present during the pre-menopause stage, most women experience the symptoms during and after menopause. Commonly experienced GSM symptoms that could impair your sex life include incontinence, reduced libido, burning, stinging or itching of the vagina, and delayed or impaired orgasm. 

“Time of onset, the severity of symptoms and symptom complex are different for all women, however, all will be affected as age progresses,” explains Dr Craig.

So how should women approach this unspoken side of menopause to continue enjoying a fulfilling sex life? Dr Craig says finding a trustworthy and knowledgeable health practitioner who can steer you in the right direction towards effective treatments and management techniques is key.

“A GP or a Specialist Gynaecologist can assist you in making an informed decision on the best treatment for you,” she says. “Seeking professional advice is important as the understanding of the risks and benefits of treatment is advancing and changing all the time.”

One treatment Dr Craig uses in her clinic is EmpowerRF, a device that uses radiofrequency energy and electro-muscular stimulation on the vaginal area to counteract and treat aspects of GSM. 

No, pain and discomfort are not normal 

According to Dr Judy Craig, a GP and cosmetic physician, the key to unlocking your menopausal sexual prowess lies in openly addressing the symptoms – embarrassment, shame or stigma aside.   

“Sadly, many women get to a point in their lives when sex is no longer enjoyable because of changes brought on by menopause and they don’t realise these issues can be treated or managed,” Dr Craig says.

“Women often don’t seek help for discomfort, pain and incontinence as they are embarrassed, believe it is just a normal part of their stage of life or are unaware that there are treatments available to reduce or eliminate their symptoms,” adds the GP.

Why do women still feel so much shame?

As Dr Craig explains, a woman’s approach to sex and sexual health largely depends on the generation they grew up in. And while we’re living in an age where discussions about menstruation and sexual liberation occur more frequently, symptoms of GSM are still rarely talked about. 

“For many women in the Baby Boomer generation, sex and genitals were never discussed. Many young girls are raised believing that you do not touch your genital area or discuss it,” she says. 

“I still see women who have never seen their own vulva and have no idea what it looks like,” says Dr Craig. “They feel a sense of shame in looking at it or discussing anything to do with incontinence, sexual difficulties or symptoms of pain, stinging and burning as a result of dryness and atrophy.”

How menopause can drastically improve a woman’s sexual experience

Once a woman feels comfortable enough to speak openly about her sexual health and menopausal experience, there are countless ways her sex life will improve, says Dr Craig. 

“Post-menopausal women can experience sexual freedom without the fear of pregnancy and are often more comfortable in their own bodies,” she says. “They are also often at a time of life where their daily home responsibilities with young children are over or significantly reduced and they are in a comfortable space in their relationship.”

Without the nagging responsibilities of childrearing clawing at their heels, menopausal women generally have more time and energy to be sexually adventurous, with many women, initially experiencing an increase in libido.

“Women want to take advantage of the benefits of this stage of life and not have it sabotaged by GSM,” Dr Craig urges. “It is so important to prevent or treat the symptoms of GSM, as these can seriously impact the sexual experience as age progresses.”