Wouldn’t we all love to know how to have better sex during menopause? Heck, how about having sex at all!

Menopause can bring your sex life to a screeching halt. Not just loss of libido but sex also become painful when the walls of the vagina become thin and dry. It’s not just “ouch that hurts,” painful but “OMG, get the F off me right Fing now!”

The vaginal tissue is loaded with estrogen receptors. When estrogen drops it causes the vaginal tissue to shrink up and dry out. Lower levels of estrogen also cause a decrease in blood flow to the vagina.  This can make it less sensitive to touch and less receptive to physical arousal.

Dry, fragile vaginal tissue can lead to vaginal atrophy and burning, itching, spotting and pain during intercourse. Some women may even experience friction burns or vaginal bleeding while having sex.

In 2020 a study found that 50% of postmenopausal women experience vaginal dryness! 

There may also be things you are doing that are actually causing more problems than they are solving. Medications and lubricants may be working against your efforts if they contain ingredients that are causing vaginal dryness.

A drop in hormone levels also impacts the health of our pelvic floor.  It begins to weaken and this can cause a host of issues. Urinary incontinence, frequent urinary or vaginal infections, pelvic pain, are some of the problems we face.

Pelvic organ prolapse is also a possibility. This is a condition where the pelvic organs move down with gravity and cause a vaginal lump or heavy feeling.

Our quality of life during changes once our menstrual cycle stops. Our sex drive fades as other medical conditions take center stage. We are at increased risk for numerous diseases and loss of muscle and bone density. This makes sexually active people less able to be as free as they were in their youth.

The biggest culprits are:

Cold and allergy medications

Anti-depressants

Birth control pills

Oil based lubricants

DO NOT quit your medications cold turkey! Talk to your doctor about your concerns and discuss what options you have for replacing or stopping your treatments.

Options for dry and weak vaginas:

Hormone Replacement Therapy (HRT)/Vaginal estrogen to restore vaginal Mucosa. The best treatment option you have is HR. Vaginal estrogens are highly effective for restoring vaginal mucosa and the flexibility and thickness of the tissue, making sex a pleasurable experience again. It also strengthens the bladder decreasing urgency and incontinence and can improve the muscle function of the pelvis. 

Estrogen creams have minimal to no side effects. They hydrate the vagina and thicken the walls. It make sex less painful and far more enjoyable again.

Vaginal Dilators are used to expand the opening of a the vagina. If the opening of your vagina is painful and too small for entry a Vaginal dilator can help.  It expands the opening of the vagina (use with lube and gently insert)   

Water-based Lubricants Vaginal lubrications don’t treat the underlying condition of vaginal dryness or atrophy. They can, however, provide relief for vaginal dryness and pain during sex.

Three types of lubrication available for vaginal dryness; oil silicone and water-based. Water-based is gentle on the vagina and more often recommended for women during menopause. Most of the popular lube brands also make a water-based option.

Vaginal moisturizers with hyaluronic acid to maintain healthier vaginal tissue. Moisturizing the vagina can keep your tissue from getting to dry and keep the vaginal walls flexible.

Prescription (non-hormonal) medication options vary depending on symptoms. They can treat  dryness and atrophy?for those of you who are not taking hormones. 

Pelvic Floor Exercises to strengthen the pelvic floor. These simple exercises can improve everything going on with your vagina during menopause. 

Squats, bird dog, kegels, and bridges are excellent to build the muscle and keep it strong throughout your reproductive region. 

Talk with a Therapist to deal with lingering feelings of fear or anxiety about sex.  Talking to a therapist can help you get back to healthy and vibrant six life.

 A healthy sex life can make us feel confident and relaxed. Good sex comes is beneficial for our health and well being.  Don’t let menopause drain your power pillar of sexual interest and ability. Making a few changes to your routine and adding some hydration can make it pleasurable once again.

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