Enjoying sex after menopause can sometimes require a little extra effort, but for those seeking a fulfilling sexual experience, the effort is worth it. Hormone changes can result in a lowered libido, vaginal dryness, or a sense of anxiety that can negatively impact your sexual desire. The familiarity of a long-term partner can also mean romance and foreplay techniques may require some rekindling.
If you’re interested in reigniting your sex life postmenopause or seeking ways to make sex after menopause more comfortable and enjoyable, read on for our best tips.
Discomfort During Sex After Menopause: Why Does it Happen?
As the female body approaches the end of its fertile years, estrogen production from the ovaries gradually decreases during perimenopause and typically affects the body in several ways. Hot flashes, heart palpitations, mood alterations, sleep disruptions, low libido, vaginal dryness, and irregular menstruation are common symptoms in the 7-12 years it takes the female body to transition through perimenopause.
Once menstruation has not occurred for 12 consecutive months, menopause is reached.
Although many perimenopause symptoms caused by low estrogen levels tend to subside once menopause is reached, low libido and a collection of symptoms known as the Genitourinary Syndrome of Menopause (GSM) can linger into postmenopause.
These symptoms, which include vaginal dryness, painful intercourse, a lack of natural lubrication, and urinary urgency or incontinence can significantly impact a woman’s quality of life and comfort during sex.
Related Read: Best Lubricants for Vaginal Dryness
Low Libido After Menopause and How It Contributes to Pain During Sex
Libido, or sex drive, is a desire for intercourse that starts in the brain and stimulates physical changes like blood flow to the vagina and an increase in vaginal lubrication to create sexual arousal. During menopause, low estrogen levels and the physical changes that occur due to aging can leave some women feeling less interested in sex or less sexually desirable.
Poor sleep during this time of life can also increase fatigue and stress, both of which are known to lower libido. Lower testosterone levels, feeling less attracted to a partner, a lack of communication, or an increased feeling of frustration, resentment, or boredom in a relationship can also impact the female sex drive.
In fact, research has highlighted that as many as 50% of women in menopause experience low libido but as little as 25% seek help or treatment.
Vaginal Dryness and Painful Sex After Menopause
Vaginal dryness, usually caused by a lack of natural vaginal lubrication is linked to diminished estrogen levels too, and regularly results in vulvovaginal itching or irritation. Less estrogen passing through the skin tissues can also cause the vaginal skin to become dryer and lose elasticity.
Just one, or all of the above, are common after menopause and known to contribute to friction, microtears on the vaginal walls, and discomfort or pain during sex.
Vaginismus: What Is it and How Does it Affect Your Sex Life?
When women experience pain or discomfort during intercourse due to vaginal dryness or micro-tearing, the experience can trigger a psychological association between sex and pain. The next time penetration or sex is attempted, an underlying anxiety or expectation of pain can cause the brain to signal a tightening of the vaginal muscles to protect itself.
Known as vaginismus, this condition can make penetration and sex painful, and sometimes impossible, for many women after menopause.
The Pelvic Floor Muscles and Sex After Menopause
Low estrogen levels are also known to weaken the pelvic floor muscles, which contributes to urinary frequency, incontinence, and painful sex during menopause. Weakened pelvic floor muscles means less support for the pelvic organs like the bladder and bowel, but also the vagina during intercourse.
On the other hand, vaginismus can cause the pelvic floor muscles to tighten, which also contributes to pain during sex.
The Best Tips to Make Sex After Menopause More Enjoyable
When sex after menopause becomes less comfortable or painful, understanding the root cause of the issue helps to find the right solution. Low libido, vaginal dryness, pelvic floor health, and pain during sex are often linked, but one can often be the cause of the others.
Improving Low Libido After Menopause
If you’ve noticed that your sex drive isn’t what it used to be before menopause, it can be incredibly helpful to speak honestly about it with your partner. Letting them know that your low libido has more to do with hormones than a lack of attraction toward them can defuse any awkwardness or embarrassment you both feel when you’re not in the mood.
It can also remind them to be more generous with compliments that boost your confidence and self-esteem.
Gaining your partner’s support and understanding is a great way to open the lines of communication and bring you closer as a couple. Making time for intimate date nights, for example, discussing foreplay, and being more open to trying new things can help you to improve your joint sexual journey after menopause.
Regular exercise has also been proven to boost libido. And if you need more guidance on getting your sexual compatibility back on track together, couples counseling is also beneficial.
Treating Vaginal Dryness to Make Sex More Comfortable After Menopause
Organic vaginal moisturizers, designed to protect the vaginal pH and prevent infections caused by synthetically made products, are typically the first step in relieving vaginal dryness. When applied daily, the replenished moisture in the vaginal skin eases itching, irritation, and dryness.
Supplementing the lack of natural vaginal lubrication with a water, silicone or oil-based personal lubricant during foreplay will make penetration more comfortable. Re-applying more lube when needed can prevent friction and make intercourse more pleasurable.
It's best to ensure the lubricant you chose is glycerin-free to avoid any further vaginal irritation or dryness. Serenity Water-Based Personal Lubricant, from Intimate Rose is our top pick. Made from high-quality, natural, and safe ingredients, this ultra-smooth and extra-silky lubricant provides longer-lasting comfort than most other water-based lubes.
Estrogen Supplementation
While moisturizers are soothing and lubricant is always an important part of sexual activity, for most women, it is not enough to manage their symptoms. The menopausal changes that occur in vaginal, vulvar and bladder tissues are progressive, meaning what might be a mild, occasional itch at age 45, can turn into painful sex and urinary urgency at age 65.
Thankfully, local estrogen treatments, which include creams, suppositories or vaginal rings can be used to supplement estrogen and relieve the symptoms of Genitourinary Syndrome of Menopause. These treatments are extremely safe and highly effective. Not only does vaginal estrogen treat bothersome genital symptoms, but it actually reduces the risk of contracting bladder infections as well.
Unlike systemic hormone therapy, local estrogen treatment does not release estrogen throughout the body and limits its transdermal absorption to the genital skin and tissues.
Restoring Pelvic Floor Strength to Improve Sexual Enjoyment
Weak pelvic floor muscles can be improved by practicing Kegel exercises daily. However, many people don’t perform Kegel exercises correctly, so it’s helpful to schedule a consultation with a pelvic floor physical therapist to learn how to perform these exercises correctly.
Using Kegel Weights is also helpful to target and strengthen the pelvic floor muscles correctly. The Kegel Weights from Intimate Rose are designed to be left inside the vagina while you complete your daily chores.
Relaxing Tight Vaginal and Pelvic Floor Muscles for More Pain-Free Sex
If you’re suffering from vaginismus or tight pelvic floor muscles, a set of vaginal dilators are one of the best solutions to relax and gently stretch delicate muscles that are not easy to reach.
Normally sold in sets of ascending lengths and widths, vaginal dilators made from medical-grade silicone are considered the best on the market for a smooth and comfortable feel in the vagina.
Start with the size dilator that causes only minimal discomfort when inserted and increase the size only when resistance subsides. This gradual stretch for the pelvic floor and vaginal muscles encourages them to relax and provide proper support for sexual comfort.
Similar to performing Kegel exercises correctly, receiving instruction from a pelvic health physical therapist or gynecologist before using vaginal dilators will ensure the best results.
Conclusion
Due to the physical, physiological, and hormonal changes that occur during perimenopause, vaginal dryness & low libido can result in pain or discomfort during sex after menopause.
Although experienced by many, only a small percentage of women seek help or speak with their partners about their genitourinary symptoms during menopause. If left untreated, having sex when suffering from vaginal dryness could lead to a more painful condition known as vaginismus.
The good news is that vaginal dryness, low libido, and vaginismus can be addressed and treated so that menopausal women can return to a pleasurable sex life well into their elder years. Follow our tips above for improving intimacy and sexual comfort after menopause.
References
NHS Inform – Sexual Well-Being, Intimacy, and Menopause - https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/sexual-wellbeing-intimacy-and-menopause/
Science Direct - Estrogen’s Effects on the Female Body - https://www.hopkinsmedicine.org/health/conditions-and-diseases/estrogens-effects-on-the-female-body
Research Gate – Menopause: Understanding the Impact on Women and their Partners - https://www.researchgate.net/publication/338627168_Menopause_-_Understanding_the_impact_on_women_and_their_partners
Johns Hopkins Medicine – Genitourinary Syndrome of Menopause - https://www.hopkinsmedicine.org/health/conditions-and-diseases/genitourinary-syndrome-of-menopause
WebMD - Finding Relief from Vaginal Dryness and Pain - https://www.webmd.com/menopause/menopause-vaginal-dryness
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.