Sex and menopause: the facts

Wondering how menopause affects things beneath the sheets? You wouldn’t be the first person.

The truth is, sex after menopause may be different—but it can still be satisfying with a few adjustments and a little effort. We’ll look at the complex effects of lowered estrogen on a women’s sexual function as well as the things you can do to maintain intimacy and boost sexual enjoyment. 

The realities

When estrogen plummets during menopause, it can lower your sexual desire—also known as libido. It can also make it more difficult to become aroused and achieve an orgasm. On top of that, it can cause intercourse to become painful. This latter effect is due to physical changes that can include vaginal dryness, thinning of the vaginal lining, and decreased elasticity in the vaginal walls. 

What can help

If you’re experiencing pain during intercourse—which affects about half of postmenopausal women—you may want to try over-the-counter vaginal moisturizers, which can restore moisture, as well as various lubricants, which can make sex more comfortable. You can also talk to your doctor about topical estrogen. Available as a cream, suppository, or ring, it can aid lubrication and thicken vaginal tissue.

Another important step is communicating openly with your partner. It may be possible to try new positions and techniques that feel better. And of course, intercourse isn’t the only way to orgasm; there’s also stimulation through touching and rubbing as well as oral sex. This is a great time to experiment and let go of expectations of what intimacy should look like.  

Arousal and orgasm

After menopause, sensitivity is reduced, and it takes longer for blood to flow to your genital area. But this doesn’t mean that an orgasm is impossible; it simply means that you may need more intense stimulation. Research has found that warming massage oils, clitoral stimulation devices (such as the Eros device), and vibrators may all assist in promoting arousal and orgasm. 

There are also things that may be impeding arousal and orgasm, and that you can work to lessen if applicable. They include heavy drinking, stress and anxiety, relationship strain, and certain medications. Antidepressants and blood pressure drugs, for example, can impact your ability to orgasm. Talk to your doctor about the benefits and risks for any medications with sexual side effects. 

Keeping perspective

All relationships evolve over time, and for many long-term couples, less intercourse is a natural progression. (Let’s not forget that male partners also undergo physical changes, including erectile dysfunction.) About a third of long-term couples no longer have sex or have sex only occasionally, yet they’re still happy. What’s most crucial is finding ways to stay intimate and spark romance at any age. 

Reviewed by the Ovia Health Clinical Team

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