Can you have great sex after menopause?

It’s one of the most common questions that I get when I’m giving my Girl Talk–my evening event where I come into churches and talk sex & intimacy. We do an anonymous Q&A session during the event, and invariably someone asks about sex and menopause.

I give some generic answers, that I’ve read about, because quite frankly I’m not there yet. But I’m researching it because I certainly don’t want menopause to be where sex goes to die. And from what I’ve been reading, it really doesn’t look like it has to! Hormones certainly affect our libidos, as I’ve written about before. And I had a really rough time with perimenopause (the 10 years leading up to menopause) before I had a uterine ablation surgery (which was a godsend). But I know the hormonal changes aren’t over. And the problem with menopause that many women find is that the hormonal changes can steal our libidos and make sex uncomfortable.

But it doesn’t have to be that way! A while ago Dr. Carol Peters-Tanksley, an OB-GYN, guest posted on how women need to “flip that mental switch” to make sex fun. And since I’ve been wanting to write about menopause, but never really felt qualified to since I’m not there yet, I jumped at the chance to ask her to write another piece for me, since she actually knows what she’s talking about.

She said yes, and I’m thrilled to have Dr. Carol back today:

“Is there even such a thing as sex after menopause? And can it actually be great?”

As much as many women under 50 may try to ignore the fact, every single one of us will pass, is passing, or has already passed through the menopause transition. There’s a common stereotype going around that women who have gone through menopause are neither interested nor interesting when it comes to sex and sexuality. But that’s just not true.

I’m a member of the over-fifty club myself, and I can assure you I’m not old! And if you ask other fifty-plus-somethings, many of them would tell you the same thing. There’s a lot of truth to the adage, “You’re only as old as you feel,” especially when it comes to intimacy.

There’s no reason women cannot continue to enjoy great sex and satisfying intimacy during and after menopause, through your fifties and beyond.

But stereotypes usually come from somewhere. It is true that during and after menopause many women experience changes in libido, sexual arousal, and sexual satisfaction. Not all these changes are negative. So it’s helpful to be aware of how your current season of life affects you so that you can maximize the benefits and address the challenges.

As an OB-Gyn physician I’ve been helping women deal with these menopausal changes for over 20 years. And I know that with the right frame of mind, and occasionally a little help, sex and sexuality can be wonderful.

Let me point out five useful things to know that will help you continue to enjoy sex, and perhaps enjoy it more than ever before.

1. Be grateful for the increased freedom to be spontaneous that menopause brings.

With menopause a number of the frustrations affecting intimacy are removed. Just think how nice it is not to have to worry about periods, pads, tampons, PMS, birth control, and all the other associated “stuff.” Whether or not you engaged in sex during your period before, that’s one issue you don’t have to worry about ever again!

And that’s not all. It’s likely you also don’t have to worry about changing diapers, soccer practice, or PTA meetings. Rather than being asleep in the next room, your kids are either in high school (and spending more evenings and weekends away from home), or moving out. Let’s just say that the impending empty nest often makes spontaneous intimacy simpler. Why not enjoy?!

The freedom to be spontaneous doesn’t always mean you or your husband will naturally take advantage of that freedom. Satisfied mature couples include sexual intimacy as part of their regular priorities, and make sure to engage in sex regularly.

2. Enjoy your maturing relationship.

If your marriage has been a reasonably good one, you’ve probably stopped trying to change each other by now. How refreshing! Hopefully you’ve learned how to forgive each other well, and how to work through conflicts. You’ve gone through enough of life together that there are few surprises. You know what pleases each other, and what hot buttons to avoid.

That may sound like sex is becoming boring and predictable, but it doesn’t have to be that way. There’s a certain safety in a long-term marriage that can pay great dividends when it comes to intimacy. Good sex can bring benefits beyond excitement – benefits such as comfort, relaxation, connectedness, reassurance, and spiritual closeness. And the safety of a strong marriage may also give you the freedom to explore new ways of experiencing pleasure.

If your marriage is not so great, this is a good time to focus on your relationship and take steps to make it better. With a little more maturity you’ve got more emotional tools to draw from. As long as you and your husband are people of good will, your relationship can just now be entering the best years of your lives together.

3. Slow sex down a little.

As women become more mature, it often takes more time to become fully aroused sexually. Your lubrication may be less and slower, and it may take longer to reach a climax. Many men will also experience a slower sexual response as they become older. If you and your husband are willing to slow down a little, it’s likely you can experience as much or even more satisfaction.

Many menopausal women will find the increased foreplay as satisfying as sex itself. Talk with your husband about what you find enjoyable and stimulating. (That’s right; talk about sex! And here are 6 foreplay ideas that can help, too!) Come from a position of desiring to mutually please the other. Hopefully you’ll spend as much time listening to what he desires as you do in sharing your own wishes.

While your life as a mature woman can be complicated, carve out dedicated time each week to focus just on one another. You may be pleasantly surprised at the stimulating results!

4. Appreciate the hormonal changes of menopause.

Some of the changes in sexuality that you experience around menopause may be hormonally related. The drop in estrogen will eventually decrease the lubrication and elasticity of the vagina, making intercourse uncomfortable or painful. For some women this happens right away; for others it happens years after menopause.

If you are easily aroused but find intercourse uncomfortable, lubricants such as Replens or Astroglide may be sufficient. If that doesn’t resolve your discomfort, please talk with your doctor about prescription vaginal estradiol. Within a few weeks you’ll notice a major improvement. Pain is a major mood killer for women, and with the discomfort resolved you may desire intimacy much more.

And if your ovaries have been removed, talk with your gynecologist or endocrinologist about the possible benefits of very small amounts of testosterone. (Yes, women need a little of that too!)

5. Take the initiative.

For some women, your libido may actually increase around the time of menopause or thereafter. The freedom from having to deal with periods or raising small children may be part of that. But testosterone does not decrease as much as estrogen does at menopause (as long as you still have your ovaries), and the different balance in hormones may increase libido also.

Whether or not your desire has increased, take some thought about the ways in which you can inspire your husband to be sexual. If he has difficulties with sexual performance, encourage him to get a medical evaluation. Take a conscious mental step in his direction, and invite intimacy.

Many husbands will welcome you creatively asking for sex. He may not say it, but he may think “Where have you been all my life?!” By now you probably know what gets his engines revved up. Take a risk. You may pleasantly surprise yourself – and him.

This has been a positive look at how you can enjoy great intimacy even after menopause. There are many ways in which your investments in a strong marriage during the years can now pay great dividends. And if you don’t have a long track record of a happy marriage, don’t give up; I married for the first time at age 48, and it was wonderful in every way. If you face challenges related to sex during menopause, I’d love to hear from you.

I believe sex can continue to be great for as long as you’re together!

Dr Carol Peters-Tanksley is a licensed OB-Gyn physician and ordained Christian minister, sometimes known to her friends as “Doctor-Doctor.” Her new book Dr Carol’s Guide to Women’s Health: Take Charge of Your Physical and Emotional Wellbeing is available wherever books are sold. Dr Carol invites you to connect with her at her ministry website www.drcarolministries.com, Twitter, or Facebook.

Thanks, Dr. Carol!

Now it’s YOUR turn: what have been your biggest challenges with sex and hormone changes? How did you handle them? Let’s talk in the comments!