SEXUAL AGEDUCATION: A Guide For Relearning Sexual Wellbeing As A Midlife Woman

Sexual Ageducation

What is “ageducation”? It's a word that I came up with up of course 🙂

It’s a word that came to me to best describe women transitioning into different stages of their lives and health that require ongoing education.  To create endearment around the process and have readers validate how their age can create a positive opportunity to learn in their era of health, ageducation was born.

Advancing in age presents with health and life states of new experiences that require education about symptoms, evaluation, and treatment options.  Sexual ageducation is my offering and normalization of learning and relearning as intimate health needs with age. 

Understand The Connection Between Menopause and Sexual Health

The hormonal changes that occur in perimenopause and menopause period can significantly impact sexual well-being if left untreated.  The decline of estrogen levels during this transition has been well-studied on libido, vaginal dryness, and overall sexual function.

Symptom management during and throughout this time should be the exception and not the outlier.  I encourage all women to discuss new sexual health symptoms during this phase of life and beyond.  Menopausal symptoms go beyond hot flashes, night sweats, and mood swings, with even those being underdressed and untreated.  Insert “sexual health” into the chat and that only increases the number of commonly unaddressed concerns in women.

Vaginal Health, Hygiene, and Comfort Measures

Women need to understand and appropriately manage vaginal thinning, drying, and possible inflammation.  The normal hormonal decline that occurs in midlife life women is associated with: 

• Vaginal dryness

• Pain with vaginal intercourse

• Increased UTI’s

• Recurrent UTI’s

• Urinary Incontinence

• Chronic vaginal inflammation (itching, burning, abnormal discharge)

These symptoms should be evaluated as they can be successfully treated in many cases. 

Guidance from your healthcare team for over-the-counter products to use or avoid for your specific situation should also be included in your vaginal health evaluation. An article related to the topic of over-the-counter vaginal product guidance that you may find helpful can be found here.

Sexual Desire and Arousal

Changes in libido, arousal, and pleasure may show up as a surprise for many women during their midlife changes.  Communication with healthcare providers and intimate partners may be the first step in a healing journey that will likely be multifactorial in this life phase.  

Be prepared to address these concerns with a wellness team that may include a clinician, a behavioral health specialist, and a pelvic floor physical therapist as an initial multidisciplinary approach.

Emotional and Psychological 

Body image, mental health, and relationship dynamics may change in ways that affect self-esteem and interpersonal dynamics during midlife.  Addressing how physical changes, anxiety, depression, and stress can impact sexual health should be considered if and when necessary with maturation in age and health changes.

Engaging in and learning open communication skills and prioritizing emotional support can strengthen intimacy and connection with romantic partners.  This may come by way of hiring professional behavioral support individually and for couples. You may find assistance with finding the right sex therapist and counseling here.

Safe Sex Practices

There is no age limit to practicing safe sex practices. Both sexually transmitted infections (STIs) and contraception counseling are important considerations in midlife women at some point.   

I advise women never to assume new vaginal symptoms are a normal part of hormonal changes without speaking to a health care provider. Regardless of age and relationship status, risk factors for sexual infections should never be assumed. Rather discussions of possible exposure and nonmonogamy should be communicated in a responsible manner that allows all parties to make mutually informed decisions.

During the perimenopausal period contraception counseling should be front and center as women understand and make choices based on their future desires. While many women may be interested in contraceptive practices that transition them to menopause to prevent an unplanned pregnancy, there will also be some interested in discussing remaining fertility options.

Pelvic Floor Health

Changes in pelvic floor health may show up as changes in urinary or bowel control.   Chronic pelvic pain +/- sexual intercourse may also indicate pathology involving the pelvic floor muscles, organs, or both.

A common theme with aging women is that urinary incontinence is normal. I often find myself directing women to treatment options who never thought to seek help for urinary incontinence after having vaginal deliveries. The mindset surrounding pelvic health and aging has significant gaps that hinder many women from the care and care teams that can reduce or even provide permanent solutions to their symptoms.

If you or any woman you know is experiencing changes in the bladder, or bowel, pain with intercourse, or has a history of trauma to the pelvic region with or without acute symptoms, a pelvic floor evaluation and treatment plan may be required.

Chronic Health Conditions

One or more chronic diseases can have an impact on sexual health.  Understanding how conditions like diabetes, cardiovascular disease, and arthritis can affect sexual health may be a different discussion at the onset of diagnosis compared to disease co-management through midlife.  

Thorough communication between providers and patients about the importance of whole wellness is necessary to balance all health states of women.  Integrating sexual health awareness strategies may be optimized by opening the door during chronic disease co-management during ongoing evaluation and treatment.

Conclusion

Midlife is a transformative period that can bring changes to sexual health and wellness. Educating yourself about these topics can empower you to take control of your sexual health and enjoy a fulfilling and satisfying sex life. Open dialogue, validation, and seeking professional guidance when needed can help navigate this life stage with confidence and vitality.