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But otherwise minor surgery may be needed to repair a prolapse or damage to the pelvic floor.’HRT, which contains oestrogen and progesterone, can help keep the vaginal tissues strong and boost natural lubrication.
It’s not just the decline in oestrogen and progesterone that have an effect: your levels of testosterone (which women produce in smaller amounts than men), also fall, affecting sex drive, mood and energy.
This is also a time when a woman’s confidence in her sexual attractiveness can falter, and there may be anxieties about children growing up and leaving home (or not leaving) and increasing commitments to aged parents.
Our sense of sexuality is so subtle and emotionally linked that psychological factors certainly play a part.
Sexual problems affect an estimated 20 to 40 per cent of women at this stage of their lives, so you are not alone if you’re having difficulties.