Sex after menopause

[timeistight]

I was gobsmacked to hear on Woman’s Hour recently that 90% of post-menopausal women are apparently enjoying an active and satisfying sex life.

I had my menopause at 58 after 18 years of peri and all sorts of symptoms including irregular bleeding, flooding, bleeding for a year solid at one point, being told by the GP all through that this was ‘normal for menopause’ etc. I am now 62.

My libido went west about fifteen years ago. Since then I have absolutely no interest, and also no sensation. You can touch me and I don’t feel a thing.

The GP gave me oestrogen pessaries about 18 months ago, so I can actually have sex now, but I just don’t see the point. However, DH is increasingly impatient, so I clearly need to do something.

I’ve done some reading and it looks as if I am too old for HRT, which has never been suggested to me anyway.

Where do I go for advice please?

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Trying to work out why living in a village has anything to do with your sex life or what an 'edit' button is?

Could you get to Soilhull for an appt with Dr Newson?

The other thing is a) try vaginal estrogen b) consider using sequential transdermal HRT so you don't get the dampening libido effect of conti. c) be grateful for the orgasms you have however they come! Lots of women can't, whichever and whatever way they try.

Apologies OP I was confusing you with the previous poster here who is on Femoston conti. You just need to ask for HRT. You aren't too old for HRT and lots of us HRT and vaginal estrogen together.

Anyone using oral HRT and wondering about libido - this can have a dampening effect as can anti-depressants. To maximise libido you need to get off other meds if safe to do so, use transdermal HRT, and ideally take it on a cycle as QueenoftheNights says - continuous progesterones can also dampen libido. Once you have your oestrogen levels to a decent level then you can think about testosterone.

As said - if you start HRT within 10 years of menopause or under 60 then this is the ideal time - but transdermal would be recommended anyway. A pity your doc isn't up to speed and that there isn;t a clinic near you. Hopefully if you do have a private consultation you can ask the c onsultant to write to your GP so that if you are prescribed hRT this can be obtained on NHS.

So, the GP prescribed Vagifem to be used 3 times a week, which has helped, but not a lot. I’ve been back in to see her this morning about something else and she showed me that she had written to Gynaecology and they had replied. They have advised that I should not use the Vagifem more than twice a week and that if it has not been effective after six months (I have been using it two years) then “other vulval conditions will need to be considered.” I am now being referred.

Oh and I name-changed as well

I think 'gynaecology' are a bit out of date. Vagifem has been reduced in strength over the last year from 25mgs to 10mgs per pellet. This means that some women are having to use it more than twice a week to get a good result. The advice is usually to increase its use to 3 x a week, and/or do the reloading again whereby you use it every day for 14 days then reduce to a few times a week.

I don't 'know' who you are. Are you the OP?

Your other option is to use systemic HRT if you are not on it anyway- some of us use both.

I am the OP yes, but under a different alias.

I have been told to drop back to 2 x per week pending the referral.

I have enquired about HRT, but been refused straight out by the GP because I am 62 (but only 4 years past menopause). I will raise this when I get to see the consultant, but if Gynaecology are peddling incorrect advice re the Vagifem, they may well peddle the same incorrect advice on that. sighs

If I were you I'd do my own thing :)
I'd try another 14 days, daily, then drop down to as many times a week as needed.
There is no risk with using vaginal estrogen but if they are worried about your womb lining you could take a course of norethisterone every year to check if anything comes away. (This is what was recommended in the past but it's now been decided it's not necessary.)

At 62 you are not too old- this is in the NICE and BMS guidelines. You can start HRT on a low dose, transdermal (not tablets.) Don't know your circs, but rather than rely on the outdated NHS can you pay for a private appt with a specialist?

menopausedoctor.co.uk/what-is-the-menopause/long-can-woman-take-hrt/

HRT for oldies! (Panay contributed to NICE guidelines)

menopausedoctor.co.uk/what-is-the-menopause/vaginal-dryness/

Going back to your first post(s) I'm a bit confused. You wrote mainly about libido. So is the issue pain with sex and unable to have penetration without pain or is it desire you need help with?

If it's the first, you may be offered dildos to help you increase your elasticity. Plus systemic HRT. If it's desire/ libido, you may need testosterone.

I think it’s probably a bit of both to be honest. Perimenopause was lengthy and awful and things like bleeding for a year at a time, perfectly normal according to my GP of the time, plus symptoms of untreated hypothyroidism and anaemia were pretty damaging. Then menopause hit and while I had been hoping for freedom, once the bleeding was finished and the hypothyroidism treated, I was hit almost immediately with the vaginal atrophy.

Yes, I’d like to be able to get back into the habit of having sex, but I’m afraid it might be too late. To do this, I need it to be comfortable rather than just manageable if I grit my teeth. Hopefully, sorting that might create some desire. If not, then yes, I’d be looking to go private and try testosterone.

what's to stop you upping the vagifem short term while you wait for your appt?
TBH there is no magic answer. The best you could hope for if you see a consultant is systemic HRT as well as topical. That may help but they may be reluctant if you have no other symptoms.

I'm sure you know that once atrophy has set in, the vagina shrinks. To help it get back to where it was it has to be used - using vaginal estrogen and lube if necessary and for women not in a sexual relationship sometimes dilators (graded sizes) are used over a period of weeks. You can buy these online.

There is also a new treatment called the Mona Lisa touch which is a device used -but it's not on the NHS.
www.monalisatouch.com/patients-home/

You could also ask to try Ovestin which is a cream version (like Vagifem) and it may help .

Believe it or not, I didn't realise it would actually shrink. I thought the 'atrophy' only referred to the state of the lining.

Would have been helpful if any of the GPS I have seen over the last two years had explained that.

Yes, they do say it can, it gets shorter and narrower.

There is a very long thread here on another forum which may help you.

www.menopausematters.co.uk/forum/index.php/topic,40477.0.html

NHS appointment cane through for the first week in January. Have tried to get to see Louise Newson, but I am away on the only date I was offered before Christmas, although she can see me in January, but after my NHS appointment.

Feeling a little lost now.

Not sure where you live but if you can hop on a train and get to London there are plenty of good drs there who could see you before Jan. I can PM you names if you want.

Otherwise, change your GP. There must be an option within the practice? Or become more stroppy and show them the NHS /NICE guidelines.

I'm not sure what you are looking for any more- full, systemic HRT or continuous Vagifem at a dose which works?

If you want to stay within the NHS system your GP can refer you to the Chelsea and Westminister Menopause Clinic and they say they see new patients within 6 weeks. Look online for info from them- they have a leaflet.

I've now managed to see Louise Newson, who was lovely. I have a bucketload of Vagifem to try first and if that isn't effective when used on a daily basis, I have a prescription for oestrogen in reserve. I feel as if there may be hope now. Thank you for all your advice.

I tried testosterone and hated the main side effect which was thick dark hair sprouting all over my face. Another strange effect was I noticed I started driving faster, took more risks.. Did increase my libido but the side effects weeent worth it in my opinion. Takes 6 weeks to kick in.

Christ pp how much were you using?!

I have only good things to say about testosterone - I use a pea blob per day. No side effects apart from lovely strong orgasms

@NaToth

It's great you have got what you need. Also good that you managed to see Dr Newson because on another forum she was quoted as having a 6-month waiting list which is clearly not the case! That may help other women who could see her.

I think I was lucky enough to get a cancellation.

Brilliant thread, so useful. Only perimenopause at this point (I think), but I've learnt loads from this.

That is good @NaToth.
I hope things get better for you . VA is extremely painful.
I did not know about out until I got it .
Mumsnet collective has been very helpful.