The menopause is a time when previously unacknowledged sexual difficulties become harder to deny, when physical changes give rise to sexual problems, and when the end of fertility brings the whole matter of women’s sexuality into high relief. Some see this period as an opportunity to give up an activity that may never have been particularly enjoyable or satisfying, whilst others feel that, with children away from home and no risk of pregnancy, a new sexual relationship can develop. There seems some pressure from the media to remain sexually active and attractive, when in truth desire and enjoyment may have gone.

Whatever the issue for any individual, there is frequently some difficulty in communicating it to a doctor or therapist if you seek advice or guidance. Help may be needed to find words to express what can feel impossible to say. Because of shame and a lack of appropriate language in which to describe sexual matters, a woman may complain of vague symptoms, confusingly described, and bewildering to the person trying to understand.

Sexual problems may be the first sign of underlying illness, or a sign of a deteriorating marital relationship. A sexual problem can be a symptom caused by hormone changes, or a way for woman to start address the issue of aging and all that brings.

Currently there is some pressure, (often from sexual partners rather than from women) for a quick fix that will answer all problems. There are a number of mechanical and pharmacological aids to choose from, and a wide selection of toys on the market, and all of these may have their place, but if something changes in your sexual life which puzzles you, it is wise to seek medical advice.