Depression is a very definite emotional overlay to the whole problem. Many women experience depression, bouts of irritability, feelings of anxiety and tension. Emotional conflicts often flare. By this time in life most children have grown up and have left home. The woman’s parents have usually died in recent years, or present a problem in a home or convalescent hospital.

Her husband has either failed in life or has made the grade. If he is a failure, there is not much chance of his extricating himself from it at this age. This fact, along with the economic and social stigma this can present in a vulnerable woman, is an extra burden she feels forced to face each day. Maybe he neglects her, and is more at home with his friends. Perhaps he drinks, gambles or otherwise spends more time following his own social pursuits than in caring for his wife.

On the other hand, if the spouse has made a success of his life, this inevitably means he is away from home for many hours each day, and perhaps is involved in trips on account of the business. He has little time to spend listening to her sad story, and often less patience to help her solve her problems that may seem trivial to him when he spends most of his waking hours involved in major decision- making experiences.

None of this benefits his wife, who often feels more and more alone in the world, deserted by all those who mean the most to her.

Doctors hear these sad but very plausible stories on a never-ending basis each working day:

“Life holds no more meaning for me.”

“Life has come to an end.”

“Nobody cares about me anymore.”

“Life is a bore, a drudge; I often wish I would never wake up in the morning.”

The sad phrases roll out regularly.

Because of the hormonal lack, the sex organs tend to be affected dramatically. With no oestrogen, the lining of the vulva and vagina thin out. They generally tend to shrink in size. However, while some women find that intercourse has lost its desirability and attraction for them, many others discover that their libido is considerably increased.

Suddenly, many realize that their child-bearing days are over. The risk of pregnancy is totally removed, and the need to take precautions for contraceptive reasons vanishes. This can add new dimensions to the thought of sex and intercourse. But when it comes to the physical act of lovemaking, the situations may be annoying and completely frustrating.

Penetration may be painful or difficult. The thin, atrophic, ageing lining tends to stretch less easily, and penile accommodation may be less readily achieved as in former times. Many women have found the demands of a thoughtless husband extremely trying. Considerable matrimonial disharmony can take place over this problem, and marriage disasters are not uncommon during the menopausal years.

Menopausal woman must be treated with love. Conversely, some husbands show a markedly reduced libido and capacity and desire for intercourse. Kinsey showed many years ago that after the age of 40, the sexual desire and capacity of most males tended to reduce gradually. Conversely, that of the female counterpart went in the opposite direction. So, once more, some women tend to accentuate their feelings of neglect. They believe their husbands no longer care, or are probably having an affair (usually imaginary) with some fictitious beauty.