Wondering how menopause affects things between the sheets? You wouldn’t be the first person.
The truth is, sex leading up to and 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 woman’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 and last several days. You may also want to incorporate the use of lubricants, which can make sex more comfortable. You can also talk to your doctor about prescription options.
- Vaginal estrogen cream: this is a low-dose cream that is placed in the vagina and acts locally. It does not increase your body’s estrogen levels, and does not increase the chance of cancers.
- Vagina DHEA: a precursor to estrogen, DHEA is made into estrogen within the vaginal cells and alleviates symptoms locally. Similarly, it does not increase your body’s level of estrogen and isn’t associated with an increased risk of cancer.
- Ospemiphene: A medication that acts on the estrogen receptors, but isn’t a hormone, itself works similarly to treat the symptoms of vaginal dryness and painful sex without increasing the risk for cancer.
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, so 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. These 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
Sources
https://www.auanet.org/guidelines-and-quality/guidelines/genitourinary-syndrome-of-menopause
