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Sex After Menopause - Breaking the Shackles, Exploring New Possibilities

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4 min read


Hormones, physical health, age, and psychosocial factors influence sexual wellness. Variation can be beneficial at times, but can menopause affect sexual health?

Medically reviewed by

Dr. Raveendran S R

Published At September 9, 2022
Reviewed AtMay 9, 2024


Menopause, also called climacteric, permanently ends a woman's menstruation and reproductive life due to the lack of follicular activity. Menopause is most common in women between the ages of forty-nine and fifty-four. Premenopause, perimenopause, menopause, and postmenopause are the four stages of menopause. Menopause causes physical, psychological, and sexual changes in a woman's body.

What Causes Menopause?

Menopause is a natural process that occurs when a woman reaches the age of menopause.

Alternatively, it could be due to one of the following factors:

  • Hysterectomy - Removal of the uterus (womb).

  • Chemotherapy.

  • Radiotherapy.

  • Primary ovarian insufficiency.

  • Removal of the ovaries.

What Changes Occur During Menopause?

  • Irregular periods during perimenopause.

  • Vaginal dryness.

  • Hot flashes.

  • Night sweats.

  • Sleeping disorders.

  • Osteoporosis.

  • Low sex drive.

  • Mood swings.

  • Weight gain.

  • Decreased metabolism.

  • Dry skin.

  • Breast changes.

What Sexual Issues Emerge as a Result of Menopause?

  • Reduced Libido - Libido or sex drive refers to an individual's desire for intimacy. Hormones have a significant impact on libido. There is a complete decline in sex drive, just as there is a substantial fall in estrogen during menopause.

  • Vaginal Dryness - During menopause, the vaginal mucous membrane thins and loses its firmness. The vaginal dryness caused by reduced discharge makes sexual intercourse uncomfortable and difficult.

  • Arousal Difficulties - The bodily signals of sexual readiness are arousal. The labia, clitoris, and upper vagina enlarge as the blood supply to the genitals rises. The lining of the vaginal canal becomes wet, which provides lubrication. Low estrogen might make arousal take longer or be more challenging to achieve due to vaginal atrophy and dryness.

  • Orgasm Difficulties - Low hormone levels decrease sex drive, making the orgasm more difficult to achieve.

  • Pain During Sex - When estrogen levels drop as women approach and enter menopause, the resulting dryness and vaginal atrophy can make penetration and intercourse unpleasant. The discomfort can range from dryness in the vaginal area to unbearable pain during intercourse.

How to Deal With Sexual Difficulties That Arise During Menopause?

  • Communication - With age, a person's desire for sex fades typically. It is critical to express one's feelings about intimacy and what turns them off and outline a strategy for resolving these issues.

  • Healthy Lifestyle - Avoid drinking and smoking, and eat a high-fiber diet to improve your general health, including your sexual health.

  • Regular Sleep Cycle - Because irregular sleep patterns are expected due to disrupted hormone levels, maintaining a regular sleep schedule can help stay active and healthy.

  • Medications - Antidepressants, hypertensive drugs, and other medications that may worsen the existing condition should be avoided. Always inform the doctor that you have hit menopause to adjust the medicine or dose.

  • Exercise and Yoga - Exercising or practicing yoga can assist in strengthening pelvic floor muscles, which will help with sexual intercourse.

  • Hormone Replacement Therapy - In postmenopausal women, hormone replacement therapy is recommended to counteract the long- and short-term effects of decreasing estrogen levels.

What Are the Indications for HRT (Hormone Replacement Therapy)?

  • Menopausal symptoms are alleviated.

  • Osteoporosis prevention.

  • To maintain a high standard of living.

  • Premature ovarian failure.

  • When there is a problem with the gonadal glands, it is called gonadal dysgenesis (abnormal ovary growth).

  • Surgery aided menopause.

  • Menopause is caused by radiation.

What Are the Hormones Used in HRT (Hormone Replacement Therapy)?

Progesterone and estrogen are the hormones that are delivered in hormone replacement therapy. Progesterone is given to those with excessive hot flushes, while estrogen is provided to ladies who no longer have a uterus due to surgical removal or radiation therapy.

What Are the Different Ways to Administer Hormones in Replacement Therapy?

  • Oral Preparations - Taken in the form of tablets.

  • Subdermal Implants - The implants are inserted subcutaneously in the belly region under local anesthesia.

  • Abdominal Gels - Gels that can be applied to the abdominal region.

  • Transdermal Patch - Applied below the waistline, changed twice a week.

  • Vaginal Cream - The medicine is delivered systemically by the modes mentioned above of administration; however, in patients with urinary difficulties, the local route is preferred to avoid systemic toxicity.

What Are the Possible Risks Associated With Hormone Replacement Therapy?

Hormone replacement therapy is often recommended for three to five years.

The long-term effects of use include:

What Is the Kegel Exercise and How Does It Aid Sexual Health After Menopause?

The weakening of the pelvic floor (the muscles that support the organs in the pelvis) is one of the most challenging changes that menopause can bring to the woman's body. Similar changes are also seen during childbirth and pregnancy. Arnold Kegel, a well-known gynecologist from California, introduced the Kegel exercises in 1948. These exercises are basic bodyweight exercises mainly involving contraction and relaxation of the muscles. The pelvic floor muscles are strengthened with Kegel exercises, improving sexual health and reducing urinary incontinence.

What Is Manopause?

Manopause or andropause is another name for male menopause. Testosterone hormone is reduced in men during andropause. Andropause can cause physical, psychosocial, and sexual problems, such as infertility, decreased libido, and erection disorders. They usually strike men about the same time as women who enter menopause.

Is It Possible to Enjoy Sex After Menopause?

Menopause may not always imply the end of a woman's sexual life. Yes, having intercourse can be challenging, but it can be dodged.

Here are a few recommendations that can help one enjoy a sex life after menopause.

  • Taking part in activities that help couples bond or deepen their relationship.

  • Exercise and relaxation activities can help you manage stress.

  • Finding strategies to reignite passion or restore partner relationships by talking to a therapist.

  • Attempting new or novel sexual behaviors

  • Addressing any discomfort, infection, or inflammation in the genital area

  • Having sex regularly

  • Use of lubricants.


During pregnancy, childbirth, and menopause, a woman's body goes through several changes. It's critical to treat sexual health concerns throughout and after menopause. Women should always seek medical advice from their doctors to receive appropriate therapy.

Frequently Asked Questions


What Is Sex Like and Does It Feel Good after Menopause?

Sex postmenopausal can be a bit compromised due to the hormonal changes happening in the body. There is a reduced libido, making it more painful and difficult to climax.


How Can a Person Satisfy Their Sexual Desires after Menopause?

A person can satisfy their sexual desires after menopause by: 
 - Touching themselves. 
 - Opting for clitoral stimulants. 
 - Applying lubricants during intercourse.


Why Is Having Sex Difficult Post Menopause and Is It Painful?

Sex post menopause is difficult due to the hormonal imbalances happening in the body, resulting in vaginal dryness, loss of libido, and prolonged time to achieve climax.


What Is the Significance of Having Sex For a Woman? What Are the Changes Occurring in a Woman’s Body After Having Sex?

There are various benefits for a woman when they have sex, and they are:
 - Improved immune system.
 - Lowers blood pressure.
 - Decrease the risk of heart disease.
 - Reduces stress levels.


How Does Menopause Affect a Husband and How Should He Treat His Wife During Menopause?

Menopause can have a mental effect on a husband's sex drive as it affects the spouse's body, altering her features like weight gain, etc. However, as the wife undergoes a lot of hormonal imbalances, it is important for the husband to understand and be supportive.


What Is the Longevity of Menopause and What Are Its Effects on Marriage?

Menopause is a lifelong condition that occurs in a woman after the reproductive period. It may affect the relationship between the couples, making them lose interest in each other, mistrust, loss of understanding, etc.


Which Is the Preferred Lubricant for Sexual Intercourse after Menopause?

Water-based vaginal lubricants are the most preferred ones, and some of the preferred lubricants are:
 - Eros aqua.
 - Astroglide.
 - Liquid silk.
 - K -Y liquid.


What Are the Drawbacks of Not Having Sex for a Long Time?

The systemic and emotional drawbacks faced when not having sex are:
 - Increased anxiety.
 - Disturbed sleeping.
 - Compromised immunity.
 - Decreased vaginal and prostate health.
 - Compromised cardiac health.


Do Women Ovulate after Menopause and What Are the Changes Seen in Female Organs Post Menopause?

No women ovulate after menopause as they attain a no-egg state, which makes it impossible to release the egg. The changes seen in the female parts are:
 - Vaginal walls become drier and more thin.
 - Compromised elasticity.
 - More prone to irritation.
Dr. Raveendran S R
Dr. Raveendran S R



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