How to Have Better Sex After Menopause

3 minute read

By: Sharon D. Malone, MD|Last updated: August 2, 2023
Couple having an intimate moment in bed, kissing, partially clothed.

Not in the mood? You’re not alone. But, there’s good news. Sex after menopause definitely exists. It just might not be as you’ve always remembered it. That may be due to a lack of desire, a lack of ability, or sometimes, both. For many women, starting in perimenopause, they start to experience vaginal dryness, decreasing sensation, and a general lack of arousal that may lead to weakened or absent orgasm.

What’s Going On?

First things first, your estrogen and testosterone levels are decreasing, and this makes it more difficult to get aroused. Factor in the aforementioned vaginal dryness, painful sex, hot flashes, fatigue, weight gain, anxiety, and depression and…it all kind of makes sense, doesn’t it. Sex might be the last thing on your mind.

And, sexual desire is cyclical. Painful sex leads to decreased desire, and decreased desire leads to decreased arousal. See how it works? 

This sounds grim. But, we’re not here just to deliver bad news. There’s good news, too. There are actions you can take, and you can break this cycle. 

What Can I Do?

Unlike sex at 20, sex at 50 requires some effort.It goes without saying, but I’ll say it anyway: a dry vagina with decreased sensation is a not part of a recipe for great sex. And while hormones are to blame for some of that, some of it is also situational. Putting the effort in means both relieving the discomfort that might come with the menopausal experience and improving your sexual environment. 

What is the difference between a vaginal moisturizer and a vaginal lubricant?

A vaginal moisturizer is used either daily or every other day for people who have persistent vulvar or vaginal dryness or discomfort not related to sexual activity.  A lubricant is used specifically for sex for those experiencing vaginal dryness or painful intercourse due to decreased natural lubrication. Lubricants may be water based, silicone based or natural such as coconut oil or Vitamin E. But remember, vaginal moisturizers and lubricants only address the symptoms, not the root cause.

To get to the root cause, there’s Estradiol cream: This will help with all of the vaginal symptoms of menopause, including dryness, burning, itching, and urinary issues. Vaginal estrogens work by actually plumping up the vaginal and vulvar tissue and restoring it to its premenopausal state. Okay, you’re not going to be twenty again, but it’s going to be way better.  The amount of estrogen in vaginal creams is so low that virtually any person can use it even if they have a personal history of breast cancer. It can increase natural lubrication and sensation. It’s easy to use and the dosing is flexible. 80% of women get relief in 4-12 weeks. But here's the deal, consistency of use is key for the best results.

Finally, communicate with your partner and make sex a priority. Talk about what’s going on.  Make a sex date with your partner. Be creative. Role play. Try weekend getaways. And don’t make sex the last thing you do. And for goodness sake, buy yourself a good vibrator. 

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