How to Make Sex Better After Menopause

You don’t have to deal with a low libido forever.

Sex After Menopause
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Going through menopause is a major life moment: On top of the uncomfortable hot flashes and night sweats, things might start to feel a bit out of sync in the bedroom, too.

But it’s not always going to be this huge cloud of doom and gloom hovering over your sex life. Here, both research and real women reveal four ways your sex life might take a hit post-menopause—and what you can do about it.

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First, what exactly happens to your body after menopause?

Your body will go through many changes during and after menopause, thanks to your tanking estrogen levels. In addition to saying goodbye to your period, the most common symptoms include:

  • Hot flashes, followed by heavy sweating or cold shivering
  • Vaginal or bladder infections
  • Lack of bladder control, like getting a sudden urge to urinate or trouble holding it
  • Night sweats or trouble sleeping
  • Mood changes
  • Potential weight gain
  • Achy joints and muscles

    On top of that, those low estrogen levels will no doubt impact your vagina, leading to issues like a lower libido and vaginal dryness, explains Lauren Streicher, MD, an ob-gyn at the Feinberg School of Medicine in Chicago and author of Sex Rx: Hormones, Health, and Your Best Sex Ever. (Here’s everything you need to know about how your vagina changes during menopause.)

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    Up to half of all women report sexual problems during and after menopause, according to The North American Menopause Society (NAMS). Here is how you can expect things to change in bed.

    The problem: You can’t get aroused


    ✅ The fix: Amp up the lubrication.

    If you find that things have gotten a bit dry down there, don’t fret. Your first step is to bring in some reinforcements, and that’s where lube comes in. It might take some experimentation to find the right one, but OTC silicone-based lubricants (like this one from Astroglide, or this one from Wet Platinum) work by reducing friction associated with thin, dry tissue, says Dr. Streicher.

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    If that’s not doing enough for you, add a vaginal moisturizer like Replens, which is absorbed into your skin and sticks to your vaginal lining (unlike lubricants, you use this every day, not just before sex). You can also try a warming gel like Zestra, which is not a lubricant per se, but increases sensation when you apply it to your clitoris.

    💡Pro tip: Stick to water- or silicone-based lubes: Oil-based ones like petroleum jelly and mineral oil can actually increase risk of vaginal irritation and infection, warns Dr. Streicher. And if you’re trying Zestra, be cautious: “I definitely felt more aroused using it, but I had burning and stinging for a couple days afterward,” says Natalie, 53, from Fairfield, CT.

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    The problem: You’re having trouble reaching orgasm


    ✅ The fix: Try a new sex toy.

    Orgasms become less frequent after you go through menopause, the NAMS notes, and even if you do reach your O, it can feel less intense. “Once I started to go through menopause, I experienced a lot of pain with sex and a noticed a big change in both my sex drive and my orgasms,” says Beth, 54, from San Francisco.

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    Hormone therapy helped with the former, but didn’t boost the latter at all. “I didn’t want to try any other medications, like off-label testosterone, so I was really looking for a drug-free option,” she explains.

    Then she came across Fiera, a device that uses suction to stimulate your clitoris (it’s hands-free, so you just insert and go on to enjoy your foreplay). “Fiera really helped because it sort of preps me and allows me to ‘get ready’ for having sex with my husband. It also seems to allow me to have more intense orgasms,” she says.

    💡Pro tip: Make sure you clean it after each use with mild soap and warm water and dry it thoroughly with a cloth, otherwise it can harbor bacteria that can lead to an infection.

    The problem: Sex is too painful


    ✅ The fix: Consider laser therapy.

    If you consistently feel pain during sex and have ruled out other medical conditions (like chronic stress, IBS, or even infections) and using plenty of lube hasn’t helped, there are other treatments you can consider.

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    A laser to your vagina may sound like pure torture, but several have gotten FDA-cleared, and some postmenopausal women swear it has saved their sex lives. “Lasers work by stimulating collagen production inside your vagina, which helps to build up tissue again and make it moist,” says Dr. Streicher.

    Both the MonaLisa Touch and FemiLift require three treatments (spaced a month apart) and cost about $3,000. Studies have shown that women will seen an overall improvement in their postmenopausal symptoms—like dryness, itching, burning, and painful sex—after a MonaLisa Touch treatment, according to one 2016 review of research.

    Plus, the procedure itself doesn’t hurt: “It feels like a small vibration for about 5 minutes,” says Sara Marsini, 52, a nurse in Naples, FL. “Even after the first treatment, the results were pretty dramatic. I went from having searing pain during sex to feeling absolutely no discomfort,” she says, adding that her partner also noticed a difference. “He said my vagina felt more plump, like the walls had some thickening.” It does require an annual maintenance treatment.

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    💡Pro tip: Beware of unscrupulous doctors hawking lasers. “MonaLisa Touch is the only one that has clinical research to prove it’s safe and effective,” says Dr. Streicher (who has no financial interest in the company). You also shouldn’t undergo laser therapy until you’ve had an updated pap test and a thorough exam by your doctor to ensure that there are no other medical issues such as uterine fibroids causing your pain.

    The problem: Your sex drive has tanked


    ✅ The fix: This will be individualized to you, so you need to talk to your doctor.

    A low libido isn’t all that uncommon, even in women who aren’t going through menopause. Experiencing a huge life change (like starting a new job), taking a new medication, or underlying medical conditions can all play a part in tanking your sex drive.

    There are plenty of things you can do to heat things back up, though. In bed, taking your time with foreplay to ensure you’re properly lubricated, masturbating more often, and talking with your partner openly about sex are all good places to start.

    But what you do outside of the bedroom can make a huge difference, too. Research shows that being more mindful (like taking 15 minutes to meditate every day), sticking with a consistent exercise routine, or even consulting with a sex therapist can help identify other parts of your life that may be exacerbating the issue.

    💡Pro tip: Because several conditions (like sleep disorders, heart issues, or even depression) and medications (like antidepressants) can impact your sex drive, make sure you see your doctor first if your low libido consistently persists. He or she will be able to determine the root of the problem and suggest treatment from there.

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