Rekindling Connection in Couplepause (Part 1)

July 25, 2022

By: Rachel Noonan, PharmD

It starts like this:

Slight discomfort during private moments with your partner grows into a burning pain. You’ve picked up a vaginal lubricant at the local pharmacy but are nervous to try it. Your thoughts are racing. Will you notice a difference? Will they? What if they ask you about it? Maybe tonight’s plans are off the table…

Tonight, is the night! But what if you can’t perform? Don’t think too much about it, you’ve been looking forward to connecting all week. Maybe it’s time to talk to someone. . .

If these concerns sound familiar, you’re not alone. Couples in long-term, stable relationships experiencing symptoms of menopause and andropause are likely to endure varying degrees of intimacy issues. Declining estrogen and testosterone levels in women and men are the natural result of a maturing body, nothing to be ashamed of. But ignored, age-related hormonal changes can negatively impact sexual health.

As you may have guessed, these hurdles don’t just affect you. Dysfunction of any kind echoes across  the partnership. It grows, as the problems of one feed off the problems of the other, creating new troubles for the pair. Research suggests couples are not on the same page during the trials of menopause and andropause. The lack of connectivity and communication about these challenges has a heavy cost.

The CLOSER study (Clarifying Vaginal Atrophy’s Impact on Sex and Relationships) uncovered remarkable truths about postmenopausal women’s struggle to share their intimacy issues with their partners. After surveying over 4,000 women, it was found 28% did not tell their partner about their physical discomfort. Of the 58% study participants using non-hormonal vaginal lubricants and moisturizers, less than 1/6th of their partners knew.  Gaps in understanding create a huge divide between heterosexual couples. Over 60% of women experiencing vaginal atrophy avoid intimacy because of it.

Even the perception of a partner’s declining interest can hurt a relationship. One study investigated the impact of male factors on female sexual dysfunction and found that a woman’s perception their partner had lost sexual interest may be a more powerful contributor to intimacy issues than erectile dysfunction (ED), premature ejaculation (PE), or delayed ejaculation (DE). The resulting intimacy disruption caused by this confusion could be more damaging to romantic attachments than functional limitations to intercourse.

Hormonal shifts aside, midlife obstacles can take a toll on relationships. Health restraints, interpersonal conflict, including the increased stress and anxiety associated with these struggles is taxing. If couples aren’t talking, what can be done to mend the bond broken by cyclical avoidance and misunderstanding? If you’re wondering where to start, the second installment of couplepause may offer support.

Read Part II

References

  1. Bachmann GA, Leiblum SR. The impact of hormones on menopausal sexuality: a literature review. Menopause. 2004 Jan-Feb;11(1):120-30. doi: 10.1097/01.GME.0000075502.60230.28. PMID: 14716193.
  2. Corona G, Petrone L, Mannucci E, Magini A, Lotti F, Ricca V, Chiarini V, Forti G, Maggi M. Assessment of the relational factor in male patients consulting for sexual dysfunction: the concept of couple sexual dysfunction. J Androl. 2006 Nov-Dec;27(6):795-801. doi: 10.2164/jandrol.106.000638. Epub 2006 Jun 28. PMID: 16809271.
  3. Elena Colonnello, Erika Limoncin, Giacomo Ciocca, Andrea Sansone, Daniele Mollaioli, Giancarlo Balercia, Hartmut Porst, Hui Zhang, Xi Yu, Yan Zhang, Emmanuele A. Jannini, The Lost Penis Syndrome: A New Clinical Entity in Sexual Medicine, Sexual Medicine Reviews,Volume 10, Issue 1,2022, Pages 113-129, ISSN 2050-0521, https://doi.org/10.1016/j.sxmr.2021.08.001.
  4. Jannini EA, Nappi RE. Couplepause: A New Paradigm in Treating Sexual Dysfunction During Menopause and Andropause. Sex Med Rev. 2018 Jul;6(3):384-395. doi: 10.1016/j.sxmr.2017.11.002. Epub 2018 Jan 19. PMID: 29371146.
  5. E. Maseroli, E. Fanni, E. Mannucci, M. Fambrini, E.A. Jannini, M. Maggi, L. Vignozzi. Which are the Male Factors Associated with Female Sexual Dysfunction (FSD)? The Journal of Sexual Medicine, Volume 13, Issue 6, Supplement, 2016, Page S252, ISSN 1743-6095, https://doi.org/10.1016/j.jsxm.2016.04.029
  6. Nappi RE, Kingsberg S, Maamari R, Simon J. The CLOSER (CLarifying Vaginal Atrophy’s Impact On SEx and Relationships) survey: implications of vaginal discomfort in postmenopausal women and in male partners. J Sex Med. 2013 Sep;10(9):2232-41. doi: 10.1111/jsm.12235. Epub 2013 Jun 27. PMID: 23809691.
  7. Parish SJ, Hahn SR, Goldstein SW, Giraldi A, Kingsberg SA, Larkin L, Minkin MJ, Brown V, Christiansen K, Hartzell-Cushanick R, Kelly-Jones A, Rullo J, Sadovsky R, Faubion SS. The International Society for the Study of Women’s Sexual Health Process of Care for the Identification of Sexual Concerns and Problems in Women. Mayo Clin Proc. 2019 May;94(5):842-856. doi: 10.1016/j.mayocp.2019.01.009. Epub 2019 Apr 4. PMID: 30954288.
  8. Rosen RC, Heiman JR, Long JS, Fisher WA, Sand MS. Men with Sexual Problems and Their Partners: Findings from the International Survey of Relationships. Arch Sex Behav. 2016 Jan;45(1):159-73. doi: 10.1007/s10508-015-0568-3. Epub 2015 Jul 31. PMID: 26228991.

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