Regular Sex and Its Link to Delayed Menopause

A 2020 study highlighted the possibility that women having regular sex may experience menopause later than those who don’t. The study, which aimed to investigate whether the frequency of sexual activity could have any bearing on when menopause occurred, also included the regularity of oral sex and masturbation as well as intercourse. 

Carried out in the UK, researchers used data from the Study of Women’s Health Across the Nation (SWAN), which started in 1996-1997. The study included almost 3,000 females with an average age of 45 at the beginning of the study, 78% of which were married or in a long-term relationship. 

What Is Menopause? 

Women reach menopause when they have not menstruated for 12 consecutive months. Previous to menopause, perimenopause occurs for 7-12 years during which time the ovaries produce less estrogen as the body transitions out of the reproductive phase of life. 

This gradual decline in the production of estrogen can result in perimenopause symptoms such as hot flashes, irregular menstruation, brain fog, and vaginal dryness. That said, with over 30 recognized symptoms of perimenopause, each individual can experience perimenopause uniquely.  

The average age of reaching menopause is 52. However, when women enter menopause before age 45, it is deemed early menopause, and when menopause occurs before the age of 40 it is defined as premature menopause.  

What Were the Results of the Study into Regular Sex and Its Link to Delayed Menopause? 

The statistics that existed on menopause before the 2020 study called ‘Sexual Frequency Is Associated with Age of Natural Menopause’ suggested that married women experienced menopause later. Therefore, the study aimed to decipher what sustained habits or consistencies contributed to this statistic.   

Participants in the study, who were either married or in a long-term relationship, answered questions regarding their overall health, typical lifestyle habits, and how often they partook in sexual activity (oral sex, masturbation, or intercourse) over the last six months. 

None of the study participants had yet reached menopause, meaning all were still menstruating, but 46% were experiencing some perimenopause symptoms.  

As per the initial data collected from the 1996 SWAN study, 64% of women engaged in sexual activity at least once per week. When the 2020 researchers examined the follow-up interviews in the SWAN study that were carried out over the following 10 years, 45% of the participants had reached menopause at the average age of 52.  

Based on this SWAN data, the 2020 study suggests that women having sex at least once per week were 28% less likely to enter early menopause than women who had sex less than once a month.

Can Regular Sex Delay Menopause?

Although the 2020 study did not explore this question, a theory from the researchers suggests that when the female body is not engaging in sex, it could innately understand that there is no more reason to ovulate. 

Medical experts already know that the energy required for ovulation can lower immune function in the female body. The theory, therefore, proposes that when the female body comprehends it is no longer having sex, and will not get pregnant, there is no further need to ovulate. 

Hence early menopause may occur in women not engaging in regular sexual activity, thereby allowing the energy once required for ovulation to be used elsewhere, such as enhanced immune function. However, this theory has not definitively been proven. 

Does A Lack of Sex Mean Menopause Occurs Earlier? 

Not necessarily. That the female body stops ovulating earlier due to an absence of sexual activity is a theory highlighted by the 2020 study ‘Sexual Frequency Is Associated with Age of Natural Menopause’, but this theory has not been proven as fact. 

Many female health experts believe that genetics are the driving force behind menopause and when it is reached in each individual. This is also a theory, however, and based on the synchronicity of many mothers and daughters entering menopause at a similar age.  

However, other medical experts suggest there is more to research and comprehend about menopause than just genetics. Declining estrogen levels during perimenopause, for example, are linked to vaginal dryness, making it painful or impossible for some perimenopausal women to enjoy regular intercourse. 

Yet many perimenopausal women suffering from vaginal dryness and abstaining from sex due to discomfort are still known to enter menopause at the average age of 52. That said, many women experiencing vaginal dryness and a lack of regular intercourse are also known to reach menopause earlier. 

Consequently, although the theory that regular sex could delay the onset of menopause or that a lack of sexual activity could cause menopause to start, is certainly interesting, more research is needed before any conclusions are drawn.   

What Causes Early or Premature Menopause? 

Early menopause and premature menopause are known to occur due to particular conditions, medications, or surgeries. However, each can also happen due to family history or for no apparent reason.  

For instance, when mothers enter menopause early or prematurely, it could mean that their daughters will too. Women who smoke are known to enter menopause up to two years earlier than non-smokers and often experience more severe symptoms. 

Health conditions associated with early or premature menopause include rheumatoid arthritis, thyroid disease, HIV, Turner syndrome, chronic fatigue syndrome, and fibromyalgia.  

Having a hysterectomy along with a bilateral oophorectomy to remove the ovaries will cause women to enter menopause, regardless of their age. However, having a hysterectomy without removing the ovaries will not cause premature or early menopause, but it may occur a year or two earlier than naturally expected. 

Women who undergo chemotherapy or pelvic radiation for cancer often experience early or premature menopause due to the damage sustained by the ovaries. 

Making Sex More Comfortable During Perimenopause and Menopause

Declining estrogen levels during perimenopause can commonly result in irregular menstruation, hormone fluctuations, vaginal dryness, low moods, fatigue, body image issues, and lowered libido – all of which can dampen one’s desire for sexual activity.

For some women, the lack of libido coupled with vaginal dryness can mean sex becomes too uncomfortable or too painful to continue. However, regular sexual activity like masturbation, oral sex, and intercourse can help the vaginal muscles to maintain elasticity and prevent the vagina from narrowing or shortening.

Sustaining your vaginal health through perimenopause will therefore not only make sex more comfortable but also enable you and your partner to enjoy sex well into your elder years. 

Tips for making sex more comfortable during perimenopause and menopause include: 

Organic Vaginal Moisturizers 

Organic vaginal moisturizers like Enchanted Rose Vaginal Balm, from Intimate Rose, are made from natural ingredients that soothe dry vaginal skin, reduce irritation, and replenish moisture in the vaginal tissues. 

Low estrogen levels are also known to affect the natural balance of bacteria in the vagina, which can result in more yeast infections or urinary tract infections during perimenopause and menopause. To prevent any further imbalance of the vaginal microbiome, organic vaginal moisturizers are recommended above those that contain synthetic materials which could further irritate the vaginal skin.       

Personal Lubricants

Vaginal dryness during perimenopause and menopause is caused by a lack of natural lubrication in the vagina due to low estrogen levels. Using a lubricant for foreplay, intercourse, and masturbation can help relieve the vaginal dryness and make sexual activity more comfortable.    

Most lubricants are available in water, silicone, or oil bases. Water-based personal lubricants are the most gentle on sensitive skin but can dry up more quickly. This can be an issue when one is already dealing with vaginal dryness. 

Silicone-based lubricants are slippery, long-lasting, and can be used in the shower, but not on silicone toys or pelvic health tools, like those mentioned below. Silicone-based lubricants are also more difficult to clean. Oil-based lubricants can be very moisturizing and provide longer-lasting lubrication, but they are not compatible with latex condoms. 

Regardless of which type of lubricant you use, it’s always recommended to avoid synthetic ingredients, flavors, or fragrances that can upset an already sensitive vagina. 

Vaginal Hormones

Vaginal estrogen is a form of MHT that treats vaginal dryness, irritation and dyspareunia during perimenopause and menopause without affecting the rest of the body. In addition to relieving bothersome symptoms it is excellent at preventing urinary tract infections. Considered safe and effective, vaginal estrogen is administered locally as a cream, ring, or suppository. Most regimens include application nightly for two weeks, after which 2-3 applications per week are sufficient. 

More recent research also suggests that intravaginally administered dehydroepiandrosterone (DHEA) can relieve vaginal dryness and prevent urinary tract infections when applied daily. Normally produced by the adrenal glands, DHEA is the parent hormone of estrogen and testosterone. Both hormones are important for the health of the genitourinary system. Studies show that DHEA is a beneficial and low-risk treatment for relieving vaginal dryness, irritation, and discomfort during sex.  

Pelvic Floor Health

The pelvic floor muscles are another body part often affected by declining estrogen levels. In some cases, low estrogen levels weaken the pelvic floor muscles, meaning there is less vaginal support during sexual activity and pain can ensue. Feeling the need to pee more frequently, or experiencing urinary incontinence are other signs of weak pelvic floor muscles. 

Daily Kegel exercises, or using Kegel weights, are the best ways to strengthen weak pelvic floor muscles. 

In other cases, the pelvic floor muscles can tighten in protection mode after pain is experienced during sex. This type of pain is often caused by vaginal dryness, which leads to friction and microtears on the vaginal walls during intercourse. The tightening of the pelvic floor and vaginal muscles, when sex is next attempted, can result in more pain. 

Working with a pelvic health physical therapist, using a set of vaginal dilators or massaging muscles with a pelvic wand in the comfort of your own home, are the best ways to relax and gently stretch tight pelvic floor muscles. Due to the complexity of the pelvic floor, it’s always a good idea to consult with a pelvic floor specialist before using Kegel weights or dilators on your own.  

Conclusion

A 2020 study suggested a link may exist between having regular sex and how early or late women enter menopause. Based on age, overall health, lifestyle habits, and how often women engaged in sexual activity; the study proposed that women having sex at least once a week were 28% less likely to enter early menopause than those engaging in sexual activity less than once a month. 

Although the theory has not been proven, regular sexual activity during perimenopause is known to prevent vaginal shortening and maintain elasticity in the vaginal tissues. Both of which largely contribute to your long-term vaginal health and sexual pleasure in later life. 

If vaginal dryness or pain during sex is preventing you from engaging in sexual activity during perimenopause or menopause, the tips and tools we outlined above can help. 

References

National Institute on Aging – What is Menopause? - https://www.nia.nih.gov/health/menopause/what-menopause

The Royal Society Open Science - Sexual frequency is associated with age of natural menopause: results from the Study of Women's Health Across the Nation - https://royalsocietypublishing.org/doi/10.1098/rsos.191020

Study of Women’s Health Across the Nation (SWAN) – Investigating Health for Mid-Life and Older Women - https://www.swanstudy.org/

Office on Women’s Health – Early or Premature Menopause - https://womenshealth.gov/menopause/early-or-premature-menopause

The Menopause Society - Vaginal Dryness - chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf