From Perimenopause to Passion: Sex and Health
- Emily Chung
- May 28, 2024
- 3 min read
Updated: Jul 19, 2024
Clearly, being in your mid life does not herald the end of your sex life. There may be challenges to face such as perimenopause, but there is absolutely no reason why you can't continue to have pleasurable sex.
Contraception
For those with cis male partners, it's still possible to get pregnant, even if you are perimenopause. Condoms are great as they also protect from sexually transmitted infections, but they do fail and so it's worth having a conversation with your GP or attend a sexual health clinic to discuss options. There is something for everyone - whether it's a pill, an implant or a intrauterine device (otherwise known as a "coil") - take the stress away, if you don't want to get pregnant. Some methods even have advantages like controlling heavy periods making your life generally more manageable.
Sexually Transmitted Infections (STIs)
Whilst it is the under 25s who bear the brunt of the majority of STIs, of course anyone who is sexually active can be at risk. All infections are currently on the rise in England, with rates higher than they ever have been. Rates of gonorrhoea diagnosis have increased by 97% since 2017, with a 71% increase in syphilis cases. Between 2012-2019 rates of STIs in the 45 and over significantly increased by 9%.
The good news is that it is extremely easy to test, with many areas offering online postal test kits that you order to your home. You do a bit of swabbing and send off a few drops of blood and results get sent to you in a few days - all free of charge. Whilst STIs can present with symptoms, for example a change in vaginal discharge, alteration in your menstrual cycle, or lower abdominal pain, they can also be asymptomatic so it's worth getting checked if you have had a change in partner.
If in doubt, contact your local sexual health service particularly if you have noticed symptoms. It's free, confidential and records are kept separately so there is no need for GP or any other doctors you may see to be informed.
Condoms reduce the risk of you getting STIs but there is also Post exposure Prophylaxis (PEP) and Pre-exposure Prophylaxis (PrEP) for HIV. PEP can be started within 72 hours of an episode of condomless sex with a partner who may have HIV and who is not on treatment and can be accessed in sexual health clinics or in Emergency Departments if it is out of hours. If in doubt, it's definitely worth contacting a sexual health clinic to discuss options. PrEP is a medication to take to reduce your risk of getting HIV and should be considered in anyone having condomless sex with multiple partners. It's well tolerated and to find out more, contact your local clinic.
Menopause
The perimenopause can present in many different ways and naturally some of these aspects can affect your sexual health. Hormonal changes can lead to thinning of the vaginal lining and dryness, making penetration painful. Some women experience reduced desire for sex which could be for a variety of reasons - "brain fog", change in mood, fatigue and the discomfort from night sweats could all have an effect.
If you think you may be experiencing some of these things, it's worth seeing your GP to explore the possibility that you're entering perimenopause, as there are treatments including hormone replacement, that can be really helpful. There are other things you can do such as exercise, mindfulness, making sure you get enough sleep and adopting a healthy diet too.
On the other hand many women from late 30s experience an increase in libido! Whether that's because of feeling freer and more aware of what they want, or perhaps being out of the shackles of a long term relationship, you should be able to have the sex that you want!
Empower yourself with knowledge and take proactive steps towards maintaining a fulfilling sex life.
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By Dr Emily Chung, NHS Doctor
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