The 411 on Sexuality After Menopause

Sexuality at any time of our lives is a complex topic. Sexuality after menopause? Even more so. We’ll give you the lowdown.

Menopause comes with some big changes that can affect every fiber of our being.

From our temperature control to our mental health, this time can rock our worlds in ways that can be (sometimes literally) dizzying.

And then there’s the topic of sexuality after menopause.

How we experience our attraction to others — and our own thoughts, bodies, and feelings — can evolve over the menopause transition.

And because so many factors go into this equation, it can be overwhelming to even start to think about what this means for us.

Knowing that no two people will experience this change in exactly the same way, let’s discuss sexuality after menopause and what you might expect as you enter this new phase.

(Psst. If you need support along the way, that’s what Peanut Menopause is there for.

Nobody should have to go through this alone.)

In this article: 📝

What is sexuality?

First up, what are we actually talking about when we say sexuality?

While the associations are often just with our bodies, there’s much more to sexuality than that.

According to this breakdown from the University of Louisville, sexuality includes:

• Sensuality: how we enjoy our bodies and the bodies of others
  
• Intimacy: our desire and ability to be close to other people
  
• Sexual identity: who we are as sexual beings, including our gender identity, and sexual and romantic orientation
  
• Sexual health and reproduction: our physical, biological systems and how we care for our bodies and health
  
• Sexual power: our feelings of sexual power within ourselves as well as the sexual power we have in our relationships

So yep, it’s beautifully complex.

And this is important to remember when we talk about how it evolves during the menopause transition.

This is not simply about changes in your physical body — it relates to so many aspects of yourself.

After menopause sexuality

Menopause is defined as 12 months after you have your last period.

But the time leading up to it is often what gives it its notoriety.

You know, the temperature rises, the mood swings, the sleepless nights?

These are all symptoms associated with what’s known as perimenopause (literally: around menopause).

And the time after menopause is called, quite appropriately, postmenopause.

One of the big changes you may experience as you crest over the menopause hill is in your sex life.

And there’s no blueprint for how exactly this will look for you.

The US Department of Health & Human Services’ Office on Women’s Health explains that for some women, sex becomes more appealing, while for others, less so.

So however this plays out for you is the right way.

If you’re on the side where sex is no longer as much fun, there are many reasons for this.

If your menopause symptoms are seriously impacting your day-to-day, dealing with this physical onslaught can leave you feeling far less interested in sex than before.

(Who wants to cuddle when night sweats are in the picture?!)

While we don’t know with 100% certainty what causes menopause symptoms, there is some consensus that hormones play a big role.

As your periods get prepared for their finale, your sex hormones do too.

(The key players here are estrogen and progesterone, but we’re learning that others come into the mix too.)

Lowering estrogen levels are front and center when it comes to symptoms like hot flashes.

Basically, this hormone goes through all sorts of ups and downs before halting production after menopause.

As your estrogen levels decrease, other hormones jump in to help, messing with your body’s internal temperature control.

And then there are the changes that happen to your vagina.

Settle in for the Birds and the Bees chat, Season 2.

If you are experiencing pain or discomfort in your genital area, or it’s harder to feel aroused, you may be experiencing the symptoms of what’s called the genitourinary syndrome of menopause (GSM).

It was previously known as vaginal atrophy, but this term is now outdated as it doesn’t explain the breadth of changes that happen during this time that affect both your reproductive system and urinary tract.

Also, it didn’t specifically tie the issue to menopause.

The symptoms of GSM include:

• Vaginal dryness
  
• Thin, dry, or inflamed vaginal walls
  
• Vaginal itching and burning
  
• Pain during sex (dyspareunia)
• Urgent and frequent urination
  
• Urinary incontinence

You may experience these symptoms when you have sex or simply when you’re going about your day.

Either way, it’s not hard to see how they could impact your sexuality.

The good news is that for GSM, as well as for other symptoms you might be experiencing at this time, there is help available.

How to increase sexuality after menopause

Because sexuality is such a multifaceted thing, there’s no one way to “increase” it once you hit menopause.

But there are things that you can do to help out with uncomfortable symptoms and improve your well-being — it all just depends on your specific symptoms.

For vaginal dryness, OTC choices include vaginal moisturizers to increase the moisture in your vagina for lengthier periods of time, and lubricants, which you can use when you’re having sex.

Prescription options include hormone therapies like estrogen creams, tablets, and rings — all of which are inserted into your vagina.

For other menopause symptoms, hormone replacement therapy really helps for some people.

If you still have your uterus, you might be prescribed hormone therapy that includes both estrogen and progesterone.

That’s because estrogen on its own may increase your risk of endometrial cancer — without the balance of progesterone, it can trigger the lining of your uterus (endometrium) to grow.

If you’ve had your uterus removed (i.e. had a hysterectomy), you will likely only get estrogen.

Unfortunately, hormone therapies aren’t appropriate for everyone and may not be ideal for you if you have a risk of breast cancer, blood clots, and strokes.

The research is currently being expanded and updated on this, so hopefully we’ll soon have more clarity for doctors and patients alike.

Either way, there are alternatives.

The FDA has approved an antidepressant called paroxetine to treat moderate to severe hot flashes.

Alternative therapies, ranging from mindfulness practices to acupuncture to hypnosis, are all currently being explored — and showing some promise.

Counseling can also really help.

Research has shown that both group and individual therapy can go a long way to improve your quality of life and even alleviate your symptoms over this chapter.

If you’re in a relationship, talking to your partner about what you’re going through is also really important. If it feels impossible to start, couples therapy can be really productive.

(And if you’d like to kick this all off by writing them a letter, we’ve got a template for you right here.)

Sexuality and menopause: a holistic view

It’s not just the physical changes of menopause that can impact our sexual experience.

Menopause mood swings are very real — and are also related to estrogen and progesterone fluctuations.

But this is also a time when there may be a lot of other stuff going on in our lives, with a variety of stressors coming at us thick and fast.

Family and work challenges can reach high points in this chapter.

As can fears about aging, confusion around our changing bodies, and uncertainty about the future.

And as we get older, we’re also more likely to have health struggles, which can have a bearing on our sex lives.

Basically, there’s a lot that may impact our sexuality.

And looking at the full picture can really help navigate where you want to go from here.

While it can be challenging to talk about what you’re going through — particularly when it comes to historically taboo topics related to sexuality — it’s important.

Your healthcare providers will be able to offer you treatment to handle your symptoms.

And we are firm believers in talking to each other as we go through these changes.

Knowing that someone else gets where you’re at goes a really long way.

We’ve got you.