A Guide to Maintaining Sexuality After Menopause

Menopause is accompanied by a wide variety of physiologic changes that can affect all aspects of a woman’s life, from her mood to her ability to sleep to her sexuality.

Many of these changes can be frustrating or distressing to both the menopausal woman and her partner(s), particularly the effects they have on libido and sexual activity.

While the hormonal shifts of menopause are clear and inevitable, this does not mean that they necessitate the end of one’s sex life.

The following guide discusses ways to tackle the changes that can make maintaining sexuality difficult in the post-menopausal years.

Use Lubrication...And Lots Of It!

The decrease in estrogen levels that occurs during menopause causes the tissues of the vaginal walls to become thinner and less elastic, which in turn can cause symptoms ranging from vaginal dryness, itching, and irritation, to pain or even tissue tearing during attempts at penetrative intercourse (Levine et al., 2008).

Using more personal lubricant (like our Water Based Velvet Rose), both on the exterior (vulvar) and interior (vaginal) tissues can significantly help reduce friction and thus discomfort during sexual activity (Strategies for Staying Sexual After Menopause, 2015b).

Additionally, the use of a topical salve like Intimate Rose’s Enchanted Rose Feminine Balm can ease pain associated with dry, irritated vulvar skin. It can be used before and after intercourse, and even on a daily basis if needed.

Maintain a Regular Routine of Vaginal Stimulation (Even if it’s Not Penetrative Sex)

In the same way that regular exercise and stretching helps keep the muscles of your arms, legs, and back supple and flexible, regular vaginal activity helps maintain tissue mobility in the pelvic floor muscles throughout the changes of menopause (Strategies for Staying Sexual After Menopause, 2015b).

This can include partnered penetrative sex, but also other types of activity, including manual stimulation from your partner and masturbation with or without sex toys.

Some people can also benefit from the use of graduated dilators, like the Intimate Rose silicone Vaginal Dilator (also called vaginal trainers) set, to gently and comfortably stretch the vaginal tissues in preparation for sex.

Vaginal trainers like these can help combat the narrowing or shortening of the vaginal canal that can make penetration painful after menopause.

Talk Honestly and Openly With your Partner

A broad survey of the male partners of menopausal women performed in 2019 found that approximately three-quarters of the men surveyed believed that their partner’s menopausal symptoms negatively affected both members of the partnership (Parish et al., 2019).

Encouragingly, nearly half of these men were aware that there are treatment options for menopausal symptoms, including menopause-related sexual dysfunction, and two-thirds of them would feel comfortable discussing these options with their female partners (Parish et al., 2019).

Regardless of your partner’s gender, talking openly with them about the symptoms you are experiencing can be a relief for both partners, and allow you to work together as a team to overcome sexual difficulties in your relationship that arise during and after menopause.

Visit Your Doctor for More Help

In some post-menopausal women, hormonal treatment such as the use of a testosterone patch or estrogen creams can boost sexual desire after menopause.

This can in turn lead to more satisfying sexual activity and decrease the distress associated with sexual dysfunction after menopause (Shifren et al., 2006).

While hormone therapy is not appropriate for all women, it is valuable to discuss your options with your physician to determine the best course of action, particularly if the previously discussed techniques have not been sufficiently effective.

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By Dr. Amanda Olson,DPT, PRPC

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Levine, K. B., Williams, R. E., & Hartmann, K. E. (2008). Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women. Menopause, 15(4), 661–666. https://doi.org/10.1097/gme.0b013e31815a5168

Parish, S. J., Faubion, S. S., Weinberg, M., Bernick, B., & Mirkin, S. (2019). The MATE survey. Menopause26(10), 1110–1116. https://doi.org/10.1097/gme.0000000000001373

Shifren, J. L., Davis, S. R., Moreau, M., Waldbaum, A., Bouchard, C., DeRogatis, L., Derzko, C., Bearnson, P., Kakos, N., O’Neill, S., Levine, S., Wekselman, K., Buch, A., Rodenberg, C., & Kroll, R. (2006). Testosterone patch for the treatment of hypoactive sexual desire disorder in naturally menopausal women. Menopause, PAP, 770–779. https://doi.org/10.1097/01.gme.0000243567.32828.99

Strategies for Staying Sexual After Menopause. (2015, October 19). NWHN. https://www.nwhn.org/strategies-for-staying-sexual-after-menopause/