I have a big birthday coming up in March. No, not 50-big, but I am on my way there. And while there are lots of lessons that I would like to impart to my children, I believe that it is ok to be a bit selfish -- in this case, to worry about myself. Many of us read -- and write -- letters to our children or retroactively pen notes to our younger selves, but we rarely think about what we want to take with us into our futures.
As I begin the final stretch to 40, I am acutely aware that I am more confident and more comfortable with who I am today than I ever was as a younger person. I have worked hard to become strong -- physically as well as emotionally. I don't sweat (pardon the pun) the ridges or bumps on my body; they tell the story of my life experiences. But as I say that, I have come face to face with mixed messages. I have read the stories of women older than me; I have become all too familiar with the stereotypes of menopausal women, complete with hot flashes, night sweats and mood swings.
I don't want to be one of those women who transitions from fierce and fabulous into forgettable or forgotten. I know that my sexuality may evolve; I know that my body will change in ways that I may or may not be immediately pleased about. But sex (and sexuality) is important throughout our lives and the idea that it simply could end is not something I am willing to take lightly.
Now don't get me wrong, I am not ignorant. I recognize that some changes I may not have control over. But I want to give myself (and because he's involved, my partner) the best shot at having a meaningful (and yes, evolved) sex life.
Sure, some of the symptoms we hear and read about are scary to consider: lower desire, lack of vaginal lubrication, or pain. But what is rarely discussed is that many of these symptoms have treatments available for them. For example, painful sex may be due to something called postmenopausal vaginal atrophy, and while that sounds terrifying, it is a treatable medical condition -- like, prescription-medication treatable. (Wouldn't it be cool to see that issue and related conversation modeled in a television show or movie?) As anything else in life that is medical-related, this is a discussion that I should be having with my health care providers, learning about all the risks and benefits of what is out there. Truth is, we all should; it may be difficult, but our health care providers are involved, too.
I've been giving a lot of thought to this because women today are spending one-third of their lives in postmenopause. (Consider this: the average age of menopause is 51 and many women live into their 80s.) I spend most of my professional life talking to children and teens about puberty, but who is talking to the over-50 crowd about the changes experienced later in life?
There is nothing better than seeing the face of a child who figures out that they are not broken, that their feelings or bodies are normal. I want that for my postmenopausal friends and family, too. I want them -- and me, eventually -- to own the changes that a depletion of estrogen may cause and work beyond them. I don't want a change in life to define me and, in turn, my sex life.
Women are the incredible storytellers. We talk about everything. We overshare -- with the best of intentions -- because we know that our experiences have the potential to help someone else. Whether we are girlfriends, sisters, mothers, aunts, or grandmothers, we have a responsibility to support and guide one another through all of life's challenges and opportunities.
As I enter my 40s and then into menopause, I plan to do it with a sisterhood of confidants, supportive medical providers willing to listen to my concerns and collaborate on solutions, and with a partner who understands that no matter what potential challenges may emerge I will prioritize my needs (which in turn takes care of our needs). And, importantly, I won't allow a loss of naturally-occurring estrogen to dictate how fierce and fabulous I am.
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References:
Nappi, R.E. and Kokot-Kierepa, M. Vaginal Health: Insights, Views & Attitudes (VIVA) - results from an international survey. Climateric 2012;15:36-44.
Kaunitz AM. Sexual pain and genital atrophy: breaking down barriers to recognition and treatment. Menopause Manag. 2001;10(6):22-32.
The North American Menopause Society. Menopause Guidebook 7th edition. Mayfield Heights, OH: The North American Menopause Society; 2012.
CDC Health United States 2011. National Center for Health Statistics. Health, United States, 2011: with special feature on socioeconomic states and health. 2011.
Dr. Logan Levkoff is a recognized expert on sexuality and relationships and works to create an environment where people feel comfortable asking (and getting answers to) their most personal questions. Dr. Levkoff served as a paid spokesperson for Pfizer in connection with a women's health event, and wrote this post based on the discussion.