painful sex after menopause 1There are nearly as many warnings about sex after menopause as there are about losing your virginity. Don’t avoid sex just because you think it might be painful or uncomfortable. But learning to understand those changes can help to prevent any discomfort. Plus, not having to worry about pregnancy is a pretty significant perk of menopause!

Menopause and You

Menopause is when your body stops having monthly cycles and becomes unable to get pregnant. Menopause officially starts twelve months after your last period [12]. According to the North American Menopause Society, the average age at which a woman experiences menopause is 51 [3], which means there are many years ahead of you that you can fill with satisfying sex! However, some women experience menopause at an earlier age due to genetics, certain cancers, or even smoking, while other women continue to have their periods into the fifties.

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This doesn’t happen all at once. The process involves three phases: perimenopause, menopause, and postmenopause [4]. Several years before your last period, your ovaries will decrease in function [5]. This causes your levels of estrogen and progesterone will drop, and you may begin to notice symptoms [3] and have irregular periods before they finally stop in the second stage of menopause.

This process comes with a bevy of symptoms ranging from hot and cold flashes, longer or heavier periods, vaginal dryness, difficulty sleeping, and moodiness [3]. Your body can even feel foreign to you as you go through the process of menopause. There are a lot of potential worries, but there are solutions too!

Surgical Menopause

While most people think of a woman’s body naturally experiencing menopause, there is another type: surgical menopause. Surgical menopause occurs after the removal of the uterus, a procedure known as a hysterectomy [6]. The surgery may also involve removal of the ovaries (oophorectomy) [7]. Without the ovaries to make estrogen, menopause kicks in.

If you’ve had a hysterectomy at a young age, you’ll experience surgical menopause earlier than you would have naturally. The symptoms of surgical menopause match those of natural menopause and can affect your body, mind, relationship, and sex life as well. However, the onset of surgical menopause can be immediate [2] and more serve [8] than natural menopause.

One concern that many women share is whether their partners will still find them attractive and want to be intimate with them. The answer to both questions is a resounding “YES!”. Single or widowed women sometimes wonder if new partners will desire them despite their changing bodies. Good news is that not only should your partner still want you, the changes you’re experiencing may be things he likes even more!

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Remember that attraction to a person isn’t just about what’s on the outside. But if you’re looking for a way to feel more confident, picking out a piece of sexy lingerie might do the trick. Learn how to pick the perfect lingerie for your body in this post.

Desire for Sex After Menopause

 

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Many women worry whether they’ll feel the same desire to have sex after menopause as they did before.  After all, you’re hardly done living! Desire doesn’t drop until the later stages of menopause [9], and many women who undergo surgical menopause also see a decrease in desire [1011].

But…

Estrogen is high during the luteal phase of the menstrual cycle but drops afterward [1213], and desire can decrease as estrogen does.

Estrogen also drops during menstruation [1415] and after the honeymoon period ends in your relationship.

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Studies have also found that desire can drop significantly during [16] and after pregnancy [17], and in periods of high stress just to name a few.

While both men and women experience a drop in sex drive throughout the course of their lives, women are two to three times as likely to experience this decrease in sex drive than men [18]. Of course, some women do feel a boost to their sex drives thanks to the freedom provided by kids leaving home and/or retirement. But dealing with the mood swings and hot or cold flashes that can accompany menopause doesn’t put anyone in the mood!

We recommend that women going through menopause as well as those ladies who are postmenopausal follow the helpful advice we’re previously written on this subject. Check out our posts below to help with a moderate drop in your sex drive.

One of the pieces of advice we give to any woman who is having trouble getting in the mood for sex or self-pleasure is to slow things down and to add foreplay. Extended foreplay can solve a problem that we’ll talk about later on: being properly lubricated. There’s really no reason not to add foreplay. It helps you get in the mood, get you wet and, sometimes, get you off even before the big event!

Ready to try it out? Check out our 22 tips and tricks for amazing foreplay. Because of the hormone drops that happen during menopause, foreplay may not be the only solution you need to add to your toolkit, nor will it solve all your potential problems.

What Happens When Estrogen Decreases

 

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Studies consistently find that women experience issues with desire, arousal, orgasm, and sexual satisfaction after menopause [19].

Even if you desire to have sex after menopause, you might run into a little trouble. It might be uncomfortable or hard because your body doesn’t lubricate as much as it did before menopause when your body was producing more estrogen. A drop in estrogen means a decrease in vaginal moisture for many women, and it can even lead to vaginal atrophy [202122], also known as vulvar and vaginal atrophy or VVA [23]. Up to 50% of women experience vaginal atrophy with menopause [24].

This dryness can even make you more susceptible to infection [5] and inflammation that can create vaginal discharge [25].

Women are often taught that being “wet” is the single most important signal of arousal, but that’s not always the case. In certain cases, you can be aroused, but your body might not produce noticeable amounts of lubrication [26].

When your subjective (mental) and physical states of arousal align, it’s known as concordance [272829]. But many women do not experience this agreement; instead, they have arousal nonconcordance [30 ch 6]. In fact, your body may not produce the exact amount of moisture that you need for comfortable sex, especially long bouts!

This arousal nonconcordance or inability to become physically aroused even when you are mentally arouse becomes difficult to ignore for many women who have experienced menopause.

The truth is that adding more foreplay may not be enough to become wet anymore.

With all these factors at play when going through menopause, it’s no wonder that 53% of women experience sexual dysfunction during this time [31].

So, the question is…

What can you do if sex after menopause is dry and uncomfortable?

Try Kegels

One study found that menopausal women who performed Kegel exercises experienced an easier time with arousal than women who did not complete the exercises [32].

Find out about the benefits of Kegels here.

Use Lube for Comfort

The easiest solution is to use personal lube, which you can buy from sex stores and even your local pharmacy. There are a few options on the shelves and even more available online, so what should you look for?

  • Choose a water-based lube if you want something compatible with sex and toys of all types – also, you want lube that washes off easily.
  • Go with silicone if you want slicker, longer lasting lube that’s condom-compatible that you can even use for massages.
  • Try a natural oil such as coconut oil if you want to limit the ingredients your body comes in contact and don’t want to use condoms for protection against STIs (as oil-based lube degrades the silicon in condoms). Oils can also be great for anal sex.

A personal lube can also add sensations like cool/tingling or warm, and flavored lubes are great for going down on your partner. Find out everything you need to know about lube here.

An alternative to personal lube to make sex during menopause more comfortable is a vaginal moisturizer, which not only makes sex slick but absorbs into your skin, unlike lube, to add moisture to your vagina [33]. According to the experts, when vaginal moisturizers are applied twice per week they can increase vaginal moisture, elasticity, and acidity. [34].

Think About This

 

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Although you might not consider it at first, a drop in estrogen may also coincide with weakened bones and osteoporosis because estrogen is necessary for bone health [35]. This condition is exemplified by brittle bones that easily break – as many as 50% of women over fifty will break a bone due to osteoporosis [36].

Keep this in mind as you enjoy sex, which you might prefer to be rougher after menopause than before you went through the change. Decreased vaginal sensitivity might have you asking for it “Harder.” Just make sure it’s not too hard.

Read: Rough Sex: The Intensely Passionate In-Depth Guide to learn what rough sex all about.

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Osteoporosis may be a concern for menopausal women because of estrogen decreases [37], so you should be careful when having sex to prevent breakage. Reconsider any position that requires you to rest on your joints, especially for long periods of time. Use a pillow to relieve stress points; sex pillows are great for getting into tricky positions, too.

Furthermore, positions where you’re on top are the best sex positions after menopause because they reduce strain on your body and hips.

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You can also focus on activities other than intercourse. Making out, dry humping and oral sex aren’t lesser substitutes for penetration. They’re all enjoyable in their own right, and they fall into the category of activities known as outercourse.

RelatedAll About Outercourse

Talk to Your Doctor About Hormone Therapy

 

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Another treatment option for menopause symptoms is hormone therapy, sometimes known as hormone replacement therapy or HRT. According to the North American Menopause Society (NAMS), “[h]ormone therapy is the most effective treatment for menopausal symptoms such as hot flashes and vaginal dryness [38].”  Your doctor can prescribe estrogen supplements that help with many of the issues that are caused by the sharp drop in estrogen during menopause or even premenopause. Creams, pills, and patches and even sprays can all replenish some of the estrogen that your body is missing [3940].

NAMS recommends low doses of local estrogen (as opposed to HRT) in the form of a cream or suppository that you can place in your vagina if your only concern is vaginal dryness and uncomfortable or painful sex [414243].  A tablet, cream or vaginal ring that contains estrogen can help with bladder problems in addition to vaginal issues causes by menopause [44].

You may still benefit from using lube, however. At the Bad Girls Bible, we recommend that everyone use lube regardless of age!

HRT is not without some risks. Estrogen therapy can lead to blood clots in the legs or lungs, as well as increase your risk of developing breast cancer if you use estrogen supplements on conjunction with progestogen therapy for more than five years [38]. The risk of heart disease also increases with hormone therapy [41].

Furthermore, some research indicates that ” the effectiveness of ERT may diminish in some women after long-term use [45].”

Whether estrogen helps or not, you might find yourself having to become reacquainted with your body, its responsiveness, and your desires. Some women don’t feel as feminine, desirable, or even as much like themselves during and after menopause. Remember that your lover may need cues to deal with those changes, so talking about sex is a must.

Some women may be good candidates for testosterone therapy as well, especially if they have experienced a decrease in desire that is not helped by estrogen [46]. Testosterone supplements come in various forms similar to estrogen.

If you’ve been with your partner for some time, you’re probably pretty good at talking about sex.  It’s an essential skill to get right because it’s so important!

ReadUse Sexual Communication for Complete Sexual Fulfillment

Sex After Menopause Can Still Be Risky

The big perk of having sex after menopause is that you don’t need to worry about getting pregnant. There’s still a chance of contracting an STI if you have unsafe sex. STIs such as HPV are so common that most people will have it during their lifetimes [47], so you can’t let your guard down.

In fact, STIs are on the rise for most age groups, including the elderly [4849], which may be connected to the fact that this group of the population is the least likely to use condoms [50], perhaps because they view condoms as more connected to the risk of pregnancy.

Get tested for STIs after you have new partners. You should also use condoms with any partner who has an STI or whose STI status is unknown to you. Remember that some STIs transmit through skin-to-skin contact, [51] however, and condoms can’t protect you from every potential infection. Still, it’s important to use them to protect against some STIs.

Many women have to get used to sex after menopause. But some women find that this is the best sex of their lives because they don’t have to worry about getting pregnant, and they have the freedom to explore their sex lives like never before.

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Lisa has a Masters of Education (M.Ed.) in Human Sexuality from Widener University's Center for Human Sexuality Studies. She is continuing her studies at the University as a doctoral candidate. Lisa is a member of the American Association of Sexuality Educators Counselors and Therapist (ASSECT). She has guest taught human sexuality at several universities including Montclair State, Kean University, and Borough of Manhattan Community College.

Lisa's passion for the field is rooted in her belief that all human beings should understand what healthy sex is, regardless of culture, body or ability.

Her particular areas of expertise focus on: desire in long-term relationship, the intersection of technology and sexuality and its affect on individuals and couples, body image and its influence on sexuality, the impact of the past on single people in America, and modern (online) dating. Her research focuses on marriage from antiquity to present day, modern romance and contemporary dating websites.