Tips For Sex After Menopause

What are the best tips for sex after menopause?

Honestly, I get this question all the time as a Family Nurse Practitioner: now that I’m menopausal how can I have a better, healthier sex life?

I always start by assessing vaginal health.

Because if your vagina is atrophic from lack of estrogen, sex will be uncomfortable. Your menopausal vagina may require estrogen replacement therapy – directly placed into the vagina. I prefer estriol over estradiol vaginal cream to get the vagina as healthy as possible. 

Estrogen helps to keep the vagina lush, thickening the tissue and helping vaginal cells to lubricate adequately for intercourse. My menopausal patients who have incontinence issues, or birth trauma or surgical trauma, and have poor vaginal tone especially benefit from vaginal estradiol.

Poor vaginal tone with age comes from loss of collagen. Besides estrogen, the use of vaginal vibrators can actually be very helpful at improving the vagnial tone as well as practicing kegels exercises. You can find kegels muscles by trying to stop your urine flow while in the process of urinating. 

Lubrication is key to good sexual health too.

Even once your vagina is healthy again and its tone is better, you may still need a little extra lubrication. That’s because arousal can be slower in menopause. So make sure you have a lubricant on hand. 

My favorite is coconut oil. It has antimicrobial activity, tastes good, and is healthy for the vaginal tissues. 

The longer you go without sexual activity, the more difficult it is to initiate but it’s not impossible. You just have to get your vagina healthy again. If you don’t have a partner, that’s where your vaginal vibrator can help maintain vaginal tone.  

Remember, as your hormones start falling, orgasm may take longer because you don’t have the same blood flow to the genitals that you did when you were younger. Everything takes a little bit longer. So you need to be patient with yourself and get to know your changing body.  A vibrator may come in handy to figure out what you need to orgasm. 

Sometimes low libido is an issue.

Estrogen is the main driver of libido in women. But if your vagina is well estrogenized and your FSH is being adequately suppressed with systemic estradiol then you may need a little bit of testosterone to help your libido. Too much testosterone can be an issue but a small amount can actually be very effective at increasing libido once your estrogen and progesterone levels are balanced. 

And communication with your partner is key. Menopause is a great time for you to have very frank conversations with your partner. Hopefully your partner has a sense of humor because things are different now. It’s important that you both understand that the female body changes after menopause. 

Sex after menopause can be very exciting, beautiful, and fun. Especially with good communication with your partner. I find male partners have a lot of questions about sex in menopause. So let’s talk. Please join me in our Hormone Support Group. You get access to it through my free Hormone Reboot Training.