Genitourinary syndrome of menopause (GMS) is a set of alterations associated with the drop in estrogen that can cause various problems with sex during menopause: vaginal dryness, discomfort or pain during sexual intercourse. It affects almost half of all women. However, to reduce female sexuality only to these symptoms would be to skim the surface.
As explained by nutritionist and educator Marta Marcè, sexologist Ana Lombardía and gynaecologist Bárbara Fernández del Bas, this pivotal moment does not necessarily mean the end of desire, but rather a transformation in the way of experiencing pleasure. To understand what is happening in the body, what signs to pay attention to and how to continue enjoying sex, they share 10 key methods that help to approach sexuality with more information and less fear.
Desire does not disappear, it changes
One of the most common fears when menopause arrives is to think that sexual desire disappears, even though Marta Marcè, a nutritionist and educator specialising in menopause, challenges this idea. Hormonal changes influence libido and sexual response, not only because they affect the genital area, but also because they modify the cerebral functioning of desire. With the drop in estrogen (and testosterone) changes may appear in vaginal lubrication, tissue elasticity or genital sensitivity.
In addition, estrogens participate in the regulation of neurotransmitters such as dopamine, related to motivation and reward and oxytocin, associated with emotional bonding. When these levels decrease, many women perceive that desire no longer appears as automatically as it used to. “In menopause, it is very common for desire to go from being spontaneous to being more responsive,” she explains. “That is, it doesn’t necessarily arise as an immediate impulse, but it can be activated when there is an appropriate context: emotional connection, intimacy, stimulation or enough time for the body to become active.”
Desire and arousal are not the same thing
To better understand these changes, it is important to clarify that sexual desire and physical arousal are not the same thing, as sexologist Ana Lombardía points out. While the former has to do with the desire or motivation towards the intimate encounter, arousal is the body’s physiological response, which includes phenomena such as vaginal lubrication or increased blood flow in the genital area.
“Menopause doesn’t automatically turn off desire,” explains Lombardy. “It can change, yes. But it also depends on the context, the bond, how you feel about yourself or the relationship you have with your partner.” Understanding this difference helps to reduce the pressure and to live sexuality more naturally.
The drop in estrogen changes the sexual response
Beyond desire, menopause also introduces changes in the way the body responds during sexual relations. For Bárbara Fernández del Bas, medical director of Womanhood Clinic and specialist in regenerative gynaecology, menopause is characterised by a marked decrease in the production of estradiol, which affects different tissues sensitive to these hormones, including the genitals. In practice, this may translate into less vaginal lubrication, changes in tissue elasticity or a slower physical response to sexual stimulation.
