Sex and menopause—what to expect and how to reclaim your confidence

Sex and menopause shouldn't be so taboo. While this process is an inevitable and natural stage in a woman's life, it doesn't mean your sex life has to suffer. Here's everything you need to know about the changes to expect and how to take charge of your sex life again. 

Many women fear the stages of menopause for the range of unpleasant menopause symptoms the milestone can bring—from night sweats to hot flushes and reduced sex drive to vaginal dryness. While some women go through menopause without feeling a thing, others may experience all of the above and more. The fluctuation in hormones can make sex seem confusing or daunting for some. But for others, it can unleash a newfound sense of freedom, and sex after menopause can be better than ever before. “Menopause is just another point in life for self-exploration sexually,” says Heather Jeffcoat, DPT, and author of Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve. “We do it in our 20s, 30s, and 40s. Sex doesn’t have to stop in menopause, women just get another opportunity to grow sexually.” 

No matter what camp you fall into, as you head into this new stage of your life, it's important to understand how it can change things in the bedroom. And, if you're not feeling as sexy as you used to, we've got some expert-approved tips to help you reclaim your confidence in the bedroom.

Sex and menopause—the most common changes 

Clinically, menopause marks the end of a woman’s regular monthly cycle. Once a woman has missed 12 months consecutively, she is post-menopausal. Menopause usually occurs when a woman is in her mid-40s to her early 50s. Though time and symptoms can vary depending on a person’s genetics and ethnicity. 

“During menopause, your levels of the hormones estrogen, progesterone, and testosterone drop,” Heather explains. “This can cause a cluster of symptoms referred to as Genitourinary Syndrome of Menopause or GSM." For some women, GSM can lead to unitary and bladder issues. It also often causes the most commonly known symptoms of menopause that might impact your sex life, such as: 

• Vaginal dryness
• Pain during or after sex 
• Low libido 
• Loss of confidence 

Menopause is different for each individual who goes through it, and there isn't a one-size-fits-all approach, says OB/GYN and Associate Professor at the University of Queensland, Gino Pecoraro. This is why you should book an appointment with your gynecologist or doctor to discuss the range of your symptom. 

However, there are ways to combat the most common symptoms of menopause that affect your sex life, to help you regain your confidence and sexual desire, or understand your newfound sexual freedom. 

Vaginal dryness

Why it happens: 

Although women can experience vaginal dryness at any age (and for a number of reasons), vaginal dryness is common during menopause. This is because during this process the vaginal tissue becomes thinner, due to a lack of estrogen, and is easily irritated. This can also lead to pain during sex if appropriate lubrication isn't used. Vaginal dryness could affect your enjoyment of sex during this time of your life if you're not prepared. Luckily there are simple treatments for vaginal dryness. 

How to deal with it:

“If vaginal dryness is the main problem, topical vaginal treatments like avocado or macadamia oils are useful,” Dr Pecoraro advises. “They are lubricants that mimic the natural protein content of vaginal secretions," adds Dr Pecoraro. These are great natural remedies for vaginal dryness that can easily be done at home. You could also try some menopausal supplements to ensure your diet is nutrient-rich.

If you try home remedies and find they don't work, speak to a pharmacist or your doctor for further advice. They may suggest other treatments for vaginal dryness such as: 

• Vaginal estrogen cream—a topical cream with a low-dose of vaginal estrogen treatment.
• Vaginal estrogen suppositories—such as Deydroepiandrosterone, a nightly vaginal suppository used to treat vulva and vaginal dryness. 
• Ospemifene—this selective oestrogen receptor modulator (SERM) medication is taken by mouth and used to treat painful intercourse associated with vaginal atrophy.

Painful intercourse

Why it happens: 

If you’re experiencing pain during sex while going through menopause, or pain during sex after menopause the first thing you should do is make an appointment with your gynecologist. This is because menopause and/or vaginal dryness may not be the only cause of this discomfort. 

“There are so many reasons as to why that pain could be going on—you really can’t know until you’ve explored the possible causes with your doctor,” says Aleece Fosnight, PA, and medical advisor at Aeroflow Urology. “It very well could be that your pelvic floor muscles are what we call hypertonic, meaning they're too tense or too tight,” Fosnight adds. “If you have pain, you should seek medical attention to make sure there isn't something else going on. The pain could even be caused by IBS so should be addressed.”

How to deal with it:

If you are experiencing pain during sex, make an appointment with your doctor to investigate this further. Once you nail down the root cause, a medical professional will be able to advise the best treatment for you. It could be as simple as reducing the number of kegel exercises you do every day, to reduce the tension in your pelvic muscles. Or, investing in the best lubes to combat vagina dryness during female masturbation or sex with a partner.

If you find penetrative sex too uncomfortable during this time, that doesn't mean you can't still have fun! While you make an appointment with a doctor to investigate the pain you're experiencing further, you can still enjoy a healthy sex life. Introduce some of the best sex toys into the bedroom and swap penetrative sex for clitoral stimulation with a vibrator if that feels comfortable for you. Get your partner involved by exploring mutual masturbation or let them take control and tease you with your favorite vibrator. 

Low libido

Why it happens: 

Loss of libido or sex drive is a common problem for both men and women and can be caused by anything from stress and fatigue to relationship issues. Your sex drive during menopause can feel super-low due to all the changes happening in your body. Depletion of estrogen combined with a slow orgasmic response, delayed clitoral reaction time, in addition to possible weight gain, can take a toll on a woman’s sex life and her mental health. 

Feeling uninterested in sex while you go through these natural changes is totally normal. But, don't give up on your sex life just yet. There are ways you can spice things up in the bedroom and boost your libido once more. Really dig into what you're feeling and communicate this with your partner. 

How to deal with it:

To get things going again, Fosnight recommends delving into discovering what your “brakes” (what keeps you from engaging in sexual activity), and “accelerators” (what turns you on) are. 

“It could be as simple as the fact your partner has done the laundry for you that can be an accelerator,” she says. “We often think that it has to be a romantic dinner or that we have to be wooed or flowers. That could work for some women, but not all the time. Some women love the fact that maybe their partner came in and vacuumed the whole house. That's a turn-on.” 

Take some time to think about what turns you on and off. Allow your mind to wander into your sexual fantasies and open up to your partner about what you want. If you're shy about discussing sex with your other half, show them instead. There's lots of ethical porn for women online you can show your partner as an example of what you'd like to get up to in the bedroom, whether that's trying new sex positions or delving into BDSM for beginners. Menopause doesn't have to result in a sexless marriage, but communication with your partner is key to helping boost your libido during this time. 

4. Loss of confidence

Why it happens:

It’s not uncommon for women who are going through menopause to struggle with self-confidence. From the constant pressure of the ever-changing societal beauty standards to feeling old, it’s hard for many to move past the worry of it all and simply embrace the natural aging process. By focusing on the positive aspects of menopause (no more periods, PMS, or pregnancy worries, for example), however, you may be able to garner self-acceptance and self-love.  

How to deal with it:

“Confidence is all about the attitude, really,” says Pauline Ryeland, sex coach, and educator. “Sometimes you have to fake it a little till you make it." Ryeland's top tips include: wearing an outfit you love, putting on makeup that makes you feel good, and treating yourself to some new sexy lingerie (even under your casual clothes when hanging around at home). "It’s like your little secret which is fun and flirty with yourself,” Ryeland adds. She also suggests talking to yourself positively every single day. It might feel silly at first, showering yourself with compliments you might not believe to be true. But, the more you do it, the more natural it will become and the more likely you are to truly feel great and show yourself some genuine self-love.

“Give yourself a compliment; every time you look in the mirror instead of saying ‘OMG I look so fat in that,’ engage in positive self-talk," Ryeland says. If saying it out loud feels too silly, instead write three things you like about yourself in a journey every day. 

5. Newfound sexual freedom

Why it happens: 

While some women experience unpleasant menopause symptoms that can impact their sex life negatively, for others this time comes with a newfound sense of sexual freedom. With no more periods to contend with, PMS, or unwanted pregnancy worries, post-menopause can feel new and exciting. "Menopause can be a sexually liberating phase for many," Dr Katherine Hertlein, expert advisor at sex therapy app Blueheart told us.

"Even if, initially, you feel that your interest in sex has lulled, this is common in the initial stages of menopause. You’re coming to terms with a range of emotional and physical changes and this can impact your energy levels and libido. But over the period of a few months, these feelings usually subside, and the process can be very liberating, on a personal level and a sexual level," 

How to deal with it: 

Revel in this newfound sense of freedom whether that's with a long-term partner or a fling from a sex app. Now is the perfect time to live out the sexual fantasies you've always wanted to explore, from bondage for beginners to tantric sex. You no longer have to worry about using birth control or dealing with PMS symptoms every month and can enjoy this new chapter of your sex life! 

"Couples or sex therapy can also be extremely beneficial for those who find that menopause is disrupting their relationship and sex life," Dr Hertlein says. "It can create a safe space to talk about things you may otherwise avoid and lead to the creation of proactive strategies to help improve things. Such strategies might include using erotic material together, reinventing foreplay in your relationship, or expanding the sexual repertoire."

The menopause can be a challenging time for some, but knowing what to expect and the effects it could have on your sex life, ensures you're prepared and know exactly what to do if you experience the most common symptoms. Knowledge is power, after all! 

w&h thanks Heather Jeffcoat, DPT, and author of Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve, Gino Pecoraro, OB/GYN and Associate Professor at the University of Queensland, Aleece Fosnight, PA, medical advisor at Aeroflow Urology, Pauline Ryeland, sex coach, and educator, and Dr Katherine Hertlein, expert advisor at sex therapy app Blueheart.