Sex and the menopausal woman : a critical review and analysis

Medical discourse has positioned the menopausal transition as a time of sexual atrophy and loss of femininity, with hormonal replacement as the solution. In contrast, feminist critics have argued that women’s experience of sexual embodiment during menopause is culturally and relationally mediated, tied to discursive constructions of aging and sexuality, which are negotiated by women. The aim of this article is to present a critical examination of women’s experiences of sexuality during and after the menopausal transition, drawing on previous research in this field, as well as qualitative research we have conducted with women at midlife, and women who have experienced premature menopause as a consequence of cancer treatment. We aim to challenge myths and misconceptions about the inevitability of sexual decline at menopause, as well as normalise the embodied changes that some women experience – whether menopause is premature, or occurs at midlife. We argue that sexual difficulties or disinterest reported by women during and after menopause are more strongly associated with psycho-social factors than hormonal status, in particular psychological well-being, relationship context and a woman’s negotiation of cultural constructions of sex, aging and femininity. However, sexuality can continue to be a positive experience for women throughout adult life and into old age, with many menopausal women reporting increased sexual desire and response. This undermines the biomedical construction of menopause as a time of inevitable sexual atrophy and decay.