Reading: What Your Husband Asks A Menopause Doc

I suppose I ask for it. My car’s license plate reads “HOTFLAS” but I forget about it until some guy pulls up next to me at a stop sign and rolls down his window and says, “Hey, I like your license plate!” He might also then say, “You must be about 50. Wow, my wife is going through that. It’s really tough. It’s been a real challenge.”

At a cocktail party or a school event, another man might say, “Remind me what you do.” “I’m a doctor specializing in menopause care…” is all I can get out before the response comes in: “Ah, yes, my wife is going through menopause,” he says. “It’s like a stranger is living in my house.”

Add to that these private messages I receive from men at my website, MiddlesexMD:
“My wife turned 40 this past December and has literally stopped being intimate.”
“My wife is 62 and has been having pain over the past year with intercourse.”
“We celebrated our 60th-anniversary last month…we had what I thought was a great sex life until about the last five years.”

So let’s just say it: if you think that you’re confused about what’s happening to you during menopause, that guy you’re with? He’s doubly confused. So to enlighten you, here are the three most common questions husbands/partners ask me about their mates of a certain age and what I tell them.

Question #1. Is not having sex the real “normal” for couples at my age?
Answer: Every couple gets to define their own normal. Data suggest, though, that more couples have sex than are sexless. An AARP study a few years ago revealed that 41 percent of those over 45 and partnered are having weekly sex; 60 percent have sex at least monthly. That said, I hear from plenty of “normal” women in my medical practice who’ve just realized that they haven’t had sex for a year or longer.

Studies support my instinct that keeping intimacy alive in a relationship is a worthy goal. There are straight-up health benefits: Sex bolsters the immune system, relieves chronic pain, protects against depression. A healthy sex life helps couples navigate health problems, especially chronic conditions. And couples who have sex report more relationship satisfaction than those who don’t.

So, with all that going for it, the next up is:
Question #2: Why isn’t my wife interested in sex anymore?
Answer: Well, as they say on Facebook, it’s complicated. First, we need to recognize that sex is different for men and for women. Women tend to be more responsive than spontaneous, and hormonal changes make this even truer after menopause. And second, we need to take seriously that emotional intimacy matters to women.

Post-menopause, when the hormonal drive for intimacy is lessened, life and relationship issues can play a larger role; these include health problems for either of you, stress, especially about finances, fatigue, boredom, or a feeling of distance in this phase of your life together. She may be unhappy with her midlife body (“He’ll see me naked!”). When you know you’re operating as partners and are nurturing the intimacy upon which women depend, then you can address a lagging libido.

Question #3: How can I help my wife, who’s experiencing pain when we have sex?
Answer: Begin by understanding what’s happening. Vaginal dryness is the most common symptom of menopause, and it can cause enough discomfort to make a woman swear off sex. The genital tissues begin to atrophy, which means they literally shrink, become fragile, and lose elasticity. Less circulation to those same tissues means it’s more of a challenge to feel the same sensations we did when we were younger.

There are plenty of products and prescription drugs that can counter these changes; it can be as simple as lubricants, moisturizers, and vibrators or as complex as hormone therapy. What’s your role? Communicate. Talk about what’s changing for her; ask her how she’s feeling about it. Ask what support she’d like from you, how you can explore solutions together. And most of all, be certain that your partner knows how important your shared intimacy is to you.