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Great Expectations

by Dr. Barb DePree MD

A woman born in 1850 could expect to live just past her 40th birthday. A woman born in 1900 was likely to make it to 50—assuming she survived the flu epidemic of 1918 and other hazards. I looked up this life-expectancy data to help me understand why we have so little shared understanding of how menopause affects women.

We think of biology as something that changes very slowly, if at all. Since the beginning of time, we think, girls have menstruated, grown up into women, entered perimenopause, and then, at some point, achieved menopause. And then…

This is where the big change (no pun intended!) has happened. Our life expectancies have increased dramatically. Only 100 years ago, it was typical for women to die before they reached menopause. Our generation, in contrast, will live a third of our average-75-year lives post-menopause. Our granddaughters (born in 2000 or later) could be post-menopausal for closer to half of their 80-year-plus lives.

A third of our lives post-menopause? That’s good reason to make sure we women know that menopause is not the end of our sex lives. Sex is good for our health: it bolsters our immune systems, releases good hormones, helps protect (like other exercise) against heart attack and stroke, burns calories, relieves chronic pain.

Sex is good for our mental health, too, protecting us against depression and stimulating feelings of affection and intimacy. And sexuality is part of our identities, part of what we are.

Sex is part of a life that is not just longer, but happier.

It’s a research report I read recently that’s brought all this to mind. Most of the REVEAL (Revealing Vaginal Effects at Mid-Life) study participants said they weren’t aware of all the effects of menopause—on their vaginal tissues, in particular. Eighty percent of the participants who experienced painful intercourse said they’ve “learned to live with the vulvar and vaginal symptoms… as a normal part of getting older.” And 61 percent of those women felt it was “still taboo” to acknowledge menopause symptoms like painful intercourse.

Live with this for a third of our lives? Give up on—or suffer through—an aspect of who we are and what makes us happy?

I don’t think so. I often use a reading glasses analogy: When, as a part of aging, our eyesight is less acute, we get reading glasses, or a stronger prescription, or bi- or tri-focals. We joke about the type size on menus, and we ask for more light in the restaurant. We don’t give up on seeing! There’s too much of life still before us.

We need to understand the changes that are affecting us. We need to know there are ways to compensate—as with reading glasses—so that we can maintain our sexuality. And we need to let go of the notion that our health and happiness for a third of our lives is somehow a “taboo” subject to talk about—with our partners, our friends, our health care providers.


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