Being rigorous, most of the times when we talk about menopause we would have to talk about climacteric. They are two different concepts and they are not synonymous. In the words of the sexologist Francisca Molero , “menopause is only one day in a woman’s life, the last day of her menstruation, while the climacteric or perimenopause is the entire process before and after.”
Interestingly, climacteric comes from the Greek term klimater, which means ‘step’. A step between two stages: the reproductive period and senescence. A step that can be used to go up or down. María José González, midwife and sexologist, has no doubts: “It is a step up, although it is popularly perceived downward: less young, less attractive, less healthy, not reproductive,” she explains. For this reason, he advocates another look: “Always forward: just as attractive, sex finally free of pregnancy, with more knowledge, desirable, free from social pressure in the face of many stories, with more wisdom.” Women are not always to stay the same. Women have lived, live and continue to live with and without climacteric. They evolve.
However, it seems that this optimistic perception is not yet widespread. What the psychologist and writer Anna Freixas calls fear-pause abounds. “There is fear of old age and loss of position in the current sex market, in which maturity does not fit,” he says.
Menopause still bears a negative burden from a longstanding Western history. If the woman is reproductive, it is valid. When it ceases to be, things get complicated. González considers that “there is a paternalistic medicine, with a marked masculine bias, which understands that menopause is a period in need of treatment. Women need to be treated to remain young and beautiful, among other things, and the boom in hormone replacement therapy begins ”.
González is not against the treatments, but clarifies: “Women go to their gynecologist, almost always male, to have their check-ups, and they leave with a treatment under the arm to avoid feeling hot flashes, to have a more hydrated vagina, more hydrated skin, etc. It is true that in some cases it may be necessary, but also that in many it is not so much. Considering that what is happening needs treatment already places women in a vulnerable place, of loss and illness ”.
The medicalization of this stage of life has managed to place itself, on a social level, as the first option. In other societies where knowledge is given more value, women, upon reaching menopause, have another look at themselves, and society on them. For Thai women, for example, it means the acquisition of a stronger social position, as indicated in a study by researchers Punyahotra, Dennerstein and Lehert, from the University of Melbourne (Australia).
In fact, this view is not alien to medicalization. Living the menopause with acceptance predisposes to a minor psychobiological symptomatology; which, in turn, may mean not requiring treatments to alleviate the changes, as indicated in the book The Age of Menopause , coordinated by the endocrinologist Antonio Becerra-Fernández. However , hot flashes or dryness of the vagina can be extremely real and uncomfortable and not due to psychosomatic causes. Not everything is white and not everything is black.
The climacteric stage and all its physical changes, in addition to those of aging, coincide with many other possible changes. Perhaps the care of dependent elderly people or of the grandchildren and granddaughters, with the consequent burden of domestic tasks, perhaps the empty nest syndrome when the children grow up and leave – as pointed out by the gynecology specialist Miguel Lugones – perhaps the deterioration of the relationship, perhaps retirement … Situations that can affect health, the economy, routines, social relationships and, obviously, also sexual relationships.
The sexual response changes, but not everything is due to aging or low self-esteem due to feeling less young and less attractive – something that, in any case, is no more than a subjective perception. Nor is it all explained by the drop in hormones, which is usually blamed for the decrease or absence of desire, something that González does not agree with: “I am convinced that estrogens have little to do with this. One should begin to consider that it is not just about hydration of the vagina or looking for a female viagra for arousal. Other possibilities must be considered. Psychological factors and external inducers influence, as well as the rhythm of life, the quality of emotional intimacy, the presence of diseases and treatments, the couple’s difficulties in this regard, etc. But let’s not forget the type of erotic practices. An erotica basically centered on intercourse at this stage of life is the least aphrodisiac there is ”.
A woman without the desire for intercourse can be a woman full of desires: caresses, kisses, sleeping embraced, perceiving through all the senses, sharing a bathroom, etc. Not everything is reduced to intercourse, nor is intercourse a guarantee of happiness. In fact, a woman without the desire for intercourse can be extremely happy satisfying the rest of her desires, she can even be happy without erotic desires if this does not cause her discomfort.
The conclusion of all the comments was already anticipated by the Nicaraguan poet Gioconda Belli: “The body is much more than hormones. Menopausal or not, a woman is still a woman; much more than a factory of humors or ovules. Losing the rule is not losing the measure, or the faculties; It is not to get like a snail in a shell and lie down to die. So there is no reason to feel devalued ”.
The average time between the onset of climacteric menstrual changes and menopause is four years, with great variability from one woman to another. Among the alterations, the following stand out:
• Hot flushes. Sudden and transient sensation of heat that begins in the neck and rises to the head.
• Night sweats.
• Vaginal dryness, dyspareunia, and decreased libido.
• Insomnia. Alteration of the sleep-wake cycle.
• Risk of osteoporosis and damage to cardiovascular health.
• Psychological effects: depression, anxiety, irritability, memory problems and lack of concentration.
But despite menopause, there are also many important things that do not change. For example , erotic relationships at this stage continue to increase health, self-esteem, and emotional control. They constitute a very adequate respiratory and muscular activity, in addition to releasing substances that increase good mood, improve the couple’s relationship – if any – and combat the feeling of loneliness.
Of course, sexuality during the climacteric continues to be of all possible colors: homosexuals, heterosexuals, bisexuals, with functional diversity, with love or without love, individual or as a couple, etc.
