It must be stressed that menopause is not an illness, despite the fact that the medical profession and pharmaceutical companies have medicalised it, terming it an oestrogen-deficiency disease. Menopause is simply a life stage, a natural rite of passage, just as menarche is. So dont be seduced by the mainstream medical literature that urges women to visit their doctors as soon as the first symptoms appear so that treatment (translation: drug therapy in the form of steroid hormones) can commence. Menopause is not a life-threatening condition.
The various chemical and psychobiological changes that occur in women during midlife are due only partly to menopause. Everything else relates to the ageing process, something that commences from the moment of birth.
Oestrogen influences the body as an entire system. When production of the hormone starts to decline, this leads to hot flashes, insomnia, depression and changes to the skin, breasts, heart, bones and sexual organs. The walls of the vagina and the skin of the labia (the lips of the vagina) become thinner, more fragile and less elastic; it bleeds more easily if scratched and can become extremely sore and raw. Additionally, the acid balance of the vagina may alter, increasing the risk of infection. The cervix becomes smaller.
Oestrogen is also responsible for prodding the mucous membranes scattered throughout the vagina and the labia to flood the area with natural lubrication when you become aroused. When oestrogen levels are declining, the vagina remains dry no matter how aroused you are. This drying up results in painful intercourse, which, not surprisingly, can cause a woman to be less than enthusiastic about the prospect of having sex.
While this aspect is widely believed to be a universal symptom of menopause, research shows its not the reality. One study involving 1109 women revealed that just 20 per cent of postmenopausal women experienced vaginal dryness and, of those, only 15 per cent were actually bothered by it. Another study reported that 45 per cent of postmenopausal women and 25 per cent of pre- and peri-menopausal women complained of vaginal dryness.
The differences between the studies may relate to the number of women who had surgical menopause through hysterectomy or who underwent menopause as a result of chemotherapy; research indicates that these women experience more problems with vaginal dryness than women who enter menopause naturally. Experts believe the reason for this is the lack of testosterone and oestrone that the ovaries would normally provide.
The problem of vaginal atrophy, as the condition is called, is not unique to menopause; it can occur at any age and is often transient, even in menopause. Once hormones come into balance again after menopause, the condition often improves. Having said that, many women find that the dryness continues, often worsening with age.
Use it or lose it!
Regular sex (with or without a partner) is the best antidote to the problem of vaginal dryness. (Its the classic use it or lose it syndrome.) Sexual activity stretches the vagina and increases blood supply to the genitals. As a side benefit, weekly sex can significantly decrease both the frequency and severity of hot flashes, according to the Stanford Menopause Study, because sexually active women apparently maintain higher levels of oestrogen in later life.
Water intake
Its very important to drink plenty of water to ensure your entire body is lubricated. The recommended daily amount is eight 250ml glasses of filtered or mineral water (or half a glass every waking hour if that quantity seems overwhelming!). Some of your liquid intake can come from herbal or green tea or fruit and vegetable juices; however, coffee, alcohol and black tea cause dehydration so cannot be classified as liquid intake.
Vaginal dryness and loss of lubrication is more likely to be an issue if severe stress, over-use of caffeine, white sugar and flour products, alcohol or dependence on steroid or cortisone drugs have exhausted your adrenals.
Dietary nutrition
Eat a diet thats as close to natural as possible. Ideally, it should comprise:
- Plenty of fresh fruits and vegetables five to nine servings a day
- Whole grains, including a serving of oats each day and some ground linseed
- Nuts and seeds
- Legumes, beans and peas
- Soy products such as soybeans, tofu, miso and soymilk for their plant oestrogens
- Low-fat dairy products such as yoghurt for the calcium (provided you can tolerate dairy)
- Seaweed, also for the calcium (try sushi for lunch)
- Oily coldwater fish such as salmon, trout, tuna, sardines and mackerel for their essential fatty acids
- Small amounts of organic meat and skinless poultry
- Hearty soups made from bone stock to which one tablespoon of lemon juice has been added (to extract the calcium from the bones during simmering)
Supplements
Supplements (dosages per day) to help lift a flagging libido include:
- A high-potency antioxidant formulation
- One high-potency B-complex tablet
- Zinc chelate 100mg
- Amino acid complex two to three tablets
- Evening primrose oil three grams
- Vitamin E is doubly beneficial, helping with vaginal lubrication and also keeping the heart healthy (after menopause women face the same risk of heart disease as men) take one 400IU or 500IU capsule of d-alpha-tocopherol with mixed tocopherols twice daily with meals
Homoeopathic remedies
- Bryonia for dry vagina, dry stools or constipation
- Lycopodium if the vagina is very dry; dry skin; withered self-confidence
- Belladonna if the vagina is painfully dry or too sensitive to tolerate touch
Herbal help
Susun S Weed in her book Menopausal Years The Wise Woman Way recommends these herbal aids:
- Chew on a piece of dong quai root during love play, as this is said to increase vaginal lubrication.
- Take 25 to 40 drops of chickweed tincture in water several times a day for two to four weeks for increased vaginal moistness.
- Start the day with one to three teaspoons of flaxseed oil or safflower oil, or 25 drops of tincture of motherwort, or a capsule of the herb chaste tree, to increase the thickness of the vaginal walls and boost vaginal lubrication.
- Insert an acidophilus capsule into the vagina four to six hours before making love. This helps prevent yeast infections and also creates copious amounts of lubrication.
- Make this slippery elm gel: combine one cup of filtered water and two tablespoons of slippery elm bark powder. Slowly bring the mixture to the boil, stirring all the time until thick. Cool/chill if you wish. Apply to the vagina and vulva, where the herb will go to work to heal, nourish and lubricate the tissue.
- Ginseng can help relieve the whole gamut of menopausal symptoms. Take five to 40 drops of tincture one to three times daily.
Comfrey
Herbal help also comes from comfrey, which nourishes and tonifies the vaginal tissues. Apply comfrey ointment to the vagina and vulva morning and night to improve skin flexibility, and use as a lubricant during sex. Alternatively, make a comfrey root infusion and use as a sitz bath.
Wild yam
Many women swear by extracts of wild yam root, which grows in the wet woods of Mexico, China, Guatemala and parts of the USA. Wild yam, which is too bitter to eat as a vegetable, contains diosgenin, a laboratory precursor of the hormone progesterone. During the 1940s, medical pioneer Professor Russell Marker developed a chemical process to transform diosgenin from Dioscorea mexicana into progesterone and other hormones.
It should be noted that no clinical evidence exists that the human body is able to convert diosgenin into hormones, or that wild yam exerts any specific effects on female hormones. However, anecdotal evidence abounds of how it has alleviated symptoms where other treatments have failed. Melinda Bonk in her book Controlling Hormones Naturally theorises that wild yams ability to support the liver may account for its effectiveness.
Wild yam is available in three forms: pill, tincture and cream. Many practitioners believe transdermal (that is, absorbed through the skin) creams are many times more effective than pills. Tablets must pass through the digestive system, where the progesterone is broken down and eliminated too quickly to be effective. The cream, which contains a highly concentrated solution of wild yam extract, is absorbed straight into the bloodstream, bypassing the digestive process. Some of the hormone also connects with specific receptor sites in the skin.
Flower essences to the rescue
Christine Wildwood in her book Flower Remedies for Women recommends taking the flower essence Pomegranate once or twice a day for as long as required as an aid to balancing hormones. Other flower essences that can help women in transition deal with personal and self-esteem issues that may impact on their ability to enjoy sexual intercourse include:
- Crab apple for feelings of shame and self-disgust about the body and its imperfections
- Holly for feeling unloved and experiencing jealousy of younger women
- Honeysuckle for deep regret at the passing of youth
- Impatiens for women who are impatient, irritable, tense or intolerant
- Larch for lack of confidence
- Olive for physical and mental exhaustion
- Pretty face for preoccupation with the idea of cosmetic surgery to attain a youthful appearance
- Walnut the transitional remedy that aids a smooth passage through to the next life stage
Exercise
Another remedy for declining sexual desire is exercise, which you should be doing in any case for heart health. In a survey conducted by the US magazine Shape, of 8000 women spanning the ages 20 to 45, 40 per cent of respondents claimed exercising led to more frequent sexual activity, while 27 per cent reported increased ability to climax.
Eighty-nine per cent of women reported that working out regularly produced heightened sexual confidence; 98 per cent reported improved self-confidence. While the age range falls a bit below the average age for menopause (48-50), it does incorporate the peri-menopausal age range (from the late 30s) when many of the ubiquitous menopausal symptoms start to manifest. However, there is little doubt that older women will derive similar benefits: the sex-ercise link is so strong, in fact, that many therapists now prescribe exercise to patients experiencing sexual dysfunction.
The exercise doesnt have to be violent or sustained over long periods. Moderate exercise is sufficient to maintain the condition of your sexual equipment for example, a brisk 20- to 30-minute walk every day, some resistance or weight training three or four times a week, plus some daily yoga and stretching to maintain youthful flexibility.
A note on prescription drugs
Lessened sexual desire can often be attributed to prescription medications. A wide range of drugs can affect sexual function in both men and women, producing arousal difficulties and orgasmic dysfunction, in addition to loss of libido. Some of the culprit groups include:
- Certain muscle relaxants
- Drugs to combat epilepsy
- Certain anti-migraine medications
- Certain anti-hypertensive drugs
- Sedatives and anti-depressants
- Drugs used to treat cancer
If youre taking prescription drugs, or if your doctor is recommending that you start, speak to them about alternative approaches to your condition, such as diet and lifestyle changes or nutritional therapy. Ask about the potential side-effects of the medication. For example, ask if sexual dysfunction is a possible side-effect and, if so, is there a suitable alternative. At this stage of your life, when you may be experiencing massive fluctuations in your sex drive, you have every right to avoid any substance that has the potential to exaggerate those problems.
Overcoming stress incontinence
Plummeting oestrogen levels can create another problem that can interfere with sexual pleasure. The hormone influences the health of the urinary system by nourishing the tissues at the base of the pelvic area. Because the uterus lies right beside the bladder, orgasm (or simply sneezing and coughing) can result in the involuntary leaking of urine, a condition known as stress incontinence. If this happens, dont panic: youre not condemned to a lifetime of incontinence pads. Practising 10 Kegel exercises three times daily keeps the crucial pubococcygeal muscles (positioned between the vagina and the anus) strong throughout your life. The action is simply contracting the muscle as though you wish to stop the flow of urine, feeling the muscles around the vagina tighten, as well as the anal sphincter muscles. These exercises give you the added bonus of increased sexual pleasure for you and your partner.
Communicating your needs
Finally, its very important that you take responsibility for explaining to your partner the changes that are occurring in your body and communicating your altered needs. Dont expect your partner to be able to simply read your mind thats not fair to either party. When you do make love, take it slow and easy, allowing plenty of time to become fully aroused. Use a commercial water-based lubricant or any of the plant oils such as olive, coconut, avocado (very nourishing to mature skin), apricot kernel, hazelnut, sweet almond or wheatgerm. Vitamin E oil works well, too (insert a 500IU capsule into the vagina about half an hour before lovemaking starts).
Aromatherapy to increase desire
Sensuality bath
1 drop patchouli essential oil
2 drops ylang ylang essential oil
2 drops rosewood essential oil
3 drops sandalwood essential oil
Swirl the oils through a warm bath. Soak for 20 minutes. Repeat as often as you wish.Hormonal balancing bath
1 drop geranium essential oil
1 drop fennel essential oil
1 drop cypress essential oil
2 drops clary sage essential oil
2 drops lavender essential oil
2 drops chamomile essential oil
Swirl the oils through a warm bath. Soak for as long as you wish. Clary sage, geranium, fennel and lavender oils are renowned for their ability to rebalance hormones during the transition.Sensuality diffuser blend
6 drops vetiver essential oil
9 drops ginger essential oil
12 drops coriander essential oil
18 drops ylang ylang essential oil
30 drops clary sage essential oil
45 drops lavender essential oil
Combine the oils in a brown glass jar. Place some of the blend in an aromatherapy burner to use in the bedroom as necessary.Aphrodisiac blend
2 tsp jojoba oil
2 drops vetiver essential oil
3 drops rose essential oil
4 drops jasmine essential oil
4 drops benzoin resin (optional)
8 drops sandalwood essential oil
8 drops neroli essential oil
Combine the oils in a brown glass jar. Wear this as a fragrance or sprinkle a few drops on a tissue or handkerchief and inhale as necessary.
