After menopause, there’s no need to worry about falling pregnant or getting your period, or having PMS, all of which could and should lead to enhanced intimacy and sex. However, for some women, hormonal changes can also change intimacy.
Vaginal dryness is a common menopause symptom that can lead to uncomfortable and sometimes painful intercourse.1 Before menopause, the body creates enough estrogen to keep the vaginal tissues elastic and well-moisturised to make intercourse comfortable.1, 2 But during menopause, there isn’t enough estrogen to keep the vaginal tissues elastic.1, 2 This causes them to get thinner, making intercourse painful.2, 3, 4
Vaginal atrophy (atrophic vaginitis) is thinning, drying, and inflammation of the vaginal walls that may occur when your body has less estrogen. Vaginal atrophy occurs most often after menopause. For many women, vaginal atrophy not only makes intercourse painful but also leads to distressing urinary symptoms, such as urinary leakage, burning during urination, and the urgent need to pee.2, 3
During perimenopause and menopause, hormone levels drop, which may affect sex drive and make it harder to get aroused.2, 4 This also makes it more challenging for the vagina to become lubricated.2
These menopause symptoms can disturb sleep, leaving a person feeling tired and not in the mood to engage in intercourse.1
Uncomfortable and painful intercourse can impact your relationship, especially if it’s left untreated. Doctors recommend using vaginal lubricants or moisturisers, eating foods high in omega-3 fatty acids, staying hydrated, and they may prescribe hormone replacement therapy. It’s also advised you maintain an active sex life as having intercourse more regularly actually promotes natural lubrication.2
Many women continue to be sexually active despite being in menopause. A few lifestyle changes and setting realistic expectations can make intimacy safe, comfortable, and enjoyable.
The key to remaining sexually active during menopause, and feeling good about it, is to engage in an open conversation with your partner. In addition to menopause, getting older and other health conditions such as heart disease or diabetes can affect how a person feels about sex and intimacy. Talk about what feels good and what doesn’t, what makes you comfortable, and discuss if you need more time to get aroused.
Complete the menopause symptoms questionnaire and take it with to discuss with your doctor.