Can You Have Good Sex After Menopause?

“Is there sex after menopause?” a reader asked, dismayed by her sexual changes. Sex after menopause does have its challenges — that’s why I keep writing books about senior sex. But I’m here from decades past menopause to tell you that life at this age can be fabulous — including the sex.

I empathise with anyone struggling with their menopause process. Back in 1994, when I was going through menopause, I wrote this:

Give us ‘Hot Flash Wear’! I want a shirt made of large patches attached with Velcro. When the flash hits and my skin feels like an electric blanket gone amok, I rip the patches open and cool my dermatological hotspots. When it subsides, I slap the patches back on.

I am 50 and menopausal. Hot flashes strike night and day. My inner furnace blasts unpredictably while I’m eating, sleeping, writing (here comes one now) or teaching aerobics. I can be high on life one minute and in tears the next. And the … uh… er… oh, yeah, memory loss! I spend ten minutes looking for my purse (it’s on my shoulder) or my keys (in the door I just opened).

A generation ago, women didn’t talk about menopause. We’re talking up a storm now. At parties, in gym locker rooms, at coffee breaks, we’re discussing hot flashes, urine leaks and vaginal dryness with as little embarrassment as we once compared diets, men or child-rearing techniques. We’re hungry for information.

We ask, “Is [insert symptom] a normal symptom of menopause?” The answer is pretty simple — usually ‘yes’. Symptoms may be subtle, or they may feel like PMS on steroids. They may include any assortment of hot flashes, anxiety, night sweats, insomnia, irritability, joint pains, bloating, constipation, mood swings, headaches, urinary tract problems or a number of other imbalances. The onslaught of symptoms may appear not with the cessation of menstruation, but for a sometimes multi-year phase preceding menopause, called perimenopause.

Over a quarter of a century later, I’m comfortably past that period in my life and am here to tell you that life post-menopause can be fabulous – and that includes your sex life.

How does menopause affect sex?

Menopause affects all of your bodily systems and so of course it is very normal for it to affect your sex life. Hormonal changes may affect your libido, vaginal comfort, and arousal patterns. Some common changes include thinning vaginal walls, decreased lubrication, longer arousal time, elusive orgasms, and lack of libido. But everybody’s experience is different. Some report feeling sexy and wild and sail through menopause!

Sexual changes are also affected by emotions: how you feel about your body and aging, how you communicate and interact with your partner, and any relationship problems. I’d need many more pages to address all these concerns (you’ll find more in my books and others), but know that life on the other side of this transition can be beautiful.

Sex will not be the same as in your youth, but with knowledge, creativity, and a sense of adventure, it can be spicy and joyful.

My experience of sex after menopause

In Better Than I Ever Expected: Straight Talk about Sex After Sixty, my first book about senior sex, I wrote this:

I welcomed menopause—no more PMS, no more bloating, no more boxes of tampons (light, medium, heavy) under the sink and in my purse, no more panic when my period didn’t arrive on schedule, no more rinsing underwear in cold water, no more bloody sheets, no more fear of wearing white. Some women feel like menopause is an ending–I felt it was a new beginning.

That doesn’t mean I had an easy time of it sexually. At first, the sexual changes were disconcerting. I stopped lubricating (easy solution: apply lubricant every time for partnered or solo sex). My vaginal walls thinned. I talked to my medical professionals about whether hormone replacement therapy (HRT) was right for me, and after trying a few different approaches, the vaginal estrogen ring worked best for me.

That solved my comfort problem, but over the years, my path to orgasm became so slow that at age 57, I feared my new lover, Robert, would get bored. When I confessed that to him, he told me, “I don’t care if it takes two weeks, as long as I can take breaks to change position and get something to eat”.

That loving attitude was one reason I fell in love with him, as you’ll read in Better Than I Ever Expected, and this led not only to a great love affair and marriage, but also to my current career! Along the way, sex became better and better.

If your doctor dismisses you, find another doctor who is sex-positive and age-positive

Menopause, your doctor and you

Is hormone replacement therapy (HRT) right for you, and if so, which kind? I can’t give medical advice and it would be irresponsible of me to try. It depends on your health, your specific symptoms, your family’s medical history and your own. Don’t tinker with your health by relying on a friend’s favorite remedy or a product that’s hyped on the Internet. You and your health professional need to work as a team. Approach your doctor with words like these:

Doctor, my sexuality is important to me. These menopausal symptoms —[insert symptoms]— are interfering with my sexual comfort and pleasure. Let’s talk about what we can do for me.

If you haven’t talked about sex with your doctor, do it now. If your doctor dismisses you with “Why do you care about sex at your age?” or “That’s just what happens as you age”, find another doctor who is sex-positive and age-positive.

Tips for better sex after menopause

– Use quality lubricant for all genital contact — external touching as well as penetration.

– Explore many ways of experiencing sexual pleasure without the goal of penetration. My webinar, Great Sex Without Penetration, describes options.

– If vaginal penetration or genital touch is painful, consult your gynecologist and/or a pelvic floor physical therapist, who is a specialist in pelvic pain.

– If lack of libido is a problem, read my article If You Don’t Want Sex Anymore, Learn About Responsive Desire and discuss it with your partner.

– Take plenty of time for sex. See slow arousal as a gift, not a defect.

– Use vibrators to intensify sensation for more reliable orgasms.

– Be honest with your partner. If communication is difficult, enlist the help of a sex therapist or sex-positive couple’s counselor.

How can I learn more?

Still Juicy: Maintaining Sexual Health through and beyond Menopause from A Woman’s Touch

Sexual Health & Menopause Online: Frequently Asked Questions from the North American Menopause Society