Perimenopausal issues in sexuality

The perimenopause, with its attendant physiological and psychological changes, has influences on a woman's sexuality. These may be positive, e.g. bringing a release from fears of pregnancy leading to an increased sexual enjoyment. More often though the perimenopause brings negative physical effects, such as erratic heavy periods, hot flushes and vaginal dryness and also negative psychological effects such as depression and low libido. Other negative factors may include psychosocial changes such as coping with ageing parents and teenagers, and increased vulnerability to disease of the reproductive organs, which obviously affects sexuality. Thus the perimenopause is a time of high risk for sexual problems of all kinds. As perimenopausal women may be reluctant to complain about sexual difficulties, it is helpful for health professionals to be aware of this and ask them about their sexual lives. Sexual problems will thus be identified early at a stage when they are easier to treat.