Sex during menopause: rediscover a new sexuality

Sexuality does not cease to exist

For many women, sex during menopause is a concern, but beyond physical changes and common assumptions, sexuality does not cease to exist in later life. 

Menopause: what happens

Menopause is the period when the ovaries stop functioning and therefore stop producing estrogen and progestogen hormones, bringing various physical and emotional changes.

Oestrogen deficiency can cause vaginal dryness, dyspareunia (pain), mood and sleep disturbances, and hot flushes. Reduced interest in sex is often associated with lower testosterone levels, a hormone naturally produced by both the ovaries and adrenal glands.

Declining desire is a matter of the mind

Libido can certainly decline during menopause, but hormones are only one of the many factors contributing to normal sexual function. Sexual response largely depends on stimuli coming from the brain.

Reduced desire in women and men of all ages is therefore linked to a fading sense of being in love, pressure from other concerns, stress, psychological factors and conflict with a partner.

Low sexual satisfaction in women is mainly caused by low self-esteem, emotional difficulties or discomfort with their bodies, and unsatisfying interpersonal relationships. These can become more pronounced with menopause, but according to the expert, addressing this problem means, above all, changing our approach.

A different approach

Views of sexuality have changed with sociocultural developments such as longer life expectancy and recognition that women's pleasure is always present. For sexuality to be satisfying, menopause needs to be viewed as a physical and emotional change rather than an illness or misfortune. Instead of continuing to mourn our youth, we should keep dreaming and discovering through sex and our relationship with our partner.

Minimize physical changes!

The only physical factors that can negatively affect sexuality are some loss of muscle tone in the genital area due to tissue relaxation—which can be prevented and reduced by training the pelvic muscles with the well-known Kegel exercises—and insufficient lubrication, which can be eased simply by using a lubricant.

Navigating changes

Oral hormone replacement therapy or a testosterone or phytoestrogen patch may also be recommended to balance hormone levels. Particular attention should also be paid to diet, weight management and an appropriate intake of soy isoflavones (phytoestrogens, which ease the most unpleasant symptoms) and vitamins A, C and E. For bone health, foods rich in vitamins E, B6 and B12, protective folic acid, vitamin D, calcium, zinc and magnesium are recommended. Finally, physical activity also matters: a daily 30-minute walk is enough.

It could even be better

The clitoris does not change during menopause. In fact, older women may even experience slight enlargement because adrenal hormonal activity predominates, and desire might even increase as estrogen's opposing effect on androgens diminishes.

A little help from surgery

For those who feel uncomfortable with their bodies, aesthetic medicine and intimate surgery may also be considered to keep the external genital area youthful: for example, dyeing and thickening pubic hair, fat transfer to the labia majora, a mons pubis lift, vaginoplasty and so on.