Why Can’t I Orgasm Anymore After Menopause?

5 minute read

By: Alloy Staff|Last updated: August 2, 2022

Menopause is associated with numerous changes, both extrinsic and intrinsic to your body. Your hormone levels, specifically estrogen and testosterone levels, are fluctuating as they slowly trend downwards. Along with hot flashes, night sweats, and mood swings, your changing hormones are likely affecting your sex life. You may be asking “Why can’t I orgasm anymore after menopause?” Well, the good news is, you can! 

It is perfectly normal for your intimate life to change after menopause, and Alloy is here to help you understand this change and to discuss what can do about it.

Hormonal Changes After Menopause

As we have already mentioned, during menopause it is as if your body’s hormone levels almost have a mind of their own and your body is constantly trying to play catch up! 

Lack of Estrogen

During perimenopause, your estrogen levels begin to fluctuate and eventually drop. You have most likely noted the effect of this change on your menstrual cycles. Irregular menstrual cycles, marked by both variable flow and unpredictable timing, may be interspersed with stretches of normal menstrual cycles. Eventually menstruation will cease altogether and once this has been ongoing for 12 months, you are officially in menopause.

Lack of Testosterone

While testosterone is commonly thought of as the “male” hormone, in reality it plays a vital role in the health and wellbeing of a woman’s body as well. While your ovaries only produce a tenth to a twentieth of the amount of testosterone as is produced by the testes in men, testosterone plays an important role in the health of your bones, breasts, vagina, and menstruation, as well as in your sex drive.

In women, testosterone levels peak in their 20s and slowly decline thereafter. By the time you reach menopause, your testosterone level is about half of what it was at its peak.

Physical Symptoms After Menopause

The hormone changes described above may lead you to experience various menopause symptoms, including those centered around your intimate life. Studies show that menopausal and postmenopausal women experience decreases in libido and orgasm which directly impact the frequency of sexual intercourse. This is most commonly due to the physiological changes of this transition rather than due to relational discord or depression.

Decreased Libido 

Your libido is comprised of your sexual thoughts, fantasies, erotic attraction to others, and genital tingling and sensitivity. Decreases in both estrogen and testosterone lead to decreased libido.

Less Clitoris Sensitivity 

Decreases in estrogen can diminish blood flow to and affect the response of nerves in your clitoris. This leads to decreased clitoris sensitivity and even clitoral atrophy. Your ability to be aroused sexually is hence diminished.

Vaginal Dryness, Irritation, or Tightness

Vaginal dryness, irritation, or tightness are all common in menopause and are the key components of the genitourinary syndrome of menopause. As your estrogen levels decline, the tissue that lines your vaginal tract thins and dries, becoming prone to lacerations and irritation. This constellation of symptoms is also known as vaginal atrophy and can dampen your sexual desire and make sexual intercourse uncomfortable.       

Urine Leakage or Incontinence

Along with vaginal atrophy, the other major set of symptoms that comprise genitourinary syndrome of menopause involve urination. Menopausal women often complain of urinary incontinence and urine leakage, along with pain with urination and increased frequency in urination. All of these symptoms can resemble those of a urinary tract infection (UTIs), and indeed the incidence of actual bacterial UTIs does increase in menopausal women. 

Pain During Sex

Due to all of the vaginal changes associated with menopause—the decreased vaginal lubrication, thinning of the vaginal walls, shortening and tightening of the vaginal canal, vaginal itching and burning—many menopausal women experience pain during sex. Without treatment, 17-45% of all menopausal women complain of painful sex

Emotional Changes After Menopause

Along with the physical changes brought on by the hormonal changes of menopause, there are emotional changes that are common and that can affect your sexual desire and arousal.

Mood Changes

Many women describe menopause as an emotional rollercoaster. One moment you may feel happy, and then suddenly you see something or hear something that triggers a crying fit or a wave of anxiety. Though you may feel like you are going crazy, you need to know that these mood changes are normal and common. Up to 75% of women complain of menopausal mood swings.  

Irritability 

Estrogen and progesterone help to regulate chemicals in your brain that modulate happiness and your sense of calm. As these hormones begin to jump around during menopause, your ability to maintain calm and composed may be strained. As a result, you may have a flash of rage or irritability over something minor. 

Anxiety or Depression

About 23% of women experience anxiety during menopause, and 18-38% report feelings of depression. Both of these mood disorders can cause debilitating symptoms including panic attacks, dread, fear, fatigue, sadness, lack of motivation, and difficulty concentrating.  

Tips for Orgasm After Menopause

Between the physical and emotional changes brought on by menopause, you may rightfully fear that you will never want or enjoy sex again. The good news is there are several treatments and interventions that you can put in place to get your sex life back on track.

Use Lubricant

Using a lubricant will help to combat the painful symptoms of vaginal atrophy. Both water and silicone lubricants can be purchased over the counter—you may want to experiment to find which one works best for you. Water-based lubricants may need to be reapplied more often; silicone lubricants are longer-lasting, but tend to be more expensive and can stain your sheets.

Try Direct Stimulation

Decreased blood flow to your clitoris and vagina is likely to have made them, and in turn you, less responsive to touch. You can try to reverse this development by directly stimulating these areas. Regularly using a vibrator, stimulating these areas with oral sex, and having you or your partner directly touch, rub or stroke your clitoris will all work to improve blood flow and increase your arousal during intercourse.

Keep the Room Temperature Cool

Hot flashes and night sweats can both interfere with intimacy. By keeping your bedroom cool you can reduce the frequency of these mood killers. Consider keeping a fan, a glass of water, and even ice cubes near your bed to help keep you comfortable as things heat up between you and your partner.

Take Extra Time for Physical Intimacy 

Making your intimate life a priority is key to tackling the sexual symptoms of menopause. If your libido is low, you may never be in the mood to have sex. To counteract this, make an appointment for intimacy with your partner. Once you have set aside time to be physically intimate, don’t rush it. Taking the extra time you need to get in the mood for physical intimacy is crucial. Spending more time on foreplay and making sure you are fully aroused will improve the chances for fulfillment and orgasm.

Menopause Hormone Therapy for Your Menopause Symptoms

Menopause hormone therapy (MHT) is safe and effective in treating menopause symptoms in the majority of healthy women. From hot flashes to night sweats to mood swings, MHT can help you get these symptoms, potential intimacy busters, under control. 

Estradiol Vaginal Cream

Vaginal dryness, irritation, and burning can all be alleviated with estradiol vaginal cream. Additionally, estradiol vaginal cream can actually reduce the number and severity of the hot flashes and night sweats you have been experiencing.

If You Are Experiencing Difficulty Orgasming After Menopause, Alloy Can Help

If menopause has derailed your sex life and you are having difficulty orgasming, Alloy can help. It’s easy to get treatment recommendations from an Alloy expert. Take our free online assessment and we’ll get you the menopause hormone therapy you need.

Alloy's Recommended Treatment for Hot Flashes

Sources

Leventhal JL. “Management of Libido Problems in Menopause.” Perm J. 2000;4(3):29-34.

“Pain with Penetration.” The North American Menopause Society. https://www.menopause.org/for-women/sexual-health-menopause-online/sexual-problems-at-midlife/pain-with-penetration#:~:text=Over%20time%2C%20and%20without%20treatment,say%20they%20find%20sex%20painful.

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