Dear Lissa: I have a question about peri menopause and the clitoris. I had gone in for a regular exam and asked my doctor Why my clitoris seems to be “shrinking;” she sort of just blew it off and said it was just the age for that to happen. Needless to say I was stunned! Is this true? I’ve never heard about that. Is there some way this can be reversed? I may be 53 yrs old but I still want and have a full sexual life. Does this mean my days of the big “O” are dwindling away? Please say it isn’t so! Is there any information you can pass on to me? Thank you very much. I’m trying not to stress out about this.
–Worried About Size
Dear Worried About Size: Oh, honey. No. Don’t despair- and please don’t stress. Your sex life is not over. You’re your body may indeed begin to change, and you may have to work a little harder for the big O. At 53, chances are that your estrogen levels are pretty low, unless you’re on hormone replacement. And yes, things like the clitoris, as well as most genital tissue, are estrogen sensitive, meaning that when estrogen decreases in menopause, the tissues may shrink, become paler, thin out, and change shape. As estrogen levels drop, blood flow decreases, and because female genitalia, much like male genitalia, depends on blood flow, you may notice a change. Bummer, yes. But unfortunately, evolution hasn’t caught up with menopause, and the age of menopause hasn’t caught up with the fact that most women live long, healthy lives well into their eighties or nineties. No, the age of menopause hasn’t been pushed back as our longevity increases. But that doesn’t mean your sex life is over after menopause.
Some women notice no difference in the intensity of orgasm after menopause. Clitoral size does not necessarily determine orgasmic strength. But if you do notice that your sexual satisfaction is diminishing, talk to your gynecologist. Your doctor can talk to you about the risks and benefits of taking hormones, such as estrogen, progesterone, and perhaps testosterone, to strengthen your tissues and improve your sex life. Most importantly, don’t worry. The big O is yours for the taking. It just might mean a little personal TLC.
Lissa Rankin is a gynecologist and author. She blogs at owningpink.com, and you can follow her on Twitter at @lissarankin.