Menopause and Masturbation

In the absence of an acceptable partner, masturbation is a reasonable and appropriate source of sexual enjoyment as well as a method of releasing sexual tension. At midlife and thereafter, women may choose this form of sexual release as the shortage of available men gives way to the general shortage of men in an aging population. Masturbation may also be the sexual outlet of choice, over and above available partners. Masturbation is also a good way of getting started for women who, because of estrogen depletion, experience arousal too slowly to begin sexual activity at the same time as a mate. It is also a loving way to express sexuality for men or women during the illness of either partner or in instances when the desired amount of sexual activity differs for each partner.

There is no right and no wrong when it comes to sex. Society’s very recent acceptance of individual sexual preferences has also lifted the taboo on masturbation. Just as children need to be assured that there is nothing wrong with masturbation, so older persons need to know that it is not an improper activity for them. Although there is less disapproval of masturbation today than in prior times, there is still significant discomfort with the issue. However, if we agree that sexu­ality is basic to life, then masturbation must be included as one of our natural sexual outlets. According to one study, nearly half of the women questioned indicated that they masturbated in their fifties, and this amount decreased to about one-third of the women at age seventy and over. Two-thirds of the men involved in this study masturbated in their fifties and this amount dropped to 47 percent at age seventy or greater. Those achieving orgasm ranged from 83 percent of the women at age fifty to 74 percent when they reached their seventies and beyond. In their fifties, 91 percent of the men reached orgasm. At age seventy and later, 73 percent of the men who masturbated reached orgasm.

Mutual masturbation is another way to enhance your sex life when you want to, or when other possibilities are limited because of illness or injury. It involves each partner giving each other pleasure until such time as they are both ready to join in whatever way is possible for them.

The techniques for masturbation are as varied and individual as what brings you satisfaction and pleasure. Do not be afraid to experi­ment. Self-experience and self-pleasure are valuable safe sex tech­niques. You do not actually need to have sexual relations with another person to feel sexually fulfilled.

In the study by Masters and Johnson that we mentioned earlier, it was found that each of the female volunteers masturbated differently. So you need to try and see what feels good to you. You may use your fingers and hands in caressing motions in whatever position feels best. Some women stroke or press, covering their entire genital area, whereas others find that stimulating the clitoris feels best. Hands and fingers can provide intense stimulation by stroking and rubbing the external genitals, by the fingers’ gentle thrusting motion in the vagina, or by a combination of both. There is no preferred way of self-stimulation; only personal preferences apply.

Vibrators also provide stimulation and excitement to many sensitive areas of the body and can be used in many ways. They come in both electric and battery-operated models and in shapes as different as women are unique. They also sidestep the old taboo of not touching oneself for women who find it is a lingering problem. These are available for purchase in pharmacies and most department stores, as well as offered in catalogues too numerous to mention.

Jacuzzi jets or hand-held shower heads playing directly on the clito­ris can offer sexual pleasure, and for some women so does the crossbar of a bicycle or the back of a horse when riding. Do not be afraid to try to seek sexual pleasure by yourself or to engage in a satisfying fantasy life that may stimulate you in different ways by “dream” imaging. Erotic books, movies, and videotapes may also be used to heighten your sexual excitement. Just remember, there would not be so many erotic items available if they were not in use. If you are not sure of how to start your process of experimentation, there are many good books available that offer specific instructions and techniques for masturbation, such as L.G. Barbach’s, For Yourself: The Fulfillment of Female Sexuality (New York, Anchor/Doubleday, 1976) and Sex Is Not Simple by Stephen B. Levine (Ohio, Ohio Publishing Co., 1988). You can also try to find a support group for women that deals with sexuality.

Sexual Problems around Menopause

For women who experience changes in sexual function during the years immediately preceding and following menopause, the com­plaints they bring to the physician’s office can be divided into five categories:

1. Loss of desire

2. Decreased frequency

3. Painful intercourse

4. Diminished responsiveness

5. Dysfunctions of their male partners

Let’s consider these individually, although sometimes these problems may be cumulative for any one couple.

Loss of Desire

Desire is a complex phenomenon. The psychological factors that in­fluence it are extremely important, including the nature of your rela­tionship with your partner. If you experience a loss of desire even though there is still normal hormonal activity in your body, your problem may require deeper evaluation and, perhaps, the help of a sex counselor. At the time of menopause, however, the decline of ovarian hormones often influences the components of sexual desire and arousal. So if your diminished desire is due to a loss of sensory perception through the local and central nervous system, changes in the rate of blood flow, less tension within the muscles, and the de­creased ability of the sexual glands to lubricate the vagina, you may be relieved to know that these changes respond very well to HRT. When adequate hormone therapy is introduced, desire and arousal normally return.

Decreased Frequency of Sexual Activity

Again, many factors are at work when you experience decreased frequency of sexual activity, and the majority of them are not hor­monal. Most are related to your lifestyle and your relationship with your partner. Together, you need to sort out such issues as fatigue, interest, time, competing activities, or other tensions in the relation­ship. Do you spend as much “bed time” as television time, or is a too-active social life competing with your sex life? If sex is important equally to you both, you need to work out a mutually satisfactory frequency pattern and set aside the time, create the mood, and satisfy your own and each other’s needs whenever possible.

Painful Intercourse

The solution to this problem must include your physician, for this problem is decidedly the easiest to address and, in most instances, it is related to decreased estrogen stimulation of the vaginal canal. Ap­propriate hormonal replacement almost without exception results in the disappearance of this uncomfortable symptom.

Diminished Responsiveness

This symptom is usually resulting from a decrease in estrogen and the subsequent lack of stimulation of nerves in the pelvic and vaginal area and in the brain itself. Estrogen treatment is of benefit in most in­stances, and is highly recommended.

Dysfunction of the Male Partner

A surprising finding from research shows that older women have more interest in sex than older men. Possibly one of the biggest problems facing the aging male is his decreased ability to become aroused and, as a result, to obtain or keep an erection for long periods of time. In many cases, this problem can be satisfactorily treated through sexual counseling, which we strongly recommend. Be reas­sured that even if your male partner is unable to obtain an erection, satisfactory sexual activity can still take place if you are motivated and instructed in other means of sexual gratification.

Achieving sexual satisfaction is largely dependent on your relation­ship with your partner. You can certainly appreciate the fact that you would not be turned on sexually or able to achieve orgasm if your partner was in pain, disabled, or obviously not enjoying the sexual activity. So it may be that when a man perceives his partner going through menopause; enduring sleep disturbances, hot flashes, and night sweats; feeling unaroused; or suffering painful intercourse, he begins to feel threatened. He may worry that you are losing interest in him because you no longer feel that he is attractive, wanted, or needed. Or he may just be concerned about you and not wish to upset or hurt you by making an issue of your waning sex life. It is true that in a strong relationship one partner suffers from the other partner’s ills.

It is important for you both to understand what is happening. Therefore, you should learn about and be willing to explain your problem. If you begin taking hormone therapy and feel relief, let your partner know that you feel better, that your sexuality is intact, and that you are interested in sex again. Knowing these things will often enhance his arousal and change problematic sexual activity back into the healthy and satisfactory sex life that you both enjoy. If you are single, HRT may stimulate you to consider and enjoy a new and invigorating sexual relationship.