| Tara Langdale
Why Sex is More Difficult After Menopause?
Written by Caroline Knight
The menopause is something that all women know they will eventually have to deal with, and many also have an idea of the type of symptoms they will experience when that time comes. The most commonly anticipated symptoms of the menopause are hot flashes, night sweats, mood swings, irritability and difficulty sleeping. There are quite a number of other symptoms that women are likely to experience during the menopause, but one of the more challenging menopause symptoms is sexual problems.
Sex after the menopause is likely to be more difficult because of the bodily changes you inevitably go through, but rest assured this does not mean that sex will be impossible, or not enjoyable. With education on the products and practices to help you deal with the physical aspects of the change, you will be able to find some equilibrium in your sexual life once again.
The average age for women to reach menopause is 51, although in some cases it arrives later. For others still, the menopause comes earlier than expected, starting at between 41 and 45. This is known as ‘premature menopause’ and affects around 1% of women. Most women enter the pre-menopausal phase in their late 40s, and that can last for up to ten years. It is called the perimenopause, and it happens when estrogen and progesterone production starts to slow down. During this phase, women are likely to experiences changes in the monthly cycle and other menopause symptoms, just at a lesser degree of intensity.
Although there are many menopause symptoms that can affect you, this article will focus on the issue of why sex is harder after the menopause. We will also give you some of the most effective solutions for a healthy sex life during menopause.
Will the menopause make sex more difficult?
Although there are no guarantees here because every woman is different, it is likely that you will experience at least some changes in your sex life after menopause. Different bodies might respond to the changes in different ways; some might experience more intense symptoms than others because of their lifestyle, their general state of health, or their lack of knowledge as to how to manage menopausal changes.
That said, given that the menopause goes through the same process in all women, you can expect your hormone production to decline as part of this process. This does lead to physical changes (over time) in the vagina, and of course differences in your libido. These are the main reasons the menopause may well affect your sex life to some extent, but it does not have to mean you completely relinquish your sexual relationship with your partner!
It is a good idea to expect some changes but to commit to making efforts to retain balance in your body so that your sex life isn’t too dramatically affected.
Which physical changes make sex harder after menopause?
The hormonal changes in the female body at menopause can lead to some physical changes that may have a detrimental impact on your sex life, until you find ways to make post-menopausal sex easier. Some of the most common physical changes that affect sex after the menopause are:
- Dryness in the vagina
- Thinning of the vaginal tissues
- Vaginal discharge
- Declining flexibility in the vaginal tissues
- Vaginal tightness and/or shortening of the birth canal
- Vaginal atrophy (inflammation and irritation)
- Loss of libido
Menopause symptoms are a big topic and there is a lot to say about them. This list is distilled down to the ones that cause the most problems when it comes to sex, but each has a treatment option that may well work for you… so read on if you want to find ways to manage your menopausal sex problems.
Which sexual problems are likely during the menopause?
When your estrogen levels decline it is probable that you will experience a drying and thinning of your vaginal tissues, which may result in sexual intercourse feeling less comfortable than before – and even painful. Pain during sexual intercourse (dyspareunia) is not uncommon in women going through the menopause; it happens most often to women over 50. In fact, it affects between 17 and 45 per cent of postmenopausal women.
You might also experience some degree of tightness in the vagina, or burning sensations in the vagina or vulva region. This can happen due to inflammation, tearing or bleeding caused by penetration when there is insufficient lubrication in the vagina. It may also happen because of vaginal atrophy. We will discuss vaginal atrophy in more detail below, since it is one of the more common problems with sex after the menopause.
As your hormone levels decline and your periods come to a stop, your libido is also likely to diminish. Falling estrogen levels are the reason for your hot flashes, mood swings, weight gain, night sweats and vaginal dryness… and (quite understandably) these won’t make you feel particularly sexy! On top of this, the decline in testosterone levels in women of menopause age can result in a decrease of sexual desire and motivation.
It is important to note that even if you have been through the menopause, painful sex can happen for other reasons. For example, you may have vulvodynia (chronic pain of the vulva) or vaginismus (involuntary spasms and tightness in the vagina) due to other underlying conditions – be they physical or psychological. Likewise, vaginal stenosis (shortening and narrowing of the birth canal) can happen because of radiotherapy treatments and is not necessarily menopause related. Another possibility is vaginitis, or a urinary tract condition. If you are unsure that your sexual challenges are due to the menopause, it is wise to discuss them with a qualified healthcare professional.
What is vaginal atrophy?
Vaginal atrophy (also called atrophic vaginitis) is characterized by the thinning and drying of the vagina, and inflammation of the vaginal walls. It happens when your estrogen levels decline, so most often after menopause. Vaginal atrophy can definitely make sex more difficult after menopause; it leads to pain, but also urinary complications, which can also contribute to uncomfortable sexual experiences. When vaginal atrophy is menopause related, it is often referred to as Genitourinary Syndrome of Menopause (GSM).
Vaginal atrophy (or GSM) symptoms are typically as follows:
- Vaginal dryness
- Vaginal burning
- Vaginal discharge
- Urinary incontinence
- Light bleeding after intercourse
- Discomfort with intercourse
- Decreased vaginal lubrication during sexual activity
- Shortening and tightening of the vaginal canal (vaginal stenosis)
- Genital itching
- Burning when urinating
- Urgency or increased frequency of urination
If you have any of these symptoms, know that there are things you can do treat vaginal atrophy… and that by treating it, you are likely to make sex easier after menopause.
How can I improve sex after menopause?
If you are finding that sex is more difficult after menopause, you might want to try out some of the tried-and-tested products and practices below:
Use vaginal lubricants
With the decline of your estrogen, you’ll also experience a decline in vaginal lubrication. It therefore makes perfect sense that you would give your body a helping hand by using a personal lubricant during sex. We recommend using a high quality water-based lubricant so as not to irritate the sensitive vaginal tissues - especially if you have any menopause-related inflammation.
Use vaginal moisturizers
Although similar to lubricants in their overall effects, moisturizers have a slightly different purpose. You can apply a vaginal moisturizer even when you are not having sex, since your vagina will gradually absorb the moisture. This way your body will already be primed for sexual activity when it does happen.
Use Neueve Suppositories
NeuEve suppositories and creams are an all-round menopause treatment because they help with symptoms such as vaginal odor, dryness, vaginal atrophy, itching, burning, painful sex, and bacterial vaginosis… all of which are common menopause symptoms that affect your sex life!
Try Vaginal estrogen therapy
ERT is a way of reintroducing the missing hormones that contribute to the decline of your sex life. ERT comes in topical estrogen creams, but you may prefer to take an estrogen tablet. ERT may not be for everyone, and there is evidence to suggest that it is not suitable for older women due to serious side effects. You will need to discuss this option with your Doctor.
Try MHT (Menopausal Hormone Therapy)
Studies have shown that menopausal hormone therapy (MHT) is one of the most effective treatments for vasomotor symptoms (such as hot flashes and vaginal atrophy). Note that for women under 60 the risks are less, but they do still exist. However, the benefits tend to outweigh them. You can ask your Doctor about this possibility.
Go for Plant-based BHT
For those who would rather stick with natural products, you might want to look into plant-based Bioidentical Hormone Therapy, which many women find very helpful. There are also lots of herbs and natural preparations recommended by holistic practitioners all around the world. Vitex and Black Cohosh may be a good place to start your research!
Have more foreplay with your partner
This may seem obvious, but if your partner is used to a certain dynamic, you may need to encourage him to take more time with you, now that you have reached menopause. This will help your body to relax more and respond better, even if your libido has decreased. It will also create more emotional intimacy, meaning that you’ll be more likely to engage in the act again sooner.
Have sex often
You might not feel in the mood as much these days, but if you want better sex after menopause you should try to have it more often. This will help to prevent the shape of your vagina from changing as much, and you’ll be able to retain your previous vaginal capacity. If your birth canal is smaller, sex will be more painful – so you can prevent this from happening by making an effort to have sex regularly.
Use vaginal dilators
VuvaTech vaginal dilators are small, cylindrical tools that help to keep the vagina open and extend its capacity. They will help to stretch the tissues so that even if you don’t feel like sex, your vagina will be ready for it when you do. Dilators help with all kinds of gynecological conditions, which is why healthcare practitioners often recommend them as part of a treatment protocol. In terms of menopause, dilators can help with vaginal atrophy and vaginal stenosis. Our Neodymium magnetic dilators improve blood flow to the tissues, which aids in muscle relaxation. They come in various sizes and full sets, and you can work your way up to the larger sizes with time. Why not check out our article on using vaginal dilators if you’re new to them? This will give you an idea of what to expect and the best ways to use them to improve your sex life after menopause.
The Bottom Line: The menopause may bring challenges but it doesn’t have to mean the end of your sex life.
The menopause can be a tricky time for women, but after some adjustment they can once again enjoy a healthy sex life with their partners. Take heart in knowing that all women go through the same process, and most will know what you are dealing with, to some extent! Even when sex is difficult after menopause, you can find treatments for your specific symptoms and it won’t be long before you can resume a normal sex life, even if it is with the help of products and tools.
There are lots of things you can try in the comfort of your own home, but it may be necessary to consult your GP or a qualified gynecological practitioner when symptoms are too difficult to manage on your own.