Few positive images come to mind when you think of menopause. Bouts of moodiness, hot flashes, increased weight, sleeplessness, menstrual changes, and vaginal changes seem to define the process. Then there are all the myths surrounding menopause and sex. For years it was assumed that women's interest in sex and sexual function just went away, along with their estrogen levels. But, this isn't inevitable for every woman.

Menopause is the end of your menstrual cycle when your estrogen and progesterone levels decrease, causing several physical, psychological and emotional changes. The process can take years, and in most women, occurs around age 51 (although your mother's menopause is a good indicator of when you'll have yours). The process isn't considered complete until 12 months after a woman's last period.

Symptoms vary - some women experience no signs at all except the end of their period. When it comes to menopause and sex, some women experience a sexual awakening during and after the menopausal transition; many others struggle with sexual desire and function.

In a 10-year University of Melbourne study women going through menopause experienced a decline in sexual interest, a decrease in arousal and in the frequency of sexual activity, and an increase in vaginal dryness and pain during intercourse. These changes were linked to a plunge in the levels of the hormone estradiol or estrogen.

An online survey presented at the North American Menopause Society also exposed the difficulties many women experience with menopause and sex. Nearly 60 percent of respondents had vaginal difficulties (dryness, narrowing or shrinkage, and pain during sex) or increased urinary tract infections. Nearly 80 percent said menopause affected their sex lives and 47 percent said they had stopped or avoided sex because of physical discomfort.

But menopause doesn't have to be the end of your sex life. In fact, many women feel freer to express their sexuality because they no longer have to worry about their period or becoming pregnant. Also, the researchers in the Australian study explain that other factors are critical to sexual response during menopause. In particular, your relationship may have the greatest effect - it's capable of overwhelming hormonal changes.

Furthermore, the emotional baggage that accompanies menopause and sex is mostly in the women's mind, states the Mayo Clinic. While the hormonal changes are definitely responsible for the physical symptoms, it's mistaken beliefs and preconceptions that fuel the emotional symptoms. Menopause doesn't zap your sexuality, or take away your femininity or attractiveness. Here are a few ways to make the best of this life-changing experience:

Tips to Cope with Menopause and Sex

  • Get a checkup. Some difficulties related to menopause and sex may not be caused by the menopausal transition. Stress, depression, diabetes, or other illnesses can affect your sex drive. Also your doctor can treat menopause symptoms that affect sex such as vaginal dryness, and vaginal and urinary infections.

  • Have sex more often. Regular sexual intercourse helps you avoid some of the changes to your vagina that occur during menopause, according to the Mayo Clinic. Increased blood flow to your genital during sex helps to prevent or lessen the pain during penetration and thrusting caused by thinning vaginal tissues.

  • Be more physically active. Sleeplessness and fatigue during menopause can take a toll on your sex drive. Thirty minutes of exercise five days a week or more can re-energize you. Even better, be active with your loved one to enhance intimacy.

  • Consider hormone replacement therapy (HRT). Several studies show that taking estrogen or estrogen combined with progestin can alleviate menopausal symptoms and keep sex pleasurable. A new approach to HRT, the Wiley Protocol®, claims to alleviate many menopause symptoms including hot flashes and migraines. However, HRT carries some risks, such as certain forms of cancer. Find out from your doctor if this is a viable option for you.

  • Try natural menopause remedies. More research is needed on herbal remedies for menopause, states the National Center for Complimentary and Alternative Medicine (NCCAM). However, they report that ginseng can relieve mood swings and sleep disturbances. DHEA, dehydroepiandrosterone, a precursor to female and male sex hormones, may relieve hot flashes and restore sexual arousal. It's available as a supplement. Talk to your health care provider before you try any natural remedy for menopause.