Getting Your Groove Back: Sex and Menopause

Sex during or after menopause can be a pain point for women, often literally. On the one hand, menopausal or post-menopausal women worry less about becoming pregnant or dealing with menstruation, making it easier to relax and enjoy sex for recreation rather than procreation with their partners. On the other hand, menopause symptoms can challenge a woman’s libido and make her unable to physically or mentally enjoy sexual activity. 

Fortunately, there is a silver lining in that “The Change” does not have to signal the end of your sexual vitality. With little effort, you can get back to enjoying a healthy, fulfilling sex life – perhaps even better than you did before menopause. 

Menopausing Your Sex Life

During menopause, your estrogen levels take a sharp decline, affecting your interest in sex, ability to become aroused or adequately stimulated through touch, and making it difficult to reach orgasm during sexual activity. This hormone depletion leads to vaginal atrophy, the thinning and weakening of vaginal tissue, which makes intercourse uncomfortable, increases the risk of UTIs and other infections, and causes tissue tearing and bleeding. 

Vaginal atrophy is one part of the overall term genitourinary syndrome of menopause (GSM) used to describe the symptoms of menopause. Other noted physical effects of GSM include the following genital, sexual, and urinary functions. 

• Vaginal dryness, tightness, discharge, itching, or burning 
• Vaginal or pelvic pain or pressure
• Sagging of the vaginal vault 
• Dyspareunia (painful intercourse)
• Frequent need to urinate or painful, difficult urination
• Recurring urinary tract infections
• Urethral collapse into the vaginal canal

In addition to the physical symptoms of menopause, you may experience mood swings, anxiety, depression, or irritability. 

Hit the Sheets Confidently

So, how can women restore their health from the negative symptoms of menopause and rediscover the joy of sex? 

Love Your Body

Improving body confidence can be a simple way to get back in the swing of things. Regular exercise boosts energy and enhances self-image, making it easier to embrace and celebrate your sexuality. Similarly, treating your body well with healthy foods and getting plenty of rest while avoiding the drugs and alcohol that slow down physical responses to sex will give your body the chance to enjoy intimacy. And discuss the side effects of any medications you are taking with your doctor.

Lube It Up

Unlike some symptoms of menopause that lessen over time, such as hot flashes, the dryness from vaginal atrophy tends to continue and worsen unless treated. Using an over-the-counter moisturizer every 2 or 3 days counteracts vaginal dryness while also providing lubrication for the friction of sexual activity. 

“Use It or Lose It”

Another way to fight a lack of sex is to have more sex or more foreplay during sex, which increases blood flow to the genitals, prevents dryness, and protects the vaginal tissue from thinning and irritation. If vaginal tightness is an issue, gradually introducing a vaginal dilator can help spread the vaginal walls to make penetration easier. During intercourse, a water or silicone-based lubricant can be used to make insertion more comfortable. 

Think About Your Moans...Hormones That Is

The most effective way to treat vaginal atrophy is to address the hormonal imbalances associated with menopause, such as using an effective low-dose estrogen cream that helps plump and remoisturize the vaginal tissue. While moisturizers and lubricants are helpful, estrogen therapy can actually reverse negative tissue changes and restore vaginal health. Your hormone replacement therapy regimen should also include a progesterone cream to prevent estrogen dominance. 

If desire is an issue, a beneficial testosterone supplement helps increase the libido, energy, and stamina needed for sex.

Dr. Randolph’s Helps You Get Your Sexy Back  

Menopause can doubtless make it more difficult to engage in spontaneous sex. But on the positive side, many women report that they are more confident and self-aware after menopause and have fewer inhibitions. Women at this stage know their bodies and desires on a different level, so while you may not have as many orgasms as you once did, the ones you do have could be even better.