Intimacy, sex and dating after early menopause: Women’s experiences

It changed who I felt I was so, yeah… And it, you know, it’s hard to be sexy when you’re cranky. [laughing] When you’re hot flushing… to think of yourself as a sexual being when you are experiencing hot flushes every hour and you’re going, ‘I don’t want anyone near me. All I want to do is feel cool,’ you know, turn the fan on high.

Yeah. It’s one of those, you know, drawbacks and that you have to sort of… you’ve got to open a whole new conversation up with, you know, the loved ones in your lives about this, about, you know, that things have changed. You’re not the person you were before surgery or menopause. You’re suddenly a different person, so, yeah… And then that all changes. It, you know, things become a little bit more longer to take, you know, you’ve got to just warm up to the idea and also [laughing], wellit’s going to, you know, ‘Okay, I’ve got to think about this,’ you know.

‘Do I really want to have intimacy as part of my life? Yes I do. And what can I do to sort of get around it?’ And then also have a sense of humour about, ‘My gosh, I’m going to have a hot flush, you know, it’s not very sexy, you know.’ And, kind of, just working that out and having someone who goes, “It’s alright, you know, you are experiencing a hot flush. It’s part of life, you know,” and doesn’t treat me as a sort of a, “You’re all hot and sweaty.” [laughing]

It sounds like you’ve had good support in your partner.

Yeah, I have. I’ve been very, yeah, it’s been fantastic! So because I know how hard it is for some whose husbands or partners didn’t understand the processes, because it’s kind of the conversations I’ve had

You don’t realise the impact that that has on intimacy and especially I think the loss of libido. You’re a young fit healthy woman and then all of a sudden you’re just not really interested in intimacy, it’s just like, ‘What has happened?’ You kind of feel ripped off in some ways and you know it’s hard on your husband too, because they’ve got to change their lifestyle. And it’s not only loss of libido but it’s like less enjoyment, it can be painful, it’s like all these other things that you don’t realise. And I don’t really think I read anything like that so I just had no idea.

We chat about it. It still is difficult for him and I’m not saying there’s no intimacy, but it’s just, you know, sometimes there’s frustration because, say for example, he might say, “It would be nice for you to initiate something.” But you just go ‘Well, to be honest, I’m just, I just couldn’t care less,’ and that’s really terrible and I think you just have to make an effort because you still have to make them feel special and it’s a partnership, it’s a marriage, that’s it, you know, it’s part of your marriage. Intimacy is really important.

I think that’s the main thing, that has the biggest impact on your relationship I think, because also if there’s less intimacy you feel less connected also and then it’s easier to just keep going in that direction. Because it’s easy for you, because, you know, it’s easy, but then you disconnect more and more and more and that’s why intimacy is so important because you reconnect again, so that’s the biggest thing I think.

HRT definitely helped. I mean when it’s too painful to wipe yourself going to the toilet, that’s not something that you want to be gone near whatsoever. And again I think you feel, it sounds, ‘less of a woman,’ is not really, you know, the cliché kind of way, but you’ve got a loving partner who’s been through all of this with you. You’ve got to the other side and you’re still not normal? I think you’re disappointed in yourself, definitely hard.

Very lucky again, to have a partner who never pressured me or made me feel like I needed to be at a stage that I wasn’t ready for, for sure. And I think that’s, in a sense maybe that’s how your relationship grows so deep, is going through all of that hardship without necessarily any sexual chemistry or action to back it up. You have such a long time of your closeness growing out of other things that when you can add that back into the picture, your relationship’s amazing yeah.

It was quite impactful on your relationship as well, your enjoyment of sex and desire for it and that sort of thing, and again, that didn’t seem to improve over time. I thought that that sort of might be just get through menopause and then sort of it might improve or what have you, but it didn’t. So that was another reason for finally going onto the HRT.

I would say really the only thing that’s impacted me was the desire, the level of desire, and yeah, I think perhaps if you were a straight person, it might be different in terms of the actual intercourse itself, but you know, but for me that’s okay. But it’s the actual desire levels that’s probably quite impactful, and I didn’t anticipate. Like they had often spoken about how, “Oh your, you know, your desire levels could go down,” that sort of thing.

But that was one of the things that that GP, that specialists assessed where I would say, “Oh no, it’s okay,” or whatever, if they ever asked. Then on a scale of zero to ten I gave myself about a one for that, where it would have normally been about an eight, nine, ten or whatever. So that was probably one that did come quite to the fore, and it has only improved a little bit with the HRT, which is one of the things that you just have to cope with, and that’s one of the, again, the pros and cons. They are definitely there, and that would probably be a big one for sure.

It’s again, having a very supportive partner makes… and I don’t know if it’s easier because it’s a woman, so she might be more sympathetic or something like that. I’m sure that can’t be true. There’s lots of men who are very sympathetic and lots of women who are not. So you know, it’s probably more of just a personality thing. And just, you know, a supportive relationship and everyone has pros and cons, you know. So we manage, but that was probably one of the biggest things that I was not prepared for, the degree of impact that it would have.

The side effects a lot of women get is vaginal dryness, which can be dryness of your skin everywhere. But with that in particular I did actually discuss that at the menopause clinic. That was something they brought up which I found really helpful. And there are vaginal moisturisers that you can use. There were other things they went through but that option appealed to me the most so I can’t actually remember what the other options were I’m sorry [laughing]. So that was something that appealed to me because it sounded like it was an easy way to deal with the problem.

Also they recommended that during sexual intercourse you use lube. I think with some lubrication there’s also other factors involved like whether it’s flavoured or whether it has extra chemicals, I’m not sure. But they also recommended using a personal lubricant during sex that lasts a long time and it’s a comfort thing. Obviously a dry vagina is not a comfortable vagina. [laughing] Particularly during sex. But it’s also something you need to worry about in regards to tears and things like that. It can affect you in that way as well. And that’s obviously something you really want to avoid so use lubrication every single time. [laughing] It’s not something we can have sex without now because of the dryness so.

And apart from sex do you feel it, like, in your day to day life and do you use the moisturiser then?

I didn’t feel it actually. Before I was using the vaginal moisturiser it felt exactly the same for me. But it definitely makes a huge difference during sex. That’s when I noticed it. My partner and I were talking about it just the other day and I mentioned to him that the first time we had sex after my oophorectomy we were… I had already been using the vaginal moisturiser, but I think I’d only used it once. So I’m not sure how effective it was at that point, and we did use lubrication but it felt like my first time.

It was quite painful the first time we had sex after the oophorectomy even though we were doing all the right things. And it was something we had to take very slow and very gently [laughing]. So it changes everything pretty much. Or at least it has for us. It’s something we need to be very aware of now. It’s not a spontaneous thing anymore. It’s something we have to prepare for and, yeah, that’s changed. It’s not changed in a bad way really but it is something we need to think about and manage as opposed to something that, as I said, could be more spontaneous. [laughing]

I think the other thing that was common was communication with your partner. I have excellent communication with my partner, we always have had, and we’re very lucky in that respect. Some of the women I spoke to weren’t supported or didn’t feel supported at all by their partner and that caused a lot of problems, particularly when it comes to sexual matters.

Without that communication it’s easy to just build up, like, a resentful feeling because most women lose their libido or it’s at least lowered a lot and then you’ve got the problem of when you do actually have sex there’s extra things you need to do now. [laughing] And if there’s no communication, if you’re not open about that I can see how that would easily lead to quite a lot of problems within the relationship. Don’t dismiss it out of hand. Make sure this is something that you talk about with your partner because it’s not something that if you ignore it it’s going to go away. You need to address it. You need to assess where you’re going to go from here without that, without having a sexual relationship that is the same as it was before. It’s different now, you know, there’s no going back. You need to address that in an open and healthy way.

I think a bit of it was caught up in my own sense of myself and that I didn’t feel particularly attractive but I just didn’t feel interested in sex at all. You know, like, once it was over, the newness of someone new and someone exciting, I just kind of felt like that spark just wasn’t there. It was pretty difficult to deal with because that was very different to how I would have responded to someone before, you know, and I thought ‘God, you know, here’s this amazing woman, she’s incredible.’ And, you know, I just felt like my body wasn’t responding in the way that it ought to or that it would have and I just, I didn’t know how to talk about it, you know. Because I knew that [partner] would see it as a reflection on her that was difficult.

So, I knew that my inability to talk about it was starting to have an impact on our relationship. So I had to talk to someone about it. Yeah. So I went to the counsellor and I think it was useful for just acknowledging it for what it was but also I think a bit in saying, ‘Well, yes, it’s whatever it is, the contribution of this, you know, early menopause isn’t helping.’

But also I think it was an opportunity to say, you know, “The last three years,” – my friend called it the ‘trifecta of shit.’ You know, she says, “Your mum died, your partner left you and you got cancer.” And she said, “There’s also a bit to do and the family’s response to my relationship breakup.” I think there was just a lot of – she said – I think she called it, like, ‘residual trauma,’ or something. She just said, you know, “There’s an awful lot of stuff that’s gone on and all of these things are, you know, in some way sort of compounding what you’re going through at that point in time.”

I had my hysterectomy and oophorectomy. So at 33, I then became celibate for 14 years. Because I think when you, well, for me – I’m not sure about anyone else – but for me when you’re so young and you have, you know, a hysterectomy and an oophorectomy it changes the way you think about yourself and your potential desirability, your I want to say utility [laughing], but that’s a very kind of stark word. But I guess your sexual identity, yeah, and how desirable or otherwise you feel to a potential partner. And then when you have a breast removed in addition to that it kind of, you know, it’s even worse really [laughing]

So these are the things, I guess, that you mightn’t often think about but that impact in other ways in terms of life. Yeah. So at 46 I developed a relationship with a man that I’d known for 20 years and we’re now married this year, so I think it’s, like, six months that we’ve been married, which is awesome. But sometimes it takes a while to kind of get there. Yeah.

When we first became physically intimate I wouldn’t take my bra off because I didn’t have reconstructive surgery initially and now the breast surgeon won’t do it because of the heart issues that I have. And, yeah, so I wouldn’t take my bra off because I didn’t want him to see me breastless I guess, yeah. And I think that was also one of the hardest things, you know, after the hysterectomy kind of getting used to, you know, the big scar and all of that sort of stuff. But after you have a mastectomy, like, someone said to me, “How long did it take you to look in the mirror?” you know. And I said, “Oh, about four days.”

Because you avoid that because it’s, you know, it changes your physical appearance and, you know, your sense of sensuality or sexuality or, you know, feminine identity and all that kind of stuff. Yeah, so it took me a long time. Having one breast doesn’t make sense. It doesn’t make sense to anyone, you know. Bras are uncomfortable. Sometimes your prosthesis becomes dislodged and it’s up around your neck or you’re uneven or – all of those sorts of things.

It’s actually made it really hard for me to date too as a single person because, I mean… like I said I was 24 when I was first diagnosed and single at that point. And so, after that first bout of everything and surgery that actually hit me quite hard emotionally because… I can’t even really explain why.

But, you know, having one ovary removed almost… even though I still had the other one, which now thinking back, I was, like, “Why didn’t you take advantage of that and get out there and find somebody?” But [laughing] at the time I sort of felt like, you know, part of my womanhood had been taken away and, you know, I didn’t get back onto the dating scene for, like, probably three years or something until I could sort of build up enough, you know, self-confidence to have another try.

And, you know, then I went on a few dates with a few guys and, you know, but then after a couple of years of that we got the recurrence and, bam, got me again. [laughing] So [laughing] – and for a while there in, like, from 2011, 2012, they were sort of nightmare years because not only… I sort of didn’t even mention, like, it came back in the ovary. But then I also had one just on the side of my spine that came back as well. And, so there was quite a big surgery for that as well and they were all, you know, within the course of a couple of years.

But by that stage I’d sort of, yeah, well, I made my way emotionally through all that stuff back in, you know, ’05, ’06 whatever. And so I did sort of bounce back to the point of being able to say, “Okay, I’m going to give dating a go again,” a bit quicker. But for those couple of years it almost felt like every time I gave it another go, bam, recurrence! [laughing]

So, yeah, I’ve, like, I’m 35 years old and I really haven’t [laughing], really haven’t had much of a fair go at a serious long term relationship because I just [laughing]… because even now it’s… It took me down again a little bit in 2013 when I actually went menopausal because then it’s, like, “Okay, well, now I definitely can’t have kids.” And I’m menopausal so, you know. [laughing] So, yeah, it took me a little while again to have another go.

And, yeah, it makes it really hard because it’s… I mean, it’s hard enough dating anyway, isn’t it? But then you find someone who you think, “Oh, I kind of like this guy.” But then I’ve got to tell them that I’m menopausal and I can’t have kids. And that I’ve got this cancer that’s, you know, that keeps coming back all the time. Which at the moment that is still the case, but I’m really hoping that these drugs might clean it up and at least that’ll be one thing that I can say, “That’s probably hopefully gone.” [laughing] But I’ve still got all this other stuff that it’s never going to change.

I find myself thinking if I met someone, how I will tell him and what will be his reaction with this? Yeah, and on those years I had three boyfriends. So one who suffered with the symptoms, one who suffered [laughing] when I found out the problem and he struggled and didn’t know how to handle the situation. And one that met me really mature and with a knowledge of myself. And I can notice how I grew up in this time and how this was good because I know I am a different person since then, I know in this three, four years my mind changed, my opinions, everything changed and I feel that I’m much better person nowadays.

So, yeah, the last one reacted really well. He supported me and he is older than me and he have a kid. So I told him, “Look, I don’t know how will be my reactions with your kid because for me it’s a big deal. And I don’t have many kids around me all the time so I don’t know how to interact with them.” [laughing] And plus this problem.

But, yeah, I think I did quite well. [laughing] The kid liked me so that’s good. [laughing] Yeah, so this last one was good because he really understood and support me and, yeah, it was fine. But, of course, in the beginning it was, like, ‘Oh my God how I will say that?’ So probably because I knew he was older and he already had his own family for him it’s not a big deal. But maybe for a guy from my age and who never married maybe it will be something not so good to tell. [laughing]

With my last boyfriend, of course, I wanted to have and construct a family with him. So the way that I put those ideas for him is different from other ones. Like nowadays I don’t… I start – even with my friends – I don’t say, like, “When I have a kid.” I say, “When I adopt a kid.” So I changed the way that I put the things. So I think this is good and how I put my ideas and how I speak with people, I can fix this on my own mind too.

Like, the second one, I was desperate because everything was happening and he left, just like this. Like what? In that time I couldn’t understand. I thought he was a coward. But now I can understand him and I know it’s something really difficult to handle.

You mentioned at the start the impact on your sex drive was quite bad. Was that in terms of, you know, desire to have sex or was it also that you were experiencing a lot of dryness?

A bit of both actually. I just had no… if I’d never had, like, at that point if I’d never had sex again I couldn’t have cared less. And, yeah, things certainly did dry up so to speak, and it hurt. It actually hurt. And I just wasn’t into it. I just couldn’t be bothered.

And that quite bothered you because – – –

I don’t know if it upset me because I’d sort of lost the feeling of what it was like. And I knew I was missing out on something and I thought, ‘Well, maybe if I do HRT that might fix it and also do the testosterone cream.’ Which my friend had told me she had been on the testosterone cream and things improved, you know, wildly for her. And I thought, ‘Well, maybe that’s what I need.’ And things did improve for me after I did the testosterone cream and the HRT. It was just phenomenally better. [laughing] So, yeah, it just wasn’t as dry as I had been and I had a sex drive again, where I’d… there’d been just completely non existent. Yeah, I suppose it was a bit of the both but, yeah.

And the testosterone cream, you’re still on it at the moment?

Yes.

Okay. And it’s not, like, like, the HRT where you think you might have to stop it?

I don’t want to stop it. [laughing] I quite enjoy having a sex drive again. It’s not actually part of the HRT, like, I don’t have to do it. But I’d talked to the endocrinologist and I said, “Look, I’d I’d really like to have sex again and I’d like to feel like I want to have sex again.” I said to her my friend had, you know, told me about this testosterone cream and can I have it too? And she said, “Yeah. Absolutely.”

She was so understanding. She never sort of said, “Well, why do you need it? You don’t have a partner or whatever.” [laughing] There was no judgement or… She was, like, “Go out and get as much as you can.” [laughing] It’s, like, ‘Yes, finally a doctor who understands female sexuality!’ You know, because I was obviously not having sex with my husband anymore. [laughing] So having sex again with boyfriends or whatever it was wonderful, so, so much fun! [laughing]