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Бажання й близькість у перехідні роки: що змінюється і як повернути комфорт

5 хвилин читанняПеревірено спеціалістом VIA-L · 17.10.2026

Бажання стало приходити рідше, близькість іноді неприємна чи болісна, і про це ніяково говорити навіть із лікарем. Ви не одна: це одна з найчастіших змін у перехідні роки — і одна з тих, що найкраще розв’язуються.

Що змінюється з бажанням

У перехідні роки часто зникає спонтанне бажання — те, що виникає «саме». Це не поломка. У багатьох жінок бажання відповідне: воно приходить уже під час близькості, а не до неї, — і це здоровий варіант.

На бажання впливають не лише гормони. Найбільше заважають:

Сухість і дискомфорт: терпіти не треба

Сухість, печіння, біль під час близькості, часті позиви чи повторні цистити бувають у половини жінок після менопаузи й більше. Але про них майже не говорять: лише приблизно половина розповідає лікарю, а більшість не знає, що з цим можна впоратися.

Важливо знати: на відміну від припливів, це саме не минає і з часом посилюється. Зате добре піддається допомозі. І ще одне: біль веде до уникання близькості, а уникання — до спаду бажання. Прибрати дискомфорт — часто означає повернути й бажання.

Що можна почати одразу, без рецепта

Зволожувач і лубрикант — це різні речі. Їх постійно плутають:

Регулярність важить не менше, ніж сам засіб: «дороге» не означає «дієве».

Тренування м’язів тазового дна й регулярна близькість чи стимуляція підтримують кровотік і комфорт.

Прибрати подразники: інтимне мило й гелі, спринцювання, ароматизовані засоби, тісну синтетичну білизну. Пити достатньо води, не курити.

Що може запропонувати лікар

Якщо зволожувача й лубриканта замало — варто поговорити з гінекологом. Є місцеві засоби, зокрема з низькою дозою естрогену: вони діють на місці, майже не всмоктуються в кров і, за багатьма дослідженнями, помітно зменшують і сухість, і сечові симптоми. Є й негормональні варіанти. Який підходить вам, вирішує лікар.

Що не допомагає

Коли до лікаря

Що спробувати цього тижня

На чому ґрунтується

Статтю написано за темами бази знань VIA-L. За ними стоять опубліковані роботи — ось вони:

  1. Hyaluronic Acid for Vaginal Health and Quality of Life in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials — International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 2026 doi
  2. Effect of Lactobacillus-Based Probiotics on Genitourinary Syndrome of Menopause in Post-Menopausal Women: A Systematic Review — Maturitas, 2026 doi
  3. Vaginal Estrogen Prescription is Associated with Reduced Risk of Serious Adverse Outcomes in Women of All Age Groups with Recurrent Urinary Tract Infection: An Epic Cosmos Database Analysis — Urology, 2026 doi
  4. Soy Isoflavone Supplementation and Sexual Function in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials — International Journal of Impotence Research, 2026 doi
  5. Cognitive Behavioural Therapeutics for Insomnia Symptoms in the Perimenopause Through to the Early Postmenopausal Period — The Cochrane Database of Systematic Reviews, 2026 doi
  6. Evaluating Tools for Assessing Mental Health Disorders in Perimenopausal Women — International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 2026 doi
  7. FIGO Best Practice Recommendations for the Mental Health of Women at Menopausal Age — International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 2026 doi
  8. Cognitive-Behavioral, Acceptance-Based, and Mindfulness-Based Interventions for Psychological and Sleep-Related Symptoms During Menopause: A Systematic Review — Acta Psychologica, 2026 doi
  9. Cognitive-Behavioral Interventions for (Peri)menopausal Symptoms: A Scoping Review of Interventions Characteristics and Content — Patient Education and Counseling, 2026 doi
  10. Pathogenesis and Potential Therapies for Perimenopausal Depression: Insights From the Estrogen-Gut Microbiota Axis — Frontiers in Neuroendocrinology, 2026 doi
  11. Depression — Lancet (London, England), 2026 doi
  12. Recent Advances in the Relationship Between Mental Symptoms in Postmenopausal Women and Estrogen Fluctuations — Journal of Psychosomatic Obstetrics and Gynaecology, 2026 doi
Показати всі (116)
  1. Effect of Saffron on Depression, Anxiety and Mood Disorder: A GRADE Assessed Systematic Review and Meta-Analysis of 34 Randomized Controlled Trials — Nutritional Neuroscience, 2026 doi
  2. Reframing menopause and menopause hormone therapy as opportunities for healthy aging — Science, 2026 doi
  3. Efficacy of Mobile Apps for Urinary Incontinence in Women: A Meta-Analysis of Randomized Controlled Trials — Frontiers in Public Health, 2026 doi
  4. Vaginal lasers for treating stress urinary incontinence in women — Cochrane Database of Systematic Reviews, 2025 doi
  5. The Effectiveness of Vitamin D as an Alternative to FDA-approved Treatment and Other Therapies for Managing Vulvovaginal Atrophy and Sexual Inactivity in Postmenopausal Women — International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 2025 doi
  6. Vaginal Estrogen Use in Breast Cancer Survivors: A Systematic Review and Meta-Analysis of Recurrence and Mortality Risks — American Journal of Obstetrics and Gynecology, 2025 doi
  7. The Effect of Pelvic Floor Exercises on the Quality of Life in Postmenopausal Women: A Meta-Analysis of Randomized Controlled Trials — European Journal of Obstetrics, Gynecology, and Reproductive Biology, 2025 doi
  8. Efficacy of Fractionated Carbon Dioxide Laser for the Treatment of Genitourinary Syndrome of Menopause: A Systematic Review and Meta-Analysis — Obstetrics and Gynecology, 2025 doi
  9. Updates in Clinical Management of Recurrent Urinary Tract Infections — Obstetrics and Gynecology, 2025 doi
  10. Probiotics: Utility, Benefits, and Risks for Gynecologic Conditions — Current Opinion in Obstetrics & Gynecology, 2025 doi
  11. Energy-Based Interventions for Genitourinary Syndrome of Menopause: A Systematic Review of Randomized Controlled Trials and Prospective Observational Studies — Menopause (New York, N.Y.), 2025 doi
  12. Isoflavones Improve Vaginal Atrophy, Skin Health, and Sex-Related Hormones in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials — Menopause (New York, N.Y.), 2025 doi
  13. The AUA/SUFU/AUGS Guideline on Genitourinary Syndrome of Menopause — The Journal of Urology, 2025 doi
  14. Alternative Treatments to Selected Medications in the 2023 American Geriatrics Society Beers Criteria® — Journal of the American Geriatrics Society, 2025 doi
  15. Natural Strategies to Optimize Estrogen Levels in Aging Women: Mini Review — Frontiers in Aging, 2025 doi
  16. An Examination Into the Effects of a Saffron Extract (Affron) on Mood and General Wellbeing in Adults Experiencing Low Mood: A Randomized, Double-Blind, Placebo-Controlled Trial — The Journal of Nutrition, 2025 doi
  17. Role of Circadian Health in Cardiometabolic Health and Disease Risk: A Scientific Statement From the American Heart Association — Circulation, 2025 doi
  18. Effects of different physical activity interventions on depressive symptoms in menopausal women: a systematic review and network meta-analysis — BMC Public Health, 2025 doi
  19. Effects of physical activity on depressive and anxiety symptoms of women in the menopausal transition and menopause: a comprehensive systematic review and meta-analysis of randomized controlled trials — The International Journal of Behavioral Nutrition and Physical Activity, 2025 doi
  20. Therapeutic Efficacy of Botanicals in Psychological Disorders in Menopausal Women: A Systematic and Scoping Review — Frontiers in Pharmacology, 2025 doi
  21. Exercise as a Therapeutic Strategy for Depression in Menopausal Women: A Metaanalysis of Randomized Trials — Frontiers in Psychiatry, 2025 doi
  22. Pelvic Floor Muscle Training With Feedback or Biofeedback for Urinary Incontinence in Women — The Cochrane Database of Systematic Reviews, 2025 doi
  23. An Empowerment Model for Managing Menopause — Lancet (London, England), 2024 doi
  24. Effectiveness of Prophylactic Oral and/or Vaginal Probiotic Supplementation in the Prevention of Recurrent Urinary Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Trial — Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 2024 doi
  25. Hormonal Treatments and Vaginal Moisturizers for Genitourinary Syndrome of Menopause : A Systematic Review — Annals of Internal Medicine, 2024 doi
  26. The Effectiveness of Psychosocial Interventions on Non-Physiological Symptoms of Menopause: A Systematic Review and Meta-Analysis — Journal of Affective Disorders, 2024 doi
  27. The Risk of Depression in the Menopausal Stages: A Systematic Review and Meta-Analysis — Journal of Affective Disorders, 2024 doi
  28. Neuroendocrine Mechanisms of Mood Disorders During Menopause Transition: A Narrative Review and Future Perspectives — Maturitas, 2024 doi
  29. Promoting Good Mental Health Over the Menopause Transition — Lancet (London, England), 2024 doi
  30. Efficacy and Safety of N-3 Fatty Acids Supplementation on Depression: A Systematic Review and Dose-Response Meta-Analysis of Randomised Controlled Trials — The British Journal of Nutrition, 2024 doi
  31. Effects of Mind-Body Exercise on Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-Analysis — Menopause (New York, N.Y.), 2024 doi
  32. "Not feeling like myself" in perimenopause - what does it mean? Observations from the Women Living Better survey — Menopause, 2024 doi
  33. Effectiveness of a Saffron and Withania Supplement on Mood in Women With Mild‐to‐Moderate Anxiety During the COVID‐19 Lockdown — Depression and Anxiety, 2024 doi
  34. Effects of Exercise on Depression and Anxiety in Postmenopausal Women: A Pairwise and Network Meta-Analysis of Randomized Controlled Trials — BMC Public Health, 2024 doi
  35. Comparisons of Approaches to Pelvic Floor Muscle Training for Urinary Incontinence in Women — The Cochrane Database of Systematic Reviews, 2024 doi
  36. Mechanisms for pelvic floor muscle training: Morphological changes and associations between changes in pelvic floor muscle variables and symptoms of female stress urinary incontinence and pelvic organ prolapse—A narrative review — Neurourology and Urodynamics, 2024 doi
  37. Pelvic Floor Muscle Training as Treatment for Female sexual Dysfunction: A Systematic Review and Meta-Analysis — American Journal of Obstetrics and Gynecology, 2024 doi
  38. Pelvic floor muscle training in women with urinary incontinence and pelvic organ prolapse: A protocol study — PloS One, 2024 doi
  39. EMAS Position Statement: Vitamin D and Menopausal Health — Maturitas, 2023 doi
  40. Pelvic Floor Muscle Rehabilitation for Genitourinary Syndrome of Menopause: Why, How and When? — Climacteric : The Journal of the International Menopause Society, 2023 doi
  41. Nonestrogen Therapies for Treatment of Genitourinary Syndrome of Menopause: A Systematic Review — Obstetrics and Gynecology, 2023 doi
  42. Menopause Hormone Therapy and Urinary Symptoms: A Systematic Review — Menopause (New York, N.Y.), 2023 doi
  43. Etiology of Recurrent Cystitis in Postmenopausal Women Based on Vaginal Microbiota and the Role of Lactobacillus Vaginal Suppository — Frontiers in Microbiology, 2023 doi
  44. The Role of Vitamin D in Menopausal Women's Health — Frontiers in Physiology, 2023 doi
  45. Premenstrual Disorders, Timing of Menopause, and Severity of Vasomotor Symptoms — JAMA Network Open, 2023 doi
  46. The Role of Magnesium in Sleep Health: A Systematic Review of Available Literature — Biological Trace Element Research, 2023 doi
  47. Effects of Long-Chain Omega-3 Polyunsaturated Fatty Acids on Reducing Anxiety and/or Depression in Adults; A Systematic Review and Meta-Analysis of Randomised Controlled Trials — Prostaglandins, Leukotrienes, and Essential Fatty Acids, 2023 doi
  48. Efficacy of B-Vitamins and Vitamin D Therapy in Improving Depressive and Anxiety Disorders: A Systematic Review of Randomized Controlled Trials — Nutritional Neuroscience, 2023 doi
  49. Effects of Nutritional Interventions on the Severity of Depressive and Anxiety Symptoms of Women in the Menopausal Transition and Menopause: A Systematic Review, Meta-Analysis, and Meta-Regression — Menopause (New York, N.Y.), 2023 doi
  50. The Therapeutic Impact of Plant-Based and Nutritional Supplements on Anxiety, Depressive Symptoms and Sleep Quality Among Adults and Elderly: A Systematic Review of the Literature — International Journal of Environmental Research and Public Health, 2023 doi
  51. Management of Menopausal Symptoms: A Review — JAMA, 2023 doi
  52. The effects of an 8‐week hypopressive exercise training program on urinary incontinence and pelvic floor muscle activation: A randomized controlled trial — Neurourology and Urodynamics, 2023 doi
  53. Effectiveness of Supervised Kegel Exercises Using Bio-Feedback Versus Unsupervised Kegel Exercises on Stress Urinary Incontinence: A Quasi-Experimental Study — International Urogynecology Journal, 2023 doi
  54. Supervised Versus Unsupervised Pelvic Floor Muscle Training in the Treatment of Women With Urinary Incontinence - A Systematic Review and Meta-Analysis — International Urogynecology Journal, 2023 doi
  55. Rethinking Menopausal Hormone Therapy: For Whom, What, When and How long? — Circulation, 2023 doi
  56. Association of Hormone Therapy With Depression During Menopause in a Cohort of Danish Women — JAMA Network Open, 2022 doi
  57. Mood Disorders and Hormonal Status Across Women's Life: A Narrative Review — Gynecological Endocrinology : The Official Journal of the International Society of Gynecological Endocrinology, 2022 doi
  58. The Effect of a Mediterranean Diet on the Symptoms of Depression in Young Males (The "AMMEND: A Mediterranean Diet in MEN With Depression" Study): A Randomized Controlled Trial — The American Journal of Clinical Nutrition, 2022 doi
  59. Association of Magnesium Intake With Sleep Duration and Sleep Quality: Findings From the CARDIA Study — Sleep, 2022 doi
  60. Behavioral Interventions for Improving Sleep Outcomes in Menopausal Women: A Systematic Review and Meta-Analysis — Menopause (New York, N.Y.), 2022 doi
  61. Conservative Interventions for Treating Urinary Incontinence in Women: An Overview of Cochrane Systematic Reviews — The Cochrane Database of Systematic Reviews, 2022 doi
  62. Adherence to professional society guidelines among women with stress or mixed urinary incontinence — Neurourology and Urodynamics, 2022 doi
  63. Time for a “Pause” on the Use of Vaginal Laser — JAMA, 2021 doi
  64. Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial — JAMA, 2021 doi
  65. Clinical Manifestations and Evaluation of Postmenopausal Vulvovaginal Atrophy — Gynecological Endocrinology : The Official Journal of the International Society of Gynecological Endocrinology, 2021 doi
  66. Hyaluronic Acid in Vulvar and Vaginal Administration: Evidence From a Literature Systematic Review — Climacteric : The Journal of the International Menopause Society, 2021 doi
  67. Omega-3 Fatty Acids for Depression in Adults — The Cochrane Database of Systematic Reviews, 2021 doi
  68. Effect of magnesium and vitamin B6 supplementation on mental health and quality of life in stressed healthy adults: Post‐hoc analysis of a randomised controlled trial — Stress and Health : Journal of the International Society for the Investigation of Stress, 2021 doi
  69. The Role of Estradiol Fluctuation in the Pathophysiology of Perimenopausal Depression: A Hypothesis Paper — Psychoneuroendocrinology, 2021 doi
  70. Biopsychosocial Predictors of Depressive Symptoms in the Perimenopause-Findings From the Swiss Perimenopause Study — Menopause (New York, N.Y.), 2021 doi
  71. Chrono-Nutrition: From Molecular and Neuronal Mechanisms to Human Epidemiology and Timed Feeding Patterns — Journal of Neurochemistry, 2021 doi
  72. Electromyographic Biofeedback for Stress Urinary Incontinence or Pelvic Floor Dysfunction in Women: A Systematic Review and Meta-Analysis — Advances in Therapy, 2021 doi
  73. Stress Incontinence in Women — The New England Journal of Medicine, 2021 doi
  74. The 2020 Genitourinary Syndrome of Menopause Position Statement of the North American Menopause Society — Menopause (New York, N.Y.), 2020 doi
  75. Vaginal Energy-Based Devices: Characterization of Adverse Events Based on the Last Decade of MAUDE Safety Reports — Menopause (New York, N.Y.), 2020 doi
  76. Impact of Estradiol Variability and Progesterone on Mood in Perimenopausal Women With Depressive Symptoms — The Journal of Clinical Endocrinology and Metabolism, 2020 doi
  77. Do women have an accurate perception of their pelvic floor muscle contraction? A cross‐sectional study — Neurourology and Urodynamics, 2020 doi
  78. Can abdominal hypropressive technique improve stress urinary incontinence? an assessor‐blinded randomized controlled trial — Neurourology and Urodynamics, 2020 doi
  79. Ability to Contract the Pelvic Floor Muscles and Association With Muscle Function in Incontinent Women — International Urogynecology Journal, 2020 doi
  80. Effectiveness of Pelvic Floor Muscle Training With and Without Electromyographic Biofeedback for Urinary Incontinence in Women: Multicentre Randomised Controlled Trial — BMJ (Clinical Research Ed.), 2020 doi
  81. Effectiveness of Hypopressive Exercises in Women With Pelvic Floor Dysfunction: A Randomised Controlled Trial — Journal of Clinical Medicine, 2020 doi
  82. Lasers and energy‐based devices marketed for vaginal rejuvenation: A cross‐sectional analysis of the MAUDE database — Lasers in Surgery and Medicine, 2019 doi
  83. The energy based devices for vaginal “rejuvenation,” urinary incontinence, vaginal cosmetic procedures, and other vulvo‐vaginal disorders: An international multidisciplinary expert panel opinion — Neurourology and Urodynamics, 2019 doi
  84. Vitamin E as Alternative Local Treatment in Genitourinary Syndrome of Menopause: A Randomized Controlled Trial — International Urogynecology Journal, 2019 doi
  85. Pelvic Floor Muscle Training as a Treatment for Genitourinary Syndrome of Menopause: A Single-Arm Feasibility Study — Maturitas, 2019 doi
  86. Female Sexual Dysfunction: ACOG Practice Bulletin Clinical Management Guidelines for Obstetrician-Gynecologists, Number 213 — Obstetrics and Gynecology, 2019 doi
  87. Healthy Dietary Indices and Risk of Depressive Outcomes: A Systematic Review and Meta-Analysis of Observational Studies — Molecular Psychiatry, 2019 doi
  88. Efficacy of Omega-3 PUFAs in Depression: A Meta-Analysis — Translational Psychiatry, 2019 doi
  89. Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations — Journal of Women's Health (2002), 2019 doi
  90. Management of Depression in Women — Journal of Women's Health (2002), 2019 doi
  91. Effect of Saffron Supplementation on Symptoms of Depression and Anxiety: A Systematic Review and Meta-Analysis — Nutrition Reviews, 2019 doi
  92. Pelvic floor muscle training is better than hypopressive exercises in pelvic organ prolapse treatment: An assessor‐blinded randomized controlled trial — Neurourology and Urodynamics, 2019 doi
  93. Efficacy of Vaginal Estradiol or Vaginal Moisturizer vs Placebo for Treating Postmenopausal Vulvovaginal Symptoms: A Randomized Clinical Trial — JAMA Internal Medicine, 2018 doi
  94. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction — Neurourology and Urodynamics, 2018 doi
  95. Efficacy of Transdermal Estradiol and Micronized Progesterone in the Prevention of Depressive Symptoms in the Menopause Transition: A Randomized Clinical Trial — JAMA Psychiatry, 2018 doi
  96. Pelvic Floor Muscle Training Versus No Treatment, or Inactive Control Treatments, for Urinary Incontinence in Women — The Cochrane Database of Systematic Reviews, 2018 doi
  97. Light and energy based therapeutics for genitourinary syndrome of menopause: Consensus and controversies — Lasers in Surgery and Medicine, 2017 doi
  98. Genitourinary Syndrome of Menopause: Management Strategies for the Clinician — Mayo Clinic Proceedings, 2017 doi
  99. Therapeutic Effects of Phytochemicals and Medicinal Herbs on Depression — BioMed Research International, 2017 doi
  100. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis — JAMA, 2016 doi
  101. Genitourinary Syndrome of Menopause: An overview of Clinical Manifestations, Pathophysiology, Etiology, Evaluation, And management — American Journal of Obstetrics and Gynecology, 2016 doi
  102. Local Oestrogen for Vaginal Atrophy in Postmenopausal Women — The Cochrane Database of Systematic Reviews, 2016 doi
  103. Ovarian Hormone Fluctuation, Neurosteroids, and HPA Axis Dysregulation in Perimenopausal Depression: A Novel Heuristic Model — The American Journal of Psychiatry, 2015 doi
  104. ACOG Practice Bulletin No — Obstetrics and Gynecology, 2015 doi

Доказова сила цих робіт різна: десь великі огляди та мета-аналізи, десь окремі невеликі дослідження. Кроки в статті — прості заходи турботи про себе з низьким ризиком, а не лікування, і підходять не всім.

Це загальні відомості, а не призначення. Обстеження й лікування підбирає лікар.

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