Sex and Menopause – How to have great sex in menopause

Sex and Menopause are often considered a contrary combination. Most women over the age of 50 years believe that their sex life after menopause should take a back seat.

Did you know that over a 100 million women going through the menopause in India stop enjoying sex because of low desire? That is almost one out of every two women over the age of 50 years!

Unfortunately, the hormonal changes during the menopause can affect a woman’s physical, psychological and genital wellbeing. This can affect her desire for sex, her ability to lubricate and get aroused, and her ability to have an orgasm.

Difficulty with lubrication and arousal and inability to orgasm can worsen the loss of desire that dropping estrogen levels bring in menopause. A lack of intimacy, desire and drive can destroy a relationship and create conflict and stress. This significantly affects a woman’s quality of life.

Sex and Menopause – Loss of desire for sex can create conflict in a relationship (Photo by Kelly Sikkema on Unsplash)

This article shows you how to enjoy sex after menopause by using simple and easy to apply techniques that are particularly useful during the menopause and beyond. When you use them consistently you can surely continue to have an orgasm after menopause.

They will help your relationship evolve to a new level and make the menopause bearable. Maybe even something to celebrate. By applying these techniques, you will enjoy a richer, balanced and empowered sexual relationship that is loving, sexy and exciting.

What are the commonest sexual problems in menopause?

The menopause is a challenging time for many reasons. Some of the commonest sexual problems in the menopause are a loss of desire, difficulty with arousal and lubrication and an inability to achieve orgasm. Vaginal dryness and irritation can also make sex uncomfortable and painful.

Loss of desire

The menopause really does cause a significant drop in desire for sex. Mostly, it is the dropping estrogen levels that are responsible. However, other factors also play an important role.

Physically, you might be exhausted, tired and in pain. Hot flushes can ruin your days as well as nights. Add to that joint pain, body ache and headaches, poor sleep, breast tenderness and period problems – now you know why you might not want to have sex. Who feels sexy when they just don’t have the energy to get through the day?

Feeling tired and exhausted can destroy your libido (Photo by Stacey Gabrielle Koenitz Rozells on Unsplash)

Heavy periods in the time leading up to the menopause can cause you to become anaemic, tired and exhausted. Most women find they are just too tired to want sex. When they do get started most will probably enjoy it if they can gradually get aroused or use some lubricant.

Hot flushes can cause tiredness too. Daytime hot flushes interfere with activities like shopping, corporate and office work, meetings, concentration and memory. Night sweats and flushes interfere with sleep and cause day time grogginess and irritability.

Hot flashes can disrupt sleep and day time activities (photo courtesy Unsplash)

Psychological issues like anxiety, depression and anger often show up as sarcasm, shutting down and avoidance. It is hard to nurture a relationship when small things irritate and annoy you.

Maybe you find yourself getting irritated by little things your once beloved partner did. After some time, you give up trying to convince yourself that sex could be as great as it was when you were 20. That’s the beginning of the end of your loving relationship.

Nothing kills a relationship faster than anger and resentment and the symptoms of the menopause combined with loss of desire are a recipe for a lot of anger and resentment.

Anger and resentment can damage relationships and cause a lot of anguish (Photo by Ben Blennerhassett on Unsplash)

Inability to feel aroused and lubricate

Genital health is adversely affected by dropping estrogen levels too. Vaginal dryness and irritation can cause painful sex after menopause. This discomfort can be severe enough to make you want to avoid sex altogether. Normal estrogen levels are responsible for keeping the cells hydrated. When estrogen levels drop during the menopause, this drying out of tissues is most obvious in the vagina and vulva.

You may notice that the dryness is also accompanied by reduced sensitivity to touch. What used to get you turned on before no longer has the same effect. The clitoris and labia no longer respond to stimulation like they used to and it takes much longer to get aroused. Staying aroused takes more effort too.

You will notice these changes if you are already aware of how your genitals work and respond. For the millions of women who have never looked at their genitals in a mirror, or ever explored their arousal, this loss of sensation is a desire killer for sure. These women most likely avoid sex altogether and never mention it to their doctors.

The psychological changes of the menopause also put a stop to getting aroused. You cannot expect to feel aroused if you are angry, irritable and moody. To ‘get into the mood’ you need to give up whatever it is that is bothering you.

Anger and resentment can stop you getting aroused (Photo by engin akyurt on Unsplash)

For some reason being menopausal makes this particularly difficult. The tendency to ruminate and chew on bygone hurts and slights is much worse at menopause and ‘letting go’ of resentment and anger can be ever so difficult.

Vaginal dryness, irritation and pain

We talked about how decreasing estrogen levels can cause the vaginal secretions to dry up. The vagina doesn’t lubricate as easily and the walls become thin and contracted if sex is infrequent.

The drop in estrogen levels also changes the glycogen content of the cells lining the vaginal. This means that the normally acidic pH becomes more alkaline. This changing pH means a change in bacterial flora. We all have our own unique vaginal microbiome and this gets affected significantly by the change in pH.

Many women find they get infections more easily and the vaginal walls seem to be chronically inflamed. This is called atrophic vaginitis in medical terms and is often responsible for a persistent white discharge after menopause. The vagina can feel inflamed with burning and stinging sensation. When the vaginal flora changes the discharge can become yellow, sticky and smelly and stain underwear.

More often than not this infection is the result of colonisation with bacteria from the anus. All of the skin of the vulva is affected by menopause and bacteria from the bowel can easily infect the skin of the vulva and vagina. You might find you are tempted to wash again and again and use soap more liberally. This further changes the pH of the vulva and small injuries to the skin can cause the infection to linger on.

Vaginal dryness, burning and irritation are part of the spectrum of menopause symptoms

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Inability to orgasm (anorgasmia)

All of the above problems can make achieving an orgasm much harder as you go through the menopause. No desire, no lubrication and no arousal combined with pain and discomfort means the dream of youthful orgasms is a distant possibility. If you have never masturbated, you may never know how all this fits together. If you don’t know what isn’t working the chances of being able to fix it is difficult but not impossible.

In women, it is important to remember that all these factors are interlinked. If you experience an orgasm, you are more likely to enjoy sex. Therefore, you are more likely to feel relaxed and enjoy being stimulated or stimulating yourself. You become far more open to looking for alternative ways to get aroused and to using lubricants or sex toys.

As you enjoy intimacy and closeness your desire to feel these again and again goes up. This completes the circle of intimacy and sex can become pleasurable again.

Needless to say, a thriving and intimate relationship is key to being able to apply the tips we talk about in this article. A good relationship with open communication channels, mutual respect and trust seems to be the foundation for exploring your changing sexuality as you go through menopause and its challenges.

It is possible to have orgasms after menopause

<a href=”https://www.freepik.com/photos/people”>People photo created by jcomp – www.freepik.com</a>

Why should women continue to have sex as they go through menopause?

I hear you ask – Is sex after menopause possible?

I would answer ‘Yes – not only is it possible – it is advisable too!”

In case you were wondering if it was ok to let your love life die out – don’t even think about it! You need great sex just as much as your partner does.

I hear you say – why should I have sex? – Isn’t it a man thing – to want sex?

Yes and No.

YES, because men don’t suffer the same consequences of decreasing estrogen levels as drastically as women do. They do have some drop in testosterone – the hormone responsible for sex drive in both men and women – but it isn’t as drastic as in women – and women also have decreasing testosterone levels as they age. So, men are more than likely to continue to desire sex like they always did.

NO, because wanting sex is not a matter of gender – it is a matter of mindset and motivation. And contrary to what you might think – it’s not the motivation for sex alone that matters – but the motivation to keep the relationship alive and sizzling that does – so in the end it is actually down to just making a decision to spice up things and keep the relationship sparkling with sexual chemistry.

Sex is a matter of mindset and motivation (Photo by Jonathan Borba on Unsplash)

Sex, Menopause and the pelvic floor

The other reason women should have regular sex is for themselves – their pelvic floor health in particular. Having sex regularly exercises the pelvic floor and keeps the vagina elastic and flexible. The blood flow to the vagina is better and the dryness and irritation are much less noticeable if sex happens regularly.

The bladder and bowel also benefit from a well exercised pelvic floor – so the risk of leaking urine or stool or flatus is reduced and so is bladder sensitivity. Rarely, bladder infections can worsen this sensitivity but that is less likely if you are sexually active with a single long-term partner.

What if you are single?

Being single doesn’t mean that you should neglect your sexual self. It is never too late to explore your body and the pleasure it can give you. In particular, learning to masturbate and experience orgasms may be the key to enjoying a smoother menopause journey overall. It certainly changes the way your brain is wired for pleasure and also the balance of your female hormones.

Sex after menopause tips

Have a look at some tips on how to increase sex drive after menopause and rock your sex life

Tip 1 – Think sexy thoughts.

I hear you say – what? just like that? – yes. I mean it. Give yourself permission to think sexy thoughts for ten minutes a day. If it’s been a long time since you had any sexy thoughts go easy on yourself but start today.

You will be surprised how such a simple step has such a dramatic effect. And do remind yourself to cut out the negative self-talk accompanying the sexy thoughts.

Commit to just ten minutes of pleasurable sexy thoughts of any kind. Use your memory to find a trigger and let your mind wander from thought to thought magnifying the sexiness.

Think sexy thoughts ! (Photo by Paola Aguilar on Unsplash)

If you find an old fantasy pushing its head up go ahead and entertain it – just for ten minutes. Then stop. That’s right. Stop at ten minutes. Schedule your next ten-minute session for the next day. If you really feel you are in the mood, schedule it for 12 hours later.

Tip 2 – Start exercising.

Studies show again and again that exercise increases blood flow to the brain (the place you actually feel sexy) and the genitals (the place that triggers the feeling).

Exercise also has several other benefits for the menopause:

  • Your hormones get better regulated.
  • Your hot flushes bother you less.
  • Your mood improves and depressive thoughts decrease.
  • Anxiety takes a back seat.
  • Your heart rate becomes more stable.
  • You sleep better so you get less irritated and moody.
  • Your body tones up and retains its shape and silhouette.
  • Any kind of body pain decreases.
  • Your risk of diabetes mellitus, hypertension, heart disease and dementia decreases.
  • You have more energy.
  • Your thinking gets clear and fast.

All of these are great for a pepped-up sex life. If your partner can exercise with you the sex gets even better.

Dancing is great exercise and sexy too (Photo by John Moeses Bauan on Unsplash)

Tip 3 – Eat right for great sex

I don’t mean start researching on aphrodisiacs- I mean eat right – really!

The best foods that improve your sex drive and performance are those rich in antioxidants – which means food that is rich in dark green leafy vegetables of all varieties, vegetables with rich dark skins, broccoli, cauliflower, roots and tubers, artichokes, summer berries, mushrooms, nuts and seeds.

There is more and more evidence that piling your plate high with vegetables – even up to nine or ten portions of vegetables – can improve your heart health, reverse diabetes and even reduce your risk of developing dementia.

If you eat meat or fish include wild caught fish and meat sources in your diet. Avoid farm cultivated meats because the animals are most likely fed grains and not the food they are supposed to eat to thrive.

Things to skip or delete from your food list include sugar and all processed food containing wheat, sugar, dairy and excessive salt. Many processed foods also contain additives that cause harm and upset our hormone balance. Try and eliminate plastics from your food storage and cooking containers

Your plate needs to look green when you sit down to eat. Try cooking your food lightly or steaming it instead of frying it or throwing the water out.

A diet rich in antioxidants can revive a flagging sex drive (Photo by Randy Fath on Unsplash)

The next step is to learn to eat with all your senses and chew your food well. Notice your thoughts as you eat and be mindful at the dining table.

When you combine these benefits with a feeling of wellbeing, energy and stamina with an improved desire for sex – everyone is happier with the results. You will look and feel sexier and get your body to look slimmer and fitter too. Your body shape is much more a result of what you eat rather than the exercise you do, although that does help. If you would like to read about how to lose excess weight click here.

Tip 4 – Start talking stop arguing

Many arguments stem from a feeling of not being heard or understood. Modern life hijacks a sense of connection with those we love.

This often happens when investment in the relationship goes down as the years pass and the couple start to take each other’s love and acceptance for granted.  It is important to work on learning and practicing simple communication skills that allow you to have the conversation you want rather than the argument that distracts you from what you need.

When you and your partner can discuss how you can each meet the other’s needs better, sex can become a talking point again. One of the books I recommend is ‘When I say No I feel guilty’ by Manuel J Smith. He teaches four simple verbal skills that can improve your communication and help you get what you need and keep the relationship sweet. When your emotional needs are met, great sex becomes the icing on the cake and desire can be rekindled.

Great conversations lead to great sex (Photo by Priscilla Du Preez on Unsplash)

Tip 5 – Date nights – romancing the night

Taking time away from the daily grind is necessary for everyone’s peace of mind but even more so for a relationship. It is important to find time to explore goals, dreams and desires together with your partner and build a relationship that is fit for the future.

As you talk about practical issues don’t forget to include sex and romance as part of this future fit relationship. Part of the excitement of building something to look forward to in the years to come is the time you get to spend together exploring aspects of each other you had either forgotten about or never knew existed. You were so caught up in raising a family or building a career, you forgot to explore the parts of your partner that excited you when you were younger.

The magic of growing old together is different to the excitement of a new relationship in your twenties or thirties. A romantic date night planned once a week and a longer one every few months will allow you to keep anticipation and excitement alive.

Date nights are key to rekindling romance (Photo by Sinitta Leunen on Unsplash)

Tip 6 – Taking time out from the routine

This is a little different to date nights. This is to allow the child in you to come out and play, have fun and forget about adulting for a while.

Here the agenda for sex or flirting takes a back seat or even gets put on hold deliberately. The idea here is to take time out from expectations and family chores or burdens. Adding lightness and fun to your week or day can work wonders for your oxytocin levels.

Having fun together is great for rekindling desire (Photo by sept commercial on Unsplash)

As your oxytocin levels rise, your stress levels drop and menopausal hormone changes cause less chaos. Find a hobby, a long-desired holiday, that book you wanted to get stuck into, pet your dog or go on a pet friendly vacation, take a walk in the forest or by the sea – all of these allow your hormones to reset and you will find that your libido comes back up again. When you restore intimacy and closeness in doing things together that have nothing to do with sex, desire naturally increases.

Tip 7 – Use a little inspiration

Books movies and erotica have been used for centuries to give inspiration for better sex.

These are resources to build your own mood, give a foundation for thinking sexy thoughts that can also help build intimacy and closeness. You can choose whether to share your thoughts or not and sometimes reading or watching together can be a huge turn-on.

Take inspiration from shared intimacy to recreate those sexy feelings (Photo by Yohann LIBOT on Unsplash)

Take inspiration from the increased intimacy and closeness you felt on date night or your vacation and try to recreate some of the emotions you felt then.  Use props or aromatherapy to trigger memories of times together when you felt sexy and desirable and you will find that desire can be switched on quite easily.

Tip 8 – Even a little helps – get some lube – make sex less painful or uncomfortable

As estrogen levels drop through the menopause the vulva and vagina can get drier and less elastic. If you are not having sex regularly the vagina can feel tight and painful when you do have intercourse and sometimes you can even bleed a bit from tiny tears.

The best lubricant for menopause dryness is a water-based lubricant. You can refresh it with a water spritzer if it dries out. It won’t cause any allergies or reactions either. Be kind to yourself and use a generous amount. You can even get special pH balanced lubricant designed for use during the menopause.

Many women feel like they are cheating if they have to use lubricant and that if they really felt like having sex, they would get aroused and the vagina would lubricate like it used to when they were younger. This is partly true and women who have sex regularly experience fewer problems with decreased lubrication as they age.

Yet, experiencing dryness or pain with intercourse should not be viewed as something abnormal as you go through the menopause. Using lubricant is a simple solution that is welcome to both partners and makes having sex so much more enjoyable and pleasant.

As you become more confident with expressing your needs and wants, what works and doesn’t, your desire for great sex will come back. Make sure you use lubricant generously, and don’t hesitate to use lubricant even when masturbating. It helps to get used to the feeling in privacy before experimenting in the bedroom with your partner.

Tip 9 – Get your doctor to prescribe some vaginal estrogen

Provided you don’t have any contraindications to using estrogen (e.g., breast cancer or other hormone dependent cancers, liver disease, thrombosis), your doctor will be able to prescribe some vaginal estrogen for you. Click here to read about menopause treatment that can make a difference to your sex drive and improve vaginal health.

Vaginal estrogen is safe to use and doesn’t stimulate the lining of the womb. When used as prescribed it can help keep the vagina lubricated, improve arousal, decrease pain and discomfort and even prevent recurrent urinary infections.

Tip 10 – Learn to masturbate for great sex after menopause

Learning about your body and its needs is a necessity not a luxury. When you understand your own sexual needs and preferences you become much better at communicating it with your partner. What better way to find out what turns you on or off than to learn how to masturbate.

Learn to pleasure yourself and rediscover parts of your body you had ignored for so long (Photo by Malvestida Magazine on Unsplash)

Contrary to what friends or your mother might say, masturbation will help you feel more satisfied and content. Knowing that your pleasure is entirely under your control is very powerful. When you include training yourself to achieve orgasms you will find that your menopause journey is much smoother because your hormones are better balanced.

You can experiment with a wide variety of props or just use your hands. Remember to use plenty of lubricant. If you are using sex toys be sure to clean and dry them after use and never to share toys. Again, water based, non-perfumed lubricants are best. Avoid silicone based lubricants because many toys have silicone in them and can get damaged.

Explore sex toys and use them to learn about your body and what turns you on (Photo by We-Vibe WOW Tech on Unsplash)

Tip 11 – New relationship – insist on a condom

In case you are newly single because of a divorce or widowhood, take your time to explore your new wants and needs.

Learning to love yourself with your new vision for life matters a whole lot more than jumping into a relationship that you didn’t particularly want but couldn’t say ‘no’ to.

When desire does kick in and the relationship is right, be sure to use plenty of lubricant the first time you have sex.

Also remember to insist on a condom. Women often get sexually transmitted infections because they think they don’t need to use contraception now that they are menopausal.

Although this is true of menopause it isn’t true of sexually transmitted infections. You can still catch an infection from someone who has it if you don’t insist on using a condom.

The alternative is to get checked out at a sexual health clinic together before becoming intimate. That way you know you can be honest and transparent about other needs and wants and having that awkward conversation need never happen.

Don’t take a chance with STIs (Photo by Reproductive Health Supplies Coalition on Unsplash)

These tips are so easy to implement in your everyday life. All you need is a willingness to experiment and a partner to experiment with.

Conclusion

Sex and Menopause are words that often don’t go together. Yet, you can enjoy a great sex life after menopause if you follow some of the tips in this article. Learning about your own sexual needs and preferences allows you to communicate better. A better relationship means more opportunities to create great sex, even if you are suffering with several menopause related symptoms

Menopause is a very challenging time for most women and the effect on sexual desire is particularly drastic. It can be the cause of a breaking point in an otherwise smooth sailing relationship.

Remember to consult your doctor for advice about any concerns regarding your symptoms. Vaginal estrogen is very helpful in relieving many of the symptoms related to vaginal dryness and painful sex. Don’t hesitate to ask for help.

Use the tips discussed in this article to rejuvenate your sex life and get your desire back. Your body and mind will thank you for it.

I hope you will use the tips in this article to revamp your sex life as you go through the menopause. Do write to me at masterthemenopause@gmail.com and let me know what you think.

References

Sexual Function and Factors Affecting Menopause: A Systematic Review . Mohammad HeidariMansureh Ghodusi, Parvin Rezaei, Shokouh Kabirian Abyaneh, Ehsan Heidari Sureshjani, and Rahim Ali Sheikhi. J Menopausal Med. 2019 Apr; 25(1): 15–27. Published online 2019 Apr 25. doi: 10.6118/jmm.2019.25.1.15 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6487288/

Sexual function and distress in postmenopausal women with chronic insomnia: exploring the role of stress dysregulation. David A Kalmbach , Sheryl A Kingsberg , Thomas RothPhilip ChengCynthia Fellman-CoutureChristopher L Drake. Nat Sci Sleep. 2019 Aug 22;11:141-153.  doi: 10.2147/NSS.S213941. eCollection 2019.

Biological and psychosocial pathophysiology of female sexual dysfunction during the menopausal transition. Alessandra GraziottinSandra R Leiblum. J Sex Med. 2005 Sep;2 Suppl 3:133-45. doi: 10.1111/j.1743-6109.2005.00129.x.

Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women. 2016 ISSM Female Sexual Dysfunction Prize. Sarah Wåhlin-JacobsenEllids KristensenAnette Tønnes PedersenNanna Cassandra LaessøeArieh S CohenDavid M HougaardMarika LundqvistAnnamaria Giraldi. J Sex Med. 2017 Mar;14(3):366-379.  doi: 10.1016/j.jsxm.2016.12.237. Epub 2017 Jan 20.

Cochrane Database of Systematic Reviews Review – Intervention Hormone therapy for sexual function in perimenopausal and postmenopausal women Carolina O Nastri, Lucia A Lara, Rui A Ferriani, Ana Carolina JS Rosa‐e‐Silva, Jaqueline BP, igueiredo, Wellington P Martins, https://doi.org/10.1002/14651858.CD009672.pub2

The Kronos Early Estrogen Prevention Study (KEEPS): what have we learned?, Miller, Virginia M. PhD; Naftolin, Fredrick MD, PhD; Asthana, Sanjay MD; Black, Dennis M. PhD; Brinton, Eliot A. MD; Budoff, Matthew J. MD; Cedars, Marcelle I. MD; Dowling, N. Maritza PhD; Gleason, Carey E. PhD; Hodis, Howard N. MD; Jayachandran, Muthuvel PhD; Kantarci, Kejal MD; Lobo, Rogerio A. MD; Manson, JoAnn E. MD, DrPH; Pal, Lubna MBBS, MS; Santoro, Nanette F. MD; Taylor, Hugh S. MD; Harman, S. Mitchell MD, PhD. Menopause: September 2019 – Volume 26 – Issue 9 – p 1071-1084.doi: 10.1097/GME.0000000000001326. https://journals.lww.com/menopausejournal/Fulltext/2019/09000/The_Kronos_Early_Estrogen_Prevention_Study.21.aspx

Endometrial safety of low-dose vaginal estrogens in menopausal women: a systematic evidence review. Constantine, Ginger D. MD; Graham, Shelli PhD; Lapane, Kate PhD; Ohleth, Kathleen PhD; Bernick, Brian MD; Liu, James MD; Mirkin, Sebastian MD, Menopause: July 2019 – Volume 26 – Issue 7 – p 800-807.doi: 10.1097/GME.0000000000001315. https://journals.lww.com/menopausejournal/Fulltext/2019/07000/Endometrial_safety_of_low_dose_vaginal_estrogens.18.aspx

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