A woman’s overall health and wellness is closely tied to her reproductive cycle. From puberty, to the reproductive years and then through menopause, every woman undergoes a series of changes.

Menopause can be a major transformative phase in a woman’s life. Clinically, menopause is defined as a complete year without menstruation, in the absence of any surgery or any medical condition. During this time, you must decide what is good and what is absolutely necessary for the second half of life. And this goes for sex, too.

Sexual life after menopause is a concern for all women. Regardless of when and how menopause starts, it can affect the desire for and experience of sex. And at times, the symptoms — night sweats, hot flashes, vaginal dryness, anxiety — can also have a negative impact on sexual life. Though menopause often brings changes in sex drive, it does not have to mark the end of your sex life.

To help you through the natural passage of menopause, here are some common reasons why your sex life is affected by menopause and what you can do about it.

Why do sexual feelings change after menopause?

The sexual feeling after menopause can be affected due to various hormonal changes and psychosocial factors; these are discussed below.

  1. Hormonal changes

    Changes in sexual feelings in the menopause period is due to hormonal changes. As your body ages, your reproductive cycle will slow down, and the ovaries will decrease the production of hormones – estrogen, progesterone and testosterone. These hormones have been regulating your reproductive cycle, sex drive, and mood. Reduced levels of these hormones are thought to be a primary cause of age-related female sexual dysfunction. They result in:
    • Vaginal atrophy: This refers to the changes of the vagina that occur due to significant decrease in levels of estrogen during menopause. Due to reduced levels of estrogen, the skin and muscle cells of the vagina and vulva deteriorate, the vaginal tissue becomes thin and less elastic and will be more prone to injury. In addition to this, the blood supply to the tissues reduces making penetration uncomfortable. Vaginal atrophy affects about half of postmenopausal women, making it more difficult to become aroused.

    • Vaginal dryness: As a result of low hormonal levels during menopause, vagina produces less natural lubricant and also delays the production of lubrication in response to sexual stimulation. Due the lack of lubrication, most women experience vaginal dryness, which increases the risk of trauma during sexual activity. Around 58% of post-menopausal women experience vaginal dryness.

    • Urinary incontinence: Urinary incontinence (involuntary leakage of urine) and recurrent urinary tract infections are associated with urethral thinning, vaginal atrophy and hormonal changes. Studies showed that urinary incontinence is significantly associated with decreased sexual desire and sexual satisfaction in postmenopausal women.

    • Vaginal prolapse: It is the condition in which the urinary bladder, uterus and or bowel protrudes into the vagina. This can cause symptoms such as a sensation of a vaginal lump, difficulty emptying the bowel or bladder, pelvic pain which will interfere with a sexual relationship. Around 50% of postmenopausal women experience some degree of vaginal prolapse.

  2. Psychosocial factors

    In addition to hormonal changes, there are some other factors which may affect a woman’s sexual function at menopause. Some of these factors include:
    • Emotional wellbeing
    • Emotional satisfaction with the relationship
    • Satisfaction with previous sexual encounters
    • Weight gain during menopause
    • Social attitudes

Improving sexual function after menopause

There are various treatment approaches available to improve sexual function in postmenopausal women. Recommendations may include sex education, counseling, and sometimes medication and hormone therapy.

  1. Sex education and counseling: Addressing your sexual concerns with a sex therapist or counselor can help you deal with low sex drive. Your therapist or counselor will provide education about sexual response and techniques and will also conduct some sessions which will help you cope with other menopausal symptoms and stress. A proper counseling will help to enhance your feelings of intimacy and desire.
  2. Hormonal therapy: Hormonal therapies are highly effective in relieving sexual symptoms in menopausal and post-menopausal women. It mimics hormones such as estrogen and progesterone that your body stops making during menopause. The therapy aims to ease vaginal symptoms of menopause, such as dryness, itching, burning and discomfort with intercourse.However, there are some risks associated with using hormone therapy. These risks depend on the type of hormone therapy, the dose and duration of the therapy.
  3. Changing sexual habits: Changing your regular sexual routines can foster a sense of intimacy with your partner. Practice stress-relieving techniques like going on dates together, taking a walk, or doing hobbies together, etc. This will help you feel more comfortable with sexual activity. In many cases, use of vaginal moisturizers (e.g. water based lubricants) helps to ease the symptoms of moderate to severe vaginal dryness associated with menopause.

Tips for better sex after menopause

After menopause, your sex life may look different. With a strategic approach, you can enjoy healthy sexual life in this second phase of your life.

Here are some tips that will help you to maintain or improve your sex life after menopause:

  • Talk with your partner about sex and the positive and negative effects of menopause
  • Try sexual activities that does not involve vaginal penetration
  • Apply vaginal lubricant before intercourse
  • Avoid using soaps, oils or feminine washes while washing the area around the vagina
  • Try new or different sexual activities
  • Engage in regular sexual activity
  • Stay hydrated
  • Exercise regularly and eat a healthy diet
  • Seek advice from a professional if you need help with any sexual problems
  1. How sex changes after menopause. https://www.hopkinsmedicine.org/health/wellness-and-prevention/how-sex-changes-after-menopause . Accessed on: 23-09-2020.
  2. Menopause and sexual issues. https://www.betterhealth.vic.gov.au/health/HealthyLiving/menopause-and-sexual-issues. Accessed on: 23-09-2020.
  3. Low sex drive in women. https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/ . Accessed on: 23-09-2020.
  4. Strategies for staying sexual after menopause. https://www.nwhn.org/strategies-for-staying-sexual-after-menopause/ . Accessed on: 23-09-2020.
  5. Tips for better sex after menopause. https://www.stamfordhealth.org/healthflash-blog/womens-health/sex-after-menopause/ . Accessed on: 23-09-2020.
  6. Effective treatments for sexual problems. https://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems . Accessed on: 23-09-2020.

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