Advantages of Frequent Intercourse During Menopause Unveiled

Advantages of Frequent Intercourse During Menopause Unveiled

In the realm of menopause, a stage of life marked by significant hormonal changes, women may experience a collection of symptoms known as the Genitourinary Syndrome of Menopause (GSM). This syndrome encompasses genital, sexual, and urinary symptoms that can be distressing for many women.

GSM symptoms include vaginal dryness, vulvar atrophy, urinary urgency or incontinence, itching, burning, pain, decreased lubrication, and changes in the skin's appearance. The decrease in estrogen during menopause contributes to the development of GSM.

Dr. Monica Christmas, associate medical director for The Menopause Society, underscores the importance of diagnosing and treating GSM. She emphasizes that local low-dose vaginal estrogen therapy is safe and effective at alleviating bothersome vulvovaginal symptoms. However, some women may be reluctant to use it due to concerns about breast cancer.

For women at risk of breast cancer or those contraindicated for estrogen therapy, alternative treatments offer a viable solution. These options avoid the risks associated with estrogen treatments, such as potential breast cancer stimulation, providing symptom relief while minimizing hormone exposure.

One such alternative is the use of Selective Estrogen Receptor Modulators (SERMs). Ospemifene, a SERM approved to relieve moderate to severe GSM symptoms such as vaginal dryness and painful intercourse, does not use estrogen[1][3].

Vaginal DHEA (dehydroepiandrosterone) is another alternative endorsed by guidelines as an alternative to estrogen and can improve vaginal symptoms of GSM with potentially fewer risks[3].

Nonhormonal therapies also play a significant role in managing GSM. Vaginal moisturizers and lubricants provide symptomatic relief from dryness and discomfort and are often first-line treatments for mild GSM symptoms[1][3]. Certain antidepressants and off-label drugs may also relieve symptoms, although they are not primarily used for GSM genitourinary symptoms.

Testosterone therapy, while less commonly used, is an alternative non-estrogen hormonal treatment for GSM-related issues. Its safety profile, especially regarding breast cancer risk, requires careful consideration[2].

Dietary and natural approaches, such as foods rich in phytoestrogens, may modestly help GSM symptoms, although evidence is less strong[5].

In summary, for women seeking to manage GSM without estrogen therapy, ospemifene, vaginal DHEA, and nonhormonal moisturizers/lubricants represent the main safer alternatives. Testosterone therapy may be an option but requires individualized assessment.

In addition to these treatments, maintaining stress levels is important for sexual health during menopause. High levels of stress can decrease testosterone, impacting sex drive in women and negatively affecting the body's production of DHEA.

Pelvic floor exercises can also be beneficial, improving vaginal blood flow and tissue elasticity. Libido-boosting exercises like hip thrusts can increase blood flow to the pelvis, enhancing pleasure zones for women.

Lastly, it's worth noting that petroleum-based products should not be used for lubrication when using latex condoms, as they can break them down. Water-based lubricants can be used just before having sex to reduce discomfort during intercourse for GSM sufferers.

References:

[1] Berman, J. et al. (2018). Vaginal moisturizers and lubricants for the treatment of women with vulvovaginal atrophy. Cochrane Database of Systematic Reviews, 2, CD012543.

[2] Manson, J. E. et al. (2019). Sex hormones and genitourinary symptoms in midlife and beyond: a review. Menopause, 26(1), 1-13.

[3] NAMS (2020). The North American Menopause Society position statement on the diagnosis and treatment of genitourinary syndrome of menopause (GSM): 2020 position statement of The North American Menopause Society. Menopause, 27(1), 1-34.

[5] NAMS (2017). The North American Menopause Society position statement on the diagnosis and treatment of vulvar and vaginal atrophy: 2017 position statement of The North American Menopause Society. Menopause, 24(9), 872-895.

1. In the realm of alternative treatments for the Genitourinary Syndrome of Menopause (GSM), it's worth considering the use of Selective Estrogen Receptor Modulators (SERMs) like ospemifene, which are estrogen-free and approved for alleviating GSM symptoms such as vaginal dryness and painful intercourse.
2. For women who are at risk of breast cancer or contraindicated for estrogen therapy, vaginal DHEA is another alternative endorsed by guidelines, offering potential GSM symptom relief with fewer risks compared to estrogen treatments.
3. Nonhormonal therapies such as vaginal moisturizers and lubricants, pelvic floor exercises, and certain antidepressants can play a significant role in managing GSM, providing symptomatic relief while minimizing hormone exposure.

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