Hot flashes and mood swings are among the more common symptoms experienced during menopause and perimenopause. But for many women, it can also become harder to have an orgasm.
The root causes can be physical as well as emotional. That said, greater difficulty with orgasm doesn't mean that satisfying climaxes are impossible. Far from it, says Dr. Brooke Faught, DNP, WHNP-BC, NCMP, FAANP, IF. Here we take a closer look at the relationship between orgasm and menopause and what you can do to make sex more satisfying.
Can you Orgasm After Menopause?
Myths and stereotypes surrounding menopause and aging have led many women to believe that pleasurable sex comes to a halt in your 40s, 50s, or beyond. "This rhetoric is often erroneously presented in the media," says Dr. Faught.
But what you might see on movies or TV isn't always true. Orgasm and menopause can absolutely coexist, experts say. "There is no age at which orgasm should disappear," Dr. Faught explains.
That said, many women find that orgasm can be harder to achieve during perimenopause, menopause, and beyond. Twice as many women over age 45 report having orgasm problems compared to those under 45, according to the North American Menopause Society.1
How Orgasm Can Change in Menopause
A number of factors can lead to changes in your sex life during perimenopause and menopause. Physical changes can be a normal part of aging, especially as your hormones shift. At the same time, emotions related to body image, relationship changes, or other stressful life events can also play a part.
Physical Menopause Symptoms That Can Affect the Female Orgasm
Perimenopause and menopause can lead to changes in levels of the hormones estrogen and testosterone that can make it harder to have an orgasm or make orgasms less intense. "Estrogen and testosterone are both considered to be prosexual hormones within the central nervous system," explains Dr. Faught. "While estrogen levels decline with menopause, testosterone levels continuously decline throughout the lifespan."
Lower levels of these hormones may reduce sex drive and make it harder to get aroused. Reduced estrogen, too, can cause vaginal tissues to become drier and less flexible, leading to dryness and pain. Lower estrogen may also be involved in changes to the vascular and nervous systems that could result in the clitoris becoming less sensitive.2
As estrogen levels decline, it's normal to experience reduced blood flow to the genitals as well. "Blood flow is critical to sexual arousal in both women and men," Dr. Faught says. "While women may experience decreased physical sensation of genital arousal, which can negatively impact orgasm potential, men often experience this as erectile dysfunction."
Emotional Symptoms That Can Affect Menopause Orgasms
Arousal needs to happen in order to achieve a satisfying orgasm. And for many women, getting turned on depends on emotional factors as well as physical ones.
Hormonal shifts can increase the risk for mood problems and depression, which can dampen libido or lead to relationship problems that may, in turn, affect one's sex life.3 Stress and fatigue from life-changing events can zap desire too. It's normal to struggle as you adjust to an empty nest, care for aging parents, navigate financial concerns, or deal with health-related worries for yourself or your partner.4
Body image, as mentioned earlier, can play a role too. If you feel more self-conscious about your body than you used to, that could lead to feeling less desirable and ultimately less interested in having sex.
How to Improve Female Orgasms After Menopause
Though there are factors that can make female orgasm harder to come by, they don't have to stop you from having a satisfying sex life. "I love to see the empowerment on the faces of many of my patients when I tell them that many women experience their greatest sexual encounters in the second half of their lives," says Dr. Faught.
Here are some strategies that can help:
- Be open with your partner. Talk about the physical and emotional challenges you may be struggling with. Honest communication is the most effective way to improve sexual function, Dr. Faught says.
- Have sex regularly. Regular sexual activity facilitates blood flow to the genitals, which helps maintain healthy vaginal tissue, says Faught. This can include penetrative sex as well as masturbation, oral sex, vibrators or other sex toys, and even non-physical erotic stimulation like books or music.
- Try a supplement. Prescription-free dietary supplement options, such as Ristela®, work through the nitric oxide pathway in the body to increase blood flow to the genitals, Dr. Faught explains. Ristela, specifically, has been shown across multiple clinical trials to improve female sexual desire, arousal, and orgasm.5-7
- Consider other treatment options. Both over-the-counter and prescription products can enhance vulvar and vaginal tissue integrity after menopause. Vaginal hormones and hyaluronic acid-based moisturizers, for instance, can increase sexual response and pleasure while diminishing dryness and pain, says Faught.
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When to Talk with Your Healthcare Provider About Orgasm and Menopause
Your healthcare provider can help you figure out the best way to address the challenges that are making it harder for you to orgasm. In fact, it's never too soon to speak up. "I always encourage patients to speak up about their sexual health," Dr. Faught says. "If you don't receive appropriate answers, continue your search for a provider that can help you." And remember, talk therapy is always a helpful option to consider as well. For those looking for qualified mental health providers with an expertise in sexual health and menopause care, the American Association of Sexuality, Educators, Counselors and Therapists (AASECT.org) can be a great resource to look into.
- Bottari A, et al. Minerva Genecol. 2013;65:435-444. 8-week, active-controlled lifestyle study in 100 premenopausal women ages 37-45.
- Stanislavov R and Rohdewald P. J Women's Health Care. 2014;3:1-6. 8-week, randomized, double-blind, placebo-controlled study conducted in 80 women ages 40-50.
- Bottari A, et al. Panminervea Med. 2013;65:435-444. 8-week, randomized, single-blind, placebo-controlled study in 83 postmenopausal women ages 45-55.
Very educational and informative, Thank you!