THE TRUTH ABOUT ORGASM AFTER MENOPAUSE
Updated: Jul 4
Having great sex after menopause is no longer a taboo. It's something women in their 50s and beyond are celebrating. But for some, desire can be diminished, or the experience can be painful. Some simple steps can help with both aspects and bring back the joys of intimacy and fun.
How can I increase my libido around menopause?
Arousal and libido are affected by complex physical and emotional factors. Our hormones are one part of this. Around menopause, the ovaries stop producing as much of the sex hormones oestrogen and progesterone and stop releasing eggs (ovulating). The amount of the hormone testosterone that circulates your body lowers naturally.
This reduction in hormones can affect sex drive, libido and arousal.
Hormone replacement therapy (HRT), the replacement of sex hormones, can improve libido and arousal. Testosterone replacement is sometimes indicated if libido does not return with HRT and can significantly affect a woman's sex drive.
Women with incontinence may also have a reduced desire for sex as they fear leaking. Topical vaginal oestrogen, combined with pelvic floor exercises, can improve these symptoms considerably for a woman.
Painful intercourse due to vaginal dryness or the Genito-Urinary Syndrome of Menopause (GUSM) will make the experience less pleasurable. However, lubricants can help. Again topical (vaginal) oestrogen replenishes the vaginal mucosa improving the sexual experience. Arousal itself improves with topical oestrogen, possibly due to increased blood supply to the clitoris and other erogenous zones.
Feelings towards a partner, relationship problems, financial stress, work stress, and self-image can also affect libido. Low mood or depression has a negative effect on libido. This is also true for some medications, which can directly affect libido or lead to difficulties achieving an orgasm. These medications include many antidepressants, spironolactone, beta-blockers and opioid pain medications.
When struggling with low libido, check medications, look at communication with a partner, spend time on self-care, maybe new lingerie, and do activities to feel good about oneself. Replacing falling levels of hormones using HRT, testosterone replacement, or topical vaginal oestrogen is the next step. It can be the missing piece of the puzzle in rekindling a woman's sex life.
How can a woman get an easier orgasm?
During Perimenopause and Menopause, it isn't uncommon for women to need more physical stimulation to become aroused and achieve an orgasm. It's possible that a reduced blood flow, a decrease in clitoral size, a loss of muscle mass that contract during an orgasm, and the ageing of the nervous system may be responsible for difficulties in achieving an orgasm.
Using a topical vaginal oestrogen can help with the replenishment of tissues and strengthening of pelvic muscles, and an improvement in blood flow to the clitoris. This, combined with strengthening the pelvic floor muscles with exercises, will help with blood flow and stimulation.
An increase in sensory stimulation using a vibrator will help with the neural pathways involved. If already using a vibrator, investing in one that can deliver more stimulation or stimulate other areas may be helpful. The saying 'use it or lose it' becomes more relevant during menopause as sexual satisfaction is higher amongst people who have sex more often.
Trying new things and strategies with a partner can be vital to keeping a sex life. Creating intimacy, which begins before the bedroom, from love notes or intimate hugs to date nights, is essential. Foreplay, massage, and perhaps candles or essential oils in the bedroom can help with arousal. Mixing things up, trying new positions, or having more oral sex can be rewarding.
HRT can be helpful to reverse a falling libido in some. However, some women on oral HRT find that libido can dip due to an increase in sex globulins, which mop up testosterone and decrease libido. Switching to a transdermal (through the skin, not a tablet) HRT preparation (gel, patch or spray) will solve this problem. And if this fails to improve libido, adding testosterone therapy will work for many women in increasing libido and achieving orgasm.
Ways to make sex more comfortable after menopause
Topical vaginal oestrogen, in the form of a cream, pessary or ring, will make sex more comfortable after menopause by replenishing the vaginal mucosa and restoring the clitoris and strengthening the muscles of the pelvis that enable a woman to orgasm. Regular vaginal moisturisers are also helpful to prevent dryness and use a lubricant during intercourse. Coconut oil is a natural vaginal moisturiser that can work wonders for dryness.
Why is sex so important for women, even after menopause
Whilst being fun and emotionally rewarding, sex also has many physical benefits. People who have sex have higher antibodies against germs, viruses, and other intruders. Researchers have found that those who have sex once or twice a week have higher antibody levels than those who have sex less often. Research also suggests a link between sex and lower blood pressure. It increases your heart rate, uses various muscles, and is appropriate for heart health.
Sex lowers stress and anxiety by releasing feel-good hormones, which can help ward off depression. Studies show that men and women who have intercourse with their partners have better mental health. Where sleep complaints are common after menopause, sex can help. After orgasm, the hormone prolactin is released, which is responsible for feelings of relaxation and sleepiness.
Being close to your partner can soothe stress and anxiety. Touching and hugging can release your body's natural "feel-good hormone." Sexual arousal releases a brain chemical that increases the brain's pleasure and reward system. Sex and intimacy can boost your self-esteem and happiness.
Are you suffering from a loss of libido or other signs? Book a complimentary discovery call to find out how we can help.
Guest Post from Dr Ferhat Uddin of Liberty Health Clinics