Sex and the menopause

As you reach the years leading up to the menopause, you may find your attitudes to sex and relationships changing. This may be for a variety of reasons:

• Your children may be growing up and leaving home, so the enormous demands they have placed on your time and energy are less
• You will have more spare time and might find your career taking off or even think about changing your job
• You may be widowed or divorced and be entering new relationships just at the time when your menopause occurs, and this can lead to anxieties about feeling attractive and worries about sex

These life changes can have effects on your mental well-being and it is important to seek help if you feel things are getting too much. Depression and anxiety are common at this time of a woman's life and are not caused by hormone changes alone. You may need counselling or anti-depressant medication, so talk to your GP or a good friend if you feel low.

When do I stop worrying about contraception?
You will be reaching the time when you no longer have to worry about contraception. However you need to wait a full 12 months after your last period before discarding contraception altogether if you are over 50, and two years if you are under 50.

With the decreased fertility that comes with the perimenopause you may like to talk to a family planning expert about suitable forms of contraception for you. 'Change of life' babies are usually born to women who thought they could not become pregnant again! Remember that HRT does not act as a contraceptive and that it is difficult to know whether you have reached the menopause if you are taking HRT, as it gives you a monthly bleed.

Will I still want to have sex after the menopause?
A menopausal woman's desire to have sex and her ability to participate in it are both affected by hormone changes. Although oestrogen plays some part, the hormone most involved with sexual desire is testosterone. This is, like oestrogen, produced by the ovaries, fatty tissue and the adrenal glands that sit on top of your kidneys. Testosterone, unlike oestrogen, continues to be produced after the menopause.