Does menopause have to spell the end of physical intimacy in a marriage? My wife is going through what our mother's generation called "the change of life," and as a result she's almost never "in the mood." She even complains that sex has become physically uncomfortable. Is she just making excuses? Is it all in her head? Or is our sex life actually over?
Not if you can muster up enough maturity, empathy and selfless concern to walk with her through this difficult but temporary phase in her life. Because it coincides with so many other mid-life pressures (including raising teenage children, experiencing an "empty nest," or caring for aging parents), menopause can be a difficult passage in any marriage. Some couples don't make it over this hump, but you can improve your chances by cultivating an awareness of and a sensitivity to your wife's needs and perceptions.
The simple answer to your question is no – your wife's current troubles are not "all in her head." Her body is going through a number of dramatic hormonally based changes as her menstrual cycles become irregular and eventually cease. These changes have the potential to produce some fairly troubling emotional effects. Estrogen loss can induce depression, insomnia, fatigue, irritability and a decreased ability to cope with the many other stresses a woman in mid-life faces. Meanwhile, lower levels of testosterone (yes, women do have testosterone) may cause a decrease in libido. On the purely physical side, your wife may also be experiencing a dryness and thinning of the vaginal membranes, resulting in discomfort during intercourse. If she says that sex hurts or is uncomfortable, she's not making it up. There's a very real physiological basis for her complaints.
The good news is that there are solutions to most of the difficulties that come with the onset of menopause. Vaginal dryness, for instance, can be remedied through the application of creams and personal lubricants. Hormone therapy (the administration of estrogen and progestin, or estrogen alone in women who have undergone a hysterectomy) can also be helpful for women who are dealing with the emotional and physical symptoms of menopause. In addition, your wife's doctor may address decreased levels of sexual interest by prescribing a low dose testosterone cream. For more detailed information, we strongly suggest that you and your wife consult your physician.
You should also understand that, in spite of the conflict and confusion you're presently experiencing in your relationship, this is not necessarily "the end of physical intimacy in your marriage." There's a great deal of myth, misunderstanding and ignorance surrounding the question of sexual intimacy during menopause. Past generations tended to assume that a woman becomes de-sexualized after passing through "the change of life." We now know that these attitudes are based largely on prejudices and misconceptions.
In actuality, menopause can have both positive and negative implications. It's true that the condition is often associated with physical, emotional and mental discomfort in varying degrees. But menopause can also open up new opportunities and lead women to new discoveries about their lives. This can be particularly true as it relates to the issue of sexual intimacy in marriage. While a great deal depends upon the mental and physical health of the individual, in a general sense it would not be unwarranted to say that, where post-menopausal sex is concerned, "the best is yet to come."
Why do we say this? Because many women eventually find considerable sexual freedom in menopause. Wives who have spent their lives fearing pregnancy or avoiding it for physical or lifestyle reasons may now be able to relax and enjoy sex without worrying. Those who have dreaded heavy periods and the uncomfortable side effects of menstruation may be relieved to see the cycle come to an end. And while menopause does put a stop to a woman's ability to conceive and bear a child, it has no effect whatsoever on her capacity for love and sensuality.
Although menopause and the period leading up to it (called perimenopause) are more clearly defined in women because of the change in their menstrual periods, you should recognize that as a man going through midlife you are also undergoing changes in sexual drive and functioning. Our advice to you, then, is to be patient and understanding as the two of you learn these lessons together. A man tends to assess his worth in terms of sexual prowess, and as a result it's easy for him to feel personally rejected when his wife seems less interested in sex. This in turn can leave him vulnerable to the lure of affairs, infidelity and pornographic material. Don't let yourself fall into this trap. Given time, the physical aspect of your relationship with your wife is almost certain to improve. Meanwhile, there are other ways of building your self-image and realizing your significance as a person. Above all, you need to demonstrate what it means to love your wife self-sacrificially, as Christ loves the church (Ephesians 5:25). You've got to show her, in every way you can, that you're still committed to her despite the temporary emotional and physical disturbances she's going through.
As a footnote, we should add that if these physical and emotional changes were to make normal intercourse impractical or infeasible for you and your wife, this still would not necessarily spell the end of your sexual relationship. It's important to keep in mind that physical intimacy in marriage is a lifelong process and that it is possible to broaden its definition to include forms of physical affection outside the range of intercourse proper. Different types of expression may be appropriate at different phases of the relationship – in youth and old age, in times of stress and times of joy, during pregnancy, childbirth and child-rearing, during and after menopause – the list could go on and on. Touch, physical closeness, skin-to-skin contact, even intimate conversation can be extremely satisfying in the absence of other forms of sexual pleasure. At every stage of life, healthy attitudes toward marital sex should be characterized by candor, prayerfulness, vulnerability, flexibility, and willingness to communicate.
If you would like to discuss these issues at greater length, feel free to call Focus on the Family's Counseling department.
Menopause's Impact on Sexual Intimacy: Dr. Michael Sytsma discusses the physiological and psychological effects of menopause, its impact on sexual intimacy, and ways married couples can address it.
Sex and Intimacy