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Having Good Sex During and After Menopause

Menopause is a natural and inevitable occurrence for 50% of the population — yet many of us confront this change of life without real or useful information about how it will impact our lives. If you’re in your 40s and 50s, you may be seeing changes in your body and your sexuality that you weren’t fully prepared for. How will perimenopause and menopause impact your sex life — and what can you do about it?

What to expect before, during, and after menopause

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You likely already know that menopause involves a significant shift in your body’s hormonal profile. Specifically, both estrogen and testosterone levels in your body will begin to drop beginning in perimenopause, often in your 40s. During and after menopause — the milestone wherein someone who’s previously menstruated goes 12 months without a menstrual period, usually between 40 and 58 — estrogen and testosterone both decline precipitously. 

The decrease in these hormones has a range of effects on your sex life. First, many menopausal people report a significant decrease in libido; they may feel less interested in sex, and have a harder time getting physically aroused even when they are interested in sex. Mood changes, including depression and anxiety, may also mean you don’t feel as interested in sex as often. Second, the body may experience physical changes related to sex and genitalia; the vulva and vagina may feel drier and less elastic, producing less natural lubrication and becoming more prone to tears or irritation during sex. Penetrative sex may feel painful or uncomfortable, or you may experience itching or burning sensations. It may be harder or take longer to reach an orgasm.

Some of these changes can be mitigated by approaches to hormone replacement therapy, but all of us should expect to adjust to some degree of changes to our sex life related to menopause.

Navigating changes in arousal and libido

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It can feel frustrating to be in a happy partnership or fulfilling sex life and feel a shift away from “being in the mood” as you move through menopause. However, just because your sex life doesn’t look the same as it did in your 20s or 30s doesn’t mean it can’t still be fulfilling and exciting.

If you’re in a long-term partnership, it’s a good idea to talk directly with your partner about your changing relationship to desire. The routines and approaches you’ve had around sex may have to change; if you’ve been having sex spontaneously, it may be time to try out having a routine or schedule for sex. It may be helpful to try more foreplay or nonsexual intimacy; your partner could give you regular sensual massages and let you decide whether you’d like them to progress into intercourse or not.

You may also want to try new practices or fantasies to engage with your arousal more intentionally. Are there fantasies you or your partner haven’t shared with each other? Would it be helpful to bring more flirting, dirty talk, or sexting into your relationship to build arousal during the day? It’s worth thinking about this not as an end to your sex life as you know it, but as a time to experiment and have fun trying new things.

Navigating changes in physical response and sensation

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It’s disconcerting when our body goes through changes unexpectedly, and having a sexual experience that’s always been pleasurable and fun feel more painful or uncomfortable can be difficult. Some interventions can help; vaginal moisturizers or topical estrogen cream can help with some symptoms of vaginal atrophy caused by a decline in estrogen, and using plenty of water-based lube during penetrative sex can help a lot in the moment. 

If you’re struggling to experience sensations of pleasure or reach orgasm during menopause, you can try products like Zestra, a massage oil designed to induce a feeling of warmth in the genital area and increase physical pleasure. You might also think about trying something new with how you stimulate yourself or try to reach orgasm — if you’ve been exclusively having sex “manually,” this could be the perfect time to start trying out toys. A strong vibrator or air compression toy might make orgasming feel easier; one study even found that ⅔ of menopausal women who used a vibrator for three months felt increased vaginal lubrication as a result.

If penetrative sex remains painful or uncomfortable even with the use of estrogen creams or moisturizers, it doesn’t mean it’s time to despair. Instead, it may be time to think about expanding your sex life and definition of sex. There are a variety of reasons why someone might find vaginal intercourse uncomfortable or painful, not just menopause; and for everyone in this boat, the good news is that sex doesn’t begin and end at penetration. Could you and your partner focus more on external play, like oral sex or clitoral stimulation? Is this a time to try anal sex — or wearing a strap-on yourself? Menopause does mean your sex life will likely look different, but it doesn’t mean it has to lose the spark and excitement it has now.

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