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Sex After Menopause: What to Expect

While our bodies constantly change throughout our lives, one of the biggest changes we experience is menopause, which marks the end of our reproductive period. The ovaries stop producing estrogen and progesterone, and this brings on a variety of changes that affect our ability to experience sex in the same way we did before.

The media bombards us with contradictory messages pitting a doom and gloom perspective that we’ll lose interest altogether, against the flipside myth promoted by ads for erectile enhancement drugs. With conflicting information, social pressures, and trepidation regarding the overall aging process, many women are confused about what to expect and how to adjust to the impact menopause can have on our sex lives.

The most common change a woman experiences after menopause is vaginal dryness. The clinical term is dyspareunia – pain or discomfort during or after intercourse. Reduced levels of the female hormones estrogen and progesterone lessen natural lubrication. This can lead to bleeding, tightening of the vaginal opening, and/or narrowing and shortening of the vagina. All of these changes can make intercourse uncomfortable or even intolerably painful, but there are ways to reduce the impact of vaginal dryness.

Sex After Menopause: What to Expect

The first step to reducing discomfort from vaginal dryness is the “use it or lose it” rule. Maintaining regular sexual activity, either with a partner or through masturbation, can help keep vaginal tissues more supple and moist. Liberal use of a water-soluble lubricant also can help. Additionally, some women turn to topical use of low dose estrogen creams applied to the outside and inside of the vagina.

After menopause you also may experience lower levels of sexual desire. Talk with your AOA physician to discover how medications you may be taking might contribute to a lower libido. Find out if there are adjustments you can make that might make help boost your libido, and recognize that feeling different about the goals of your sex life doesn’t have to be negative.

While some people may adjust without any problems to a lower libido, if you are in a relationship with a partner it is very important to talk about the changes you are experiencing to avoid any misunderstandings, and to make learning new ways to remain intimate a shared experience, such as discovering the rewards of “outercourse,” which includes sexual activity not focused on penetration. It’s important to remember that sex begins in the brain, not the genitals, so use your imagination to discover new ways to be sensual with one another and talk with your doctor. Your AOA healthcare provider can help you know what to expect and help you better understand how other women are navigating their post-menopause sex lives.

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