by Rosenblum LB

Sex After Menopause

IMAGE Menopause does not signal the end of female sexuality. In fact, many women find that intimacy is enhanced in midlife.
Several years ago Judy realized she was no longer getting her period, her vagina was drier than usual, and sexual arousal was taking longer. She began to worry that her sex life would soon disappear.
She had heard that women lose their interest in and ability to have sex after menopause. But since she started using a little artificial lubricant and adjusted her expectations, she's found that she enjoys sex more than ever. She especially likes the extra time that she and her husband spend stroking and cuddling before they try to reach orgasm.
Like Judy, many women fear that menopause signals the end of their sexual desirability and pleasure. This fear comes from stereotypes about older woman as unattractive and asexual. In addition, loss of the ability to bear children may become confused with loss of sexual desire.
The reality is that the need for and capacity to have satisfying sexual relationships does not disappear as a natural or irreversible part of aging in women or men. How you perceive and deal with the changes can have a significant impact on your sexual health and pleasure. Some women have a reawakening of sexual interest when they are no longer concerned about getting pregnant and adult or older children require less time and attention. However, the experience varies from woman to woman.

Changes at Menopause That May Affect Sexuality

Physiologic changes at menopause can sometimes affect sexual activity and desire in some women. Changes may occur in lubrication, the vaginal walls, arousal, orgasm, and sex drive that make sex less comfortable and enjoyable.

Vaginal Dryness and Pain During Intercourse

The most common problem is vaginal dryness, although not every women will experience it. The vaginal walls may also become thinner and less flexible. Itching, burning, and occasional pain may occur during intercourse.
Over-the-counter water-based lubricants can help with vaginal dryness. Do not use petroleum-based lubricants, such as Vaseline, because they may cause latex condoms to weaken.
If lubricants are not sufficient, vaginal estrogen cream, rings, or tablets may be helpful. These products are prescribed by your doctor.

Stimulation and Orgasm

Some women have fewer and less intense orgasms when they reach menopause. It may take more time and stimulation to become aroused. For all women, having intercourse or masturbating regularly can help increase sexual responsiveness and pleasure. Kegel exercises, contractions of the pelvic muscle near the vagina, can also help strengthen the vaginal muscles.

Sexual Desire

Loss of interest in sex, temporary or long-term, occurs in some women during and after menopause. There are a range of possible causes for this, such as:
  • Stress
  • Difficulty sleeping
  • Illness
  • Bladder control problems
  • Relationship problems
  • Psychological issues
  • Side effects from medicine
  • Hormonal changes
  • Discomfort from the physical changes of menopause
Relationship problems tend to be the cause of decreased sexual desire only when there have been ongoing difficulties in the relationship. These difficulties may increase with menopause. If this is the case, consider seeing a therapist who specializes in sexuality.
If the problem is hormonal, estrogen may help. However, its effect is generally on the physical changes, such as vaginal dryness and pain during intercourse.
A natural decrease in testosterone at menopause might play a role in sexual desire, although this remains unproven. Testosterone is available in pills, injections, and creams, but side effects are a major concern.

Increased Intimacy

The changes that take place in midlife can provide an opportunity to explore new and different sexual experiences. Men also go through changes, such as needing more time and stimulation to become aroused. The slower, more sensuous foreplay that often results is a welcome change for some women.
Increased focus on sensuality, intimacy, and communication can help a sexual relationship become more rewarding than ever. There are many ways of expressing your love besides intercourse:
  • Hugging, cuddling, kissing
  • Touching, stroking, massage, sensual baths
  • Manual stimulation
  • Oral sex
Sexual relationships after menopause can indeed be satisfying if you are able to adapt to the changes that occur.

A Note About Birth Control and Safe Sex

You will need to continue using birth control until you have not had a period for 12 months in a row. However, protection against sexually transmitted diseases , including HIV/AIDS, remains a concern. Unless you are in a monogamous relationship, be sure to use a male latex condom.


National Institute on Aging—National Institutes of Health
The North American Menopause Society


The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters


Atrophic vaginitis. EBSCO DynaMed website. Available at: Updated February 9, 2015. Accessed March 24, 2015.
Avis NE, et al. Is there an association between menopause status and sexual functioning? Menopause. 2000;7(5):297-309.
Can menopause change your sex life? National Institute on Aging website. Available at: Published September 15, 2000. Accessed March 24, 2015.
Changes in the vagina and vulva. The North American Menopause Society website. Available at: Accessed March 24, 2015.
Effective treatments for sexual problems. The North American Menopause Society website. Available at: Accessed March 24, 2015.
Facts about menopause. Illinois Department of Public Health website. Available at: Accessed March 24, 2015.
Sex and menopause. Cleveland Clinic website. Available at: Updated May, 13, 2010. Accessed March 24, 2015.
Sexual health & menopause online. The North American Menopause Society website. Available at: Accessed March 24, 2015.
Sexual problems at midlife. The North American Menopause Society website. Available at: Accessed March 24, 2015.

Revision Information

Health Library Search

Only show results from the selected categories.

Think you only need to go to the doctor when you're sick? Think again. Regular doctor visits could save your life. Here's why....

5 Could You Have Prediabetes? lifestyle - men's health

Prediabetes is a major warning sign for trouble ahead. And with the number of overweight, sedentary Americans quickly rising, this condition is becoming more common....

6 Staying Active to Enjoy Your Later Years lifestyle - aging & health

You are in your golden years, but what if your body does not feel so golden? Read on to find out why staying active is so important and what you can do to introduce acti...

7 Keeping Your New Year's Resolutions lifestyle - food & nutrition
10 Vitamin C (Ascorbic Acid) lifestyle - food & nutrition
11 Health Check-Ups for Women lifestyle - women's health
13 Cancer Tests That Can Save Your Life lifestyle - women's health

Which cancer screenings do women need? Learn about the American Cancer Society's screening guidelines....

14 Asthma -- Adult condition

Asthma is a chronic disease that affects the function and lining of the airways or tubes of the lungs. It narrows the airways and makes it difficult to breathe....

16 Influenza Vaccine procedure

No matter what your age, there are some things that it is never too late for—especially giving up smoking. Read this article to find out why....

18 Zinc lifestyle - food & nutrition
20 Health Screenings for Women lifestyle - women's health

Regular health screenings are vitally important. Unfortunately, many women do not get recommended screenings. Read here to find out which screenings you may need and how...