Sex After Menopause | What Should You Know?

Menopause can have a profound impact on sex drive and sexual health. For many women, desire and enjoyability nosedive leading up to, during, and after menopause. A lack of information regarding hormonal changes can leave women in the dark about their options. Quality, enjoyable sex after menopause is possible. In fact, it should be considered the standard. Here’s what every woman needs to know about menopause and sex.


How Does Menopause Affect Your Sex Life?

Menopause is a natural part of life. It should be looked at as something to be managed with grace and confidence instead of something to be “cured.” However, there’s no denying that some menopause symptoms can cause pain and stress for many women. Understanding why these symptoms happen is an important part of feeling empowered in your menopause journey. Here’s a look at some of the ways that menopause can alter sexual health.


Low Libido

During menopause and perimenopause, estrogen and testosterone production dips significantly. For most women, this signals dramatic changes in sexual function. In addition to lowering desire, estrogen dips can make it difficult to become aroused when engaging sexually. In fact, more than 30% of perimenopausal or postmenopausal women report having sexual struggles that range from lack of sexual desire to orgasm difficulties.


Vaginal Dryness

In addition to reducing overall sexual desire for many women, the estrogen and testosterone dip that occurs during menopause, and decreased sexual activity can also cause vaginal dryness. Sometimes referred to as vaginal atrophy or atrophic vaginitis, vaginal dryness caused by reduced estrogen levels actually results in shrinkage of the vaginal wall. As this happens, the vaginal lining can become smooth and dry. Dryness is often accompanied by sensations of burning, itching, and tightening that can cause extreme discomfort. Of course, any vaginal itching or discomfort shouldn’t be dismissed as normal menopausal symptoms even if you are of menopausal age. Be sure to book an appointment with a gynecologist to rule out infections or other conditions that could be causing pain or discomfort.


Pain or Discomfort During Intercourse

Dyspareunia is the term for painful vaginal sex. According to research, up to 30% of postmenopausal who are not being treated hormonally experience this condition. Dyspareunia is actually divided into three different categories based on the type of pain that is experienced. These categories are superficial pain upon penetration, deep pain, or a combination of both. Dyspareunia can produce a sharp, burning pain that either persists or fades as intercourse goes on.

Like other symptoms that can make enjoying sex after menopause challenging, pain and discomfort during intercourse are largely caused by reduced estrogen and testosterone levels. In addition to leaving vaginal tissue more fragile, reduced estrogen can also cause urinary and bladder issues that make sex feel uncomfortable.

Not all painful sex after menopause is strictly hormone-related. Some women experience pain caused by childbirth, pelvic trauma, pelvic surgery, and other underlying conditions. Even stress, fear of intimacy, or insecurity about a changing postmenopausal body can make enjoying sex feel like a challenge. Some common medications prescribed for depression and high blood pressure are linked with excessive vaginal dryness.


Reduced Elasticity

Another common cause of painful or uncomfortable sex after menopause is reduced elasticity. Reduced estrogen levels can cause vaginal tissue to lose its elasticity. In addition to being tender, vaginal tissue can be more vulnerable to tearing and bleeding.


RELATED: What is Labial Hypertrophy?


Improving Your Sex Life After Menopause

Countless women have gone from believing that sex could never be pleasurable again to enjoying sex after menopause. The key to restoring sexual health is getting a proper diagnosis that gets to the root of why you are experiencing pain, lack of desire, or other common symptoms that show up in women after ages 40, 50, and beyond. Here’s a look at common treatments for menopausal sexual health.


Hormone Therapy

With reduced estrogen being at the core of so many negative symptoms that affect sex after menopause, hormone therapy is generally the most common treatment. However, hormone therapy is never a one-size-fits-all solution. Natural hormone therapies that are tailored to the needs of an individual patient can include levels of estrogen, progesterone, and testosterone that can often restore sexual function. These therapies can also be important for improving heart and bone health. Vaginal estrogen and lubricants can also help increase blood flow to promote natural lubrication and responsiveness.


Non-Hormonal Therapy

Radiofrequency and laser technology has also been helpful in alleviating dryness, increasing lubrication, improved blood flow to the vagina and clitoral area, as well as increasing the collagen deposit in the genitalia. These methods of treatment are safe and can be applied in conjunction with other modalities or by themselves and have been shown to be very safe and effective. 


Vaginal Rejuvenation

Vaginal rejuvenation is increasingly becoming popular among women who want to restore the function and appearance of the internal and external genitalia. Rejuvenation actually refers to a collection of treatments that can either be performed independently or together as part of a plan to repair and restore damaged or atrophied tissue. Options include:


  •  Laser and radiofrequency vaginal rejuvenation
  •  Surgical rejuvenation
  •  Perineoplasty
  •  Vaginal tightening
  • Labiaplasty and clitoral hood reduction
  • Labial Puff
  • G Spot Injection


In addition to restoring cosmetic appearance, vaginal rejuvenation can correct a weakened pelvic floor to improve overall health and quality of life. It can also help to enhance sexual pleasure. In many cases, rejuvenation treatments allow women to correct ongoing muscle, tissue, and nerve injuries that they have lived with for years following childbirth.

Would you like to learn more about treatments that are available to help you enjoy sex after menopause? Our offices in Glendale and Los Angeles provide an array of minimally surgical treatments, nonsurgical treatments, hormonal treatments, and exercise-based therapies to help our patients with rejuvenation, restoration, and restored pleasure. Dr. Michael Tahery has been helping women manage perimenopause and menopause symptoms for more than 20 years. Contact our office today to book an appointment.