What happens to your ability to orgasm after menopause?
In the last few months I’ve talked to three women in my social circle who say that orgasm has completely stopped once they started menopause, though it was pretty easy before. For one woman it’s been ten years now, after having a great sex life when she was younger. And I’ve had several emails along these lines:

Reader Question
I have had absolutley NO problem getting to climax during intercourse, at least once if it multiply times (when I am greedy). We have been happily married for 26 years. For the last month I have been totally unable to orgasm. I am totally excited and almost there…but never get there. I know it is totally a ‘brain’ thing and I am in the moment. So do you have any suggestions as to what the problem may be?
As someone who is starting menopause myself, all of these emails and all these stories from friends have made me really nervous. Is my sex life over? After all, when I did my surveys for The Good Girl’s Guide to Great Sex, I found that the best years for sex in marriage were years 16-24. After that it does take a dive. And I’m sitting at year 25 right now.
So I’ve started doing some research, in some of the gynecological journals and with some physician friends that I know. And they all say the same thing: orgasm can become harder after menopause, yes, but there is no medical reason that you can’t orgasm at all.
Let me repeat that.
Orgasm can become harder after menopause,
but there is no medical reason why you can’t orgasm at all.
Whew.
When I was giving my Girl Talk down in Austin, Texas this year (my talk where I come into a church and and discuss why God made sex the way He did and how to make it awesome–along with a super fun Q&A), I met up with Dr. Carol Peters-Tanksley, a gynecologist who has guest posted for me before, and the author of Dr. Carol’s Guide to Women’s Health, and awesome resource of all things gynecological. It’s always fun to meet people I know online in real life!
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I would LOVE to bring my Girl Talk to your church! It’s one of the most fun parts of my job, and I so enjoy meeting new people and touring around.
Girl Talk is fun, seeker friendly, and informative, and you’ll find it’s an easy women’s event to get people out to (people really love talking about sex!)
And it’s affordable, too. The ticket price can cover my fee and expenses, and it’s a great way to bring different churches together.
So while we were in line for the food (yes, even speakers stand in line for food), I asked her all the menopause and orgasm questions I could. And then we followed up with some emails. Here’s what she said:
After menopause lubrication takes longer, and with the loss of estrogen lubrication diminishes. When it’s dry, it hurts! Talk with your doctor about vaginal estradiol. And don’t be afraid using one of the many lubricants available. Your response will be much easier when it doesn’t hurt.
And then she added this:
The orgasmic peak postmenopausal women experience may not feel quite as dramatic as in earlier years, but it can be intensely satisfying. If there’s one encouragement I have for postmenopausal women when it comes to sex, it’s SLOW DOWN! Longer foreplay, more conscious attention to what feels good, alternating between lighter and more intense stimulation – you’ve earned the right to take the time and enjoy it! You have every reason to continue to enjoy orgasmic sex for as many years as you wish.
So that’s a little bit encouraging!
But if it’s totally possible to orgasm, then why do so many women stop? I’m going to paraphrase her for a minute, mixed in with some other stuff I’ve read.
Why is Orgasm Difficult After Menopause?
Menopause affects several things:
- Our hormone levels change
- Blood flow to the genital area reduces (and it’s blood flow that causes things to enlarge and become aroused)
- Lubrication diminishes
What this adds up to is that:
- Women take much longer to get aroused (because of hormone levels)
- When we are aroused, we aren’t as “wet” (because of lubrication issues)
- When we are aroused, it often isn’t as great, and it’s harder to cross that threshold (because of blood flow issues)
Now, I realize that’s a vast oversimplification of how arousal after menopause works (and I know they’re all linked to hormonal changes, not changes on their own), but bear with me for a minute. What Dr. Carol is saying is that this doesn’t add up to an inability to orgasm; it just means that it may be more challenging.
Orgasm can become harder after menopause, but there is no medical reason why you can’t orgasm at all.
Why Can Some Women Orgasm After Menopause and Some Women Can’t?
So here’s the weird thing: these hormonal and blood flow changes happen to everyone. And yet some women have no problem with orgasm after menopause, and some women do. When I did my surveys for The Good Girl’s Guide to Great Sex, it wasn’t like nobody had an orgasm once they hit menopause. There was just a drop off. In years 21-29, for instance, 60.9% of women said that they usually or always had an orgasm when they made love. After thirty years it became 44.7%. So a definite drop off–but not everyone.
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And yet these women weren’t saying that they only sometimes had an orgasm. They were saying they never did. How can that be?
I have a theory about this.
Orgasm After Menopause Becomes More Brain Focused than Body Focused
One of my friends who is really struggling described it this way:
It never used to be an issue for me at all! But now I’m finding that when my mind wanders I can’t get my mind focused again and arousal just stops. It’s like I have to concentrate. And my husband keeps saying, ‘Did I lose you? Where are you?’
I know that she and her husband have always had a great and active sex life, sort of like our letter writer there. But now she’s finding that her main battle is keeping her brain engaged.
For some of you, that doesn’t sound so weird, because you’ve been battling to keep your brain engaged for years already! In fact, that’s one of the huge things I talk about in my Boost Your Libido course–how we have to concentrate in order to feel aroused.
Some women, though, never really struggled with orgasm earlier in their marriage. And now they do.
So here’s where my special theory comes in:
I think that women who struggled with orgasm earlier in their marriage don’t have a big problem with orgasm after menopause, because for them orgasm is more brain focused already. Women whose bodies were responsive right out the gate when they got married, though, often struggle with orgasm after menopause because their sexual response was more tied to their body than their brain, and now their body isn’t cooperating.
In other words, some women have a hard time EARLY in their marriage. But because of the work they did figuring out how to orgasm and how to handle arousal, menopause isn’t as big a deal. Some women have an easy time EARLY in their marriage, but then when menopause comes, they have to relearn everything. They have to learn to make sex more brain focused than body focused.
They have to learn all of those things many wives already learned–about how to keep your mind focused; how to think sexually confident thoughts while you’re making love (like “I can turn him on!”, or “X makes me feel great!”); how to focus on certain body parts to enjoy the feeling.
So What Do You Do to Help with Postmenopausal Orgasm?
1. Keep your mind focused
Your body isn’t going to just carry you along anymore. You have to carry your body along.
2. Use a lubricant
These make sex feel luxurious! One of the great sponsors of my blog is Femallay, who has amazing vaginal suppositories that you insert just before sex, and that melt quickly and make you lubricated not just in the outer area but deep inside, too. And this means that you get far more feeling and sensation when you’re making love.
I’ve had readers write me back and tell me that they just love these! And their husbands do, too.
You can get them in one of twelve different flavours:
Or you can get it flavourless:
Check out Femallay here! They have awesome natural products for women (including natural menstrual products, too).
3. Talk to your doctor about topical hormonal creams
These aren’t lubricants, but instead creams that can help with blood flow to the area. If the problem is more that arousal starts but then comes to a standstill, then these creams can help you overcome that hurdle.
4. Relearn how to have sex after menopause
The commonality between my letter writer and all of my friends is that sex was really easy for them beforehand. I know there are some women who stop orgasm after menopause who struggled with sex earlier, too, and who never quite managed to figure it out, but often the problem seems worse for people who thought they had it all figured it out.
Now it doesn’t work at all anymore, and they thought they were good at this.
You just have to go back to square one and figure out how it works for you now, as if you’re starting all over again. Don’t think, “but this should work! This always works!” Your body is different now. That doesn’t have to be a bad thing. But you may have to relearn what helps, and that may mean taking a LOT of time on foreplay. Even read this post from my friend about how she finally reached her first orgasm after she got married. You’re starting over, too.
I know menopause can be really, really lousy. I’m finding sleep is really hard! But when we think of it as relearning rather than just trying to get back to what it was, that really can help!
Tomorrow I’m going to share 10 things that can help with menopause symptoms, including some tips I got from many of you! But for today, remember: everything is likely new right now, because your body is different. Don’t give up because things have changed. Just make it a fun research project for your husband and you!
Spot on! Exactly what I would have suggested having been there, done that! It’s the brain, it’s the brain, it’s the brain!!! New work, more work, never-ending work! It is the answer, though! However, I would also like to say that (what you have stressed many times, Sheila) now especially, in this stage of life, it is super important that you have learned that sex is not just the physical act of making love; the emotional connection (relationship) a couple has is of optimal importance! It really IS the cement to the whole deal! Trust, understanding and faith in the other to be patient…because as we all know what works real well one time just does not seem to work the next! Emotional and spiritual connection precede the physical, and together the fireworks are much more attainable, AND if the bang isn’t as great this time as the next, you still have the faith in each other that there will be another time and you won’t give up on each other!
Love that, M! Thank you!
Wow! Very interesting. I’m 38 and have been in perimenopause for almost 3 years. I started having issues with orgasm about a year ago. I use natural progesterone cream and it has helped many of my other problems, like mood swings and sore breasts.
I used to have no problem reaching orgasm, ever, but I cannot get my brain there, as much, anymore. For me, it’s definitely the blood flow. Oddly enough, I have no problem getting wet, but I just don’t get all the tingly, throbbing feelings. It’s like my brain and heart are on board, but my body isn’t paying attention! For what it’s worth, I’ve been married 19 years.
Funnily enough I’ve also been married 19 years today! I have never found orgasm too easy, however I am the same as you in that there’s no problem with getting wet, however the tingling/ throbbing sensations feel muted. I too feel that it is a blood flow problem.
Lubrication…lubrication…lubrication! I never needed it in my marriage, and the dryness crept in so slowly that we didn’t notice. But things weren’t working the way they used to. We introduced coconut oil and that made ALL the difference…for both of us. He loves coconut oil!
Does CO stain sheets?
Menopause dropped my libido to zero, and along with dryness and pain and hot flashes, sex ceased to be fun for me at all and became something that I tolerated for the sake of my marriage. These problems are not in my brain; they are hormone related. I started hormone replacement therapy about a year ago (I chose bioidentical hormone pellets). BHRT made a HUGE difference in sex drive, response and ability to orgasm. My husband also gets testosterone pellets – says they are worth every penny.
Pain is a definite mood killer! So glad you have experienced the benefits of postmenopausal hormones. For women where sex becomes painful this can often be a life-changer (and marriage-changer!)
Hello, fellow menopause ladies. My husband and I have been doing a bit of research about dryness and low libido. We’ve discovered a low dose of l’arginine (what bodybuilders use to workout with) is helpful in increasing blood flow and therefore lubrication. Mixed with Korean ginseng and ginkgo biloba, Echinacea, Garlic, horseradish and vit C. I feel really well, less aches and pains and surprise myself how agile I feel both in the bedroom and at work (in a school). I was reluctant to take the hormone replacement road and whilst I was sceptical this would help I have had to admit to hubby I believe it’s actually helping heaps. š¤ Don’t give up ladies. Keep working at “working out how we tick” it’s a consistently changing thing.
Hi Marg – this sounds like a complicated recipe, but well worth it. Could you share the details? Thanks.
Sadly, my husband and I have not been intimate fir over 5 years. I am 67 and he is approaching 75. I have been on HRT for almost 2 years. What I have discovered is that POP (pelvic organ prolapse) has contributed to the challenge. My Urogynecologist has recommended a surgical procedure to remove the uterus (it falls out of the vagina š¢), remove the Fallopian tubes, lift the bladder with a sling and remove a cystoseal from the intestine. This is more extensive than anything suggested in this article. Have an acquaintance that had this done and it gave her so much relief.
Oh, dear! That sounds awful! But it sounds like you really need it. And I guess we should just be grateful that modern medicine can do it. I’ve talked to so many women who were so scared to have different surgeries, but then afterwards they wondered why they waited so long. I really hope that surgery helps you!
Some women do need surgery but there are women who have healed prolapse with specifically designed exercise programs. If anyone is looking for more info on this, a trainer named Trisch Richardson has a program for diastasis recti healing that also strengthens the pelvic floor and the muscles that hold our organs where they belong.
Women’s bodies are different from men’s in so many ways. We need to keep our core muscles strong and we often need specialized programs. http://www.t-tapp.com is a great resource on using exercise for hormonal balance as well as keeping our pelvic floor strong. It’s helped me so much.
Is there a link to the rest of this series?
I’m entering menopause + we are like newlyweds right now trying to figure out our sex life. Even though we’ve been married for 28 years. So we’re like newlyweds, but with a lot of baggage. We thought something to make it easier would help. The biggest thing for me is to work hard on my brain, and what I’m thinking. I’m totally new to that . So I was looking for some help.
But $13.99 + $15.00! shipping to Ontario.
The Femally vaginal suppositories sounded like a great idea. Expensive, though, for us.
Sheila, do you know of any local or even Canadian options?
…. Lisa
I’ve had a number of people ask that and I am trying to find out! I’ll get back to you, Lisa.
I’m experiencing this right now and, to be honest, it’s heartbreaking. I can still orgasm. But on a scale of 1-10 it’s about a 0.5. It happens but it’s not even worth the immense amount of work it takes to get there. I’m only in permi-menopause so I’m wondering if it will peter out to nothing with full menopause.
Sometimes I really feel like women got the shaft. Sex is so much harder for us when we first get married. It can hurt like heck. And take years to feel good. Then we have babies, breastfeed, lose our figure, work hard to get it back, only to get pregnant again. We’re exhausted and out of shape and still supposed to figure out how to work on our sex lives. Then, when the kids finally start growing up and we have time for a fun sex life again, our hormones have a hearty laugh and say, “good luck with that!”
There’s a high divorce rate at this stage, too. I know that won’t be us but I’m no longer surprised by it. I used to wonder how people could get divorced after surviving the trenches of little kids.
I could have written this reader question and many of these comments. I feel like taking sex off the table but that wouldn’t be fair to my husband who seems to be enjoying more intense orgasms now than in our earlier years. I’ve been perimenopausal for over 10 years. At first I had increased sex drive – which was fabulous – but after a few months it went to zero. I have about one toe-curling orgasm a year – the rest are more just a muscle spasm and very unsatisfying. I’m at the stage where I wonder why I even bother. Sex is often painful (had that in the beginning too and worked through it) and can never seem to get enough artificial lube to alleviate the pain. Even clitorial stimulation feels as if he’s using sandpaper. My husband is generous and loving so that’s not the problem. After searching and trying different things, it just feels hopeless. And I’m not even 55 yet.
I’m post menopausal about 10 years.
Lost my libido completely. I started bio-identical hormones 6 years ago.
Thankfully they pretty much alleviated my sleep, sweats, and heart palpitation issues.
But, I’ve found I’ve completely lost my ability to become aroused.
Even sexual touch doesn’t feel good anymore. It’s like my mind and body just sexually shut down about 5 years ago.
I have remained sexual but it’s become outercourse and entirely for him.
It’s not so bad really. I don’t feel like I’m missing anything. In some ways it’s highly liberating.
My husband would be happier if my body would cooperate more, but he’s mature enough to realize it’s a body issue not a love issue.
His body isn’t working like it used to either:)
Ah, the readjustments to aging.
I found you on Pinterest and couldn’t wait to read this article. I am still considered Peri but have found my libido took a nosedive in the last couple of years. I am soon 50 and researching everything I can. I hope I can share this article with my readers if you don’t mind. I am going to take this advice to heart myself and I’m sure other women could benefit. The funny thing is that I am so busy researching other midlife self care ideas that I haven’t even thought of sex. You are right. I deserve it and so does my husband š Thanks bunches.
I am 57. My husband is 58. Heās got a high desire for sex. Iāve lost all interest. This causes some conflict. I can barely orgasm – almost not worth the work or time. Not interested in hormonal treatment because breast and uterine cancer run in our family. I agree with the earlier comment about it really being unfair to women. The brain piece of it does not work for me either. I think I just have to adjust to that new reality. I have grieved for this loss but am getting more used to it. Of course nobody is working on something similar to Viagra. Are all the researchers men??!!
Yeah!! Whatās with the no help like viagra for women! I so wish someone would come up with something like that for women. They would become an instant millionaire!
Iām sorry, but Iām just not buying that āitās (largely) the brainā, implying that menopausal women just have to work harder at it. Thatās nonsense. Iāve had no problem achieving orgasm all my life and had a very healthy, robust, inhibition-free sex life. Then, as perimenopause progressed, it became much harder and took longer to get there, though I was eager and enthusiastic to put in the effort. Now, with menopause, climax is nearly impossible, even with the powerful vibrator that was my failsafe in the past. It feels good for a bit, then just feels irritating. When Iām finally able to get to orgasm (sometimes), the climax lacks intensity, and frankly, is uncomfortable, and this is not because of dryness, because I donāt appear to have that problem. Iāve tried many natural supplement, and changing up my diet for nutritional purposes several times. The next step is natural or conventional hormone replacement, I suppose. Unless there is some breakthrough in the womenās hormonal health field, Iām afraid that my sex life is over.
I agree. I can still orgasm and relatively quickly but the intensity is completely gone. For me it started to decline suddenly around 40 but got increasingly worse until I was post menopausal. Now it just stinks. Tried testosterone cream, scream cream and Estrace. Canāt take full on HRT. Nothing really works. Zestra is probably the best. I was a OB/Gyn nurse so Iāve tried it all.
Where’s the female viagra, like for reals? I mean if the medical community treated our sexuality with the same seriousness that it treats male pleasure, we’d have way more options. Pro tip! Try bupropion. It’s an add-on for treatment-resistant depression and it can not only help with motivation but jack up your sex drive.
I am 51 and had a complete hysterectomy at 45. I’ve always had little bit trouble achieving orgasm due to nervousness self confidence but was working thru it. After the surgery I haven’t been able to I get almost there then I what I call lose it. I’m pretty much ready to give it up and stop having sex and disappointing my partner. I’m already taking antidepressants and always have. I’m turned on but just can’t happen. Using plenty lubes. Doing kagel exercise.
I’m 47 and premenopausal, and am having difficulty with having an orgasm, please tell me that this can be normal too.
It really is, Michelle! Hormone changes do affect us. Go slow, get lubricant, and spend a lot of time figuring out what works now!