Menopause is no pleasure trip. Along with hot flashes, sleepless nights, slipping memory, and lousy moods, a lot of us put up with painful sex. As estrogen falls, vaginal skin thins and loses elasticity—and then, ouch.
“There are about 65 million menopausal women in the United States,” says Dr. Ricki Pollycove, a gynecologist at California Pacific Medical Center in San Francisco, and co-author of The Pocket Idiot’s Guide to Bio-identical Hormones. “And eighty percent of those—about one in three menopausal women– will develop this condition called dyspareunia, or painful sex, related to vaginal atrophy.” That’s a lot of women having no fun in bed.
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Most treatments—a vaginal pill, vaginal rings, vaginal creams–are estrogen-based, says Pollycove. Another option is a newly approved non-estrogen oral medication, ospemifene (Osphena).
The Shionogi Company, which developed Osphena, is also confronting painful sex through an education campaign called Finding the Words. We talked to Oscar-nominated actress Virginia Madsen, 51, star of the upcoming movie The Hot Flashes, about the condition, why it’s important to her, and what it’s like to face aging in Hollywood.
Spry: Why did you get involved with the Finding the Words Campaign?
VM: To get the word out about dyspareunia, or painful sex–to talk about menopause, the vagina, and sex. And who better to talk about sex than Virginia Madsen? I’m following in Dr. Ruth’s [the TV sex therapist] footsteps. Can’t you just hear her: It’s so juicy and wonderful making the vagina better.
Spry: Is dyspareunia something you or friends are experiencing?
VM: No, I’m just in perimenopause. But I wanted to find out what’s ahead. And I’d never heard of dyspareunia. For some women sex becomes so painful, they stop having it. But this condition can be treated and reversed.
Spry: Why do women stay silent about it?
VM: Women have a long history of not telling the truth to doctors. They don’t want to seem complaining, or they feel the doctor is in a rush, or they’re embarrassed. Not everyone is comfortable talking about sexual health. But it’s so important to our overall health. And sex is a vital part of lives. If that is taken away, what does it do to our self-esteem?
Spry: How can women talk about painful sex with doctors?
VM: By empowering ourselves with knowledge. This campaign and website are ways to find out what the condition is and how it is treated. Take notes from the website and take them to the doctor’s. If you don’t know how to bring it up, practice what you want to ask with a girlfriend.
Spry: How can you talk with your partner so he doesn’t think this is just another version of “Not tonight, honey, I’ve got a headache”?
VM: It depends on how open your relationship is. It’s very healthy to talk about sex and what your needs are. Look at the website together and say, “I think this is happening to me. I want you to read this. I want to know what you think.”
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Spry: How are you feeling about aging?
VM: I feel more beautiful than I ever have in my life. Because I’m more confident, I’m more empowered, and I don’t have to hold back on my opinions or sex life.
Spry: How do you stay in such good shape?
VM: Three times a week no matter what, I do Bikram yoga, and Pilates in-between. If I get bored, I’ll hike or swim. My body is in better shape than when I was 25. I know it will change, and that’s coming, but right now I feel so strong. I love my body—even the bits that I don’t quite love.
I also have a healthy sex life. That gets the endorphins [feel-good neurotransmitters] going. I’m not married. I did that once. I have a wonderful lover—and I encourage everyone to.
Spry: Is it tougher to age in Hollywood?
VM: I never bought into the whole myth about aging in Hollywood. I can’t change someone’s perception about my age if it’s negative. But I’m in control of how I feel about myself. I have great role models: Helen Mirren, Susan Sarandon, Meryl Streep. We are allowed to age in Hollywood. And women are taking the reins now and controlling how we are portrayed.
Spry: What’s your attitude about plastic surgery?
VM: Right now I use injectables–fillers like collagen–that replace what you lose as you age. It’s important to age so you still look like yourself. If I suddenly blew up my lips, my audience wouldn’t trust me. If I altered my face to something artificial, for me, there’s a dishonesty in that. But if you like that look, be honest about that.
Spry: What’s it been like to work on The Hot Flashes, your movie about middle-aged, former female basketball stars who challenge the state high-school champs to raise money for breast cancer?
VM: My character is the one who denies that she has hot flashes and gets pummeled by basketballs from the entire team. Eric Roberts’ character tells Brooke Shields’ character that we’re making fools of ourselves, that we’re not leading ladies anymore, like we’re not supposed to be doing something physical. It stings, but we keep fighting against it.
Our characters’ stories are important for women of any age because these stories are almost nonexistent. I invite women to come out in droves to support the film.
Spry: Have you had discussions with your co-stars Wanda Sykes, Brooke Shields, Darryl Hannah, and Camryn Manheim about what it’s like for American women to age?
VM: Gosh, yes. We all fell in love with each other. And we’ve had lots of discussion about aging. What matters is how you feel personally about each new phase in life. Sometimes a comment may sting, but if you’re standing tall, aging won’t matter as much.
We all started acting when we were really young, and we were all labeled: Brooke as she was modeling and trying to be an actress, Daryl and me as sex symbols, Camryn about weight, Wanda about color. But it didn’t matter to any of us because we made it through all that wilderness.
Spry: What was it like playing all that basketball at 51?
VM: On the set, Wanda was the one who never got hurt. We’d all be limping around with a giant bottle of ibuprofen or lying on the ground, and she’s like, “Why aren’t we filming?”