Health Library

Sex After Menopause

IMAGE Menopause is not the end of a woman’s sex life. In fact, many women find that intimacy can be better in midlife. Every woman’s experience is different. It helps to know how to deal with changes in your body.

How Changes at Menopause May Affect Sexuality

At menopause changes can affect sexual activity and desire in some women. Changes may occur in the vagina, arousal, orgasm, and sex drive. These changes can make sex less comfortable and enjoyable.

Vaginal Dryness and Pain During Intercourse

Vaginal dryness is a common problem. However, not every woman will have it. The vaginal walls may also become thin and less flexible. There may be itching or burning, and sometimes pain with sex.

Water-based lubricants can help vaginal dryness. You can buy them over the counter. Do not use petroleum-based lubricants, such as Vaseline. They may cause latex condoms to weaken.

If lubricants are not enough, there are other options. Estrogen cream, rings, or tablets may be helpful. These can be prescribed by your doctor.

Stimulation and Orgasm

Some women find that orgasms change at menopause. They may have fewer and less intense orgasms. It may take more time and effort to be aroused. Some women find it helps to have intercourse and touch themselves regularly. This can help increase their sex response and pleasure. Strengthening the vaginal muscles can also help. This can be done with Kegel exercises. Kegel exercises squeeze the pelvic muscle near the vagina.

Sexual Desire

Loss of interest in sex happens in some women during and after menopause. This may be short-term or long-term. There are many possible causes for this, such as:

  • Stress
  • Problems sleeping
  • Illness
  • Bladder control problems
  • Relationship problems
  • Mental health issues
  • Side effects from medicine
  • Hormonal changes
  • Discomfort from the physical changes of menopause

Ongoing relationship problems can also reduce sexual desire. These problems may increase with menopause. If so, seeing a couple's counselor or sex therapist can help.

If the problem is hormonal, estrogen may help. However, it usually does not improve desire. It reduces vaginal dryness and pain during sex.

The hormone testosterone may help sexual desire in some women. However, there is not enough proof that it works well or is safe.

Increased Intimacy

Midlife changes offer a chance to explore new sexual experiences. Men also go through changes. They need more time and touch to get aroused. Many women enjoy the slower, more sensuous foreplay.

Increased touch and closeness can be helpful. There are many ways to express your love besides intercourse:

  • Hugging, cuddling, kissing
  • Touching, stroking, massage, sensual baths
  • Oral sex

Sex after menopause can be satisfying. The key is to adapt to the changes. Do not expect sex to be the same as it was in your 20's. Think about what is best for you and your partner.

A Note About Birth Control and Safe Sex

Women still need birth control until they have not had a period for 12 months in a row. Sexually transmitted infections are also a concern. Unless you are in a monogamous relationship, be sure to use a male latex condom.

Resources

The North American Menopause Society
http://www.menopause.org

Office on Women's Health
https://www.womenshealth.gov

Canadian Resources

Health Canada

Women's Health Matters—Women's College Hospital
http://www.womenshealthmatters.ca

References

How sex changes after menopause. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/wellness-and-prevention/how-sex-changes-after-menopause.

Menopause and sexuality. Office on Sexuality website. Available at: https://www.womenshealth.gov/menopause/menopause-and-sexuality.

Menopause. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/menopause.