Yes, you can have good sex during menopause and beyond!

Photo credit iStock / Artem Peretiatko

I first heard of “perimenopause” last year, at the tender age of 44, when one of my girlfriends told me (lowering her voice so no one sitting at the bar could hear her, as if we were discussing top-secret information) that her doctor had confirmed that she had officially entered that stage of her life.

“Sorry, what’s perimenopause?” was my response.

“The years leading up to menopause when you start experiencing a bunch of weird symptoms and you think you’re going crazy,” was her reply.

I was dumbfounded. Already?! I thought, as she is a few years younger than me and I was 100% in denial and delusional, thinking that I was still years from the infamous and much-dreaded “menopause”.

Well, I can now say that delusional I am no more, as her speech that night made me realize I was already experiencing some of those “weird symptoms” and that I was most likely already in perimenopause myself. But then I wondered, how is it possible that in this formidable era of advanced science and technology, in which information can spread faster than the speed of light, I had never heard of perimenopause? Shouldn’t that be standard talk at your annual gyneco’s appointment when you turn 40? Like “hey Steph, just thought you should know that you may start experiencing this range of undesirable symptoms-here’s a list to supplement your bedtime reading-oh, and this list is by no means exhaustive as we don’t know much what’s going on either. But, you should know something wonky will start happening soon, and it’s normal.”

Not once has the subject been broached.

It would have been helpful, for instance, to know that the process of menopause (which includes the aforementioned perimenopause) takes about 7 years but can last up to 14 years, during which, you may or may not experience an interesting array of more than 30 symptoms (itchy ears anyone?). Some of those not-so-fun symptoms include a lower libido, vaginal dryness and pain during intercourse, which can affect more than half of women. The good news is that there are ways to deal with those issues and continue experiencing pleasure during this transitional period and even after menopause. Many women have even said that they discovered pleasure in their 40s and 50s. Finally, a bit of hope!

How can you boost your pleasure during perimenopause and menopause?

Experiment with vibrators

During perimenopause, your ovaries begin producing less sex hormones (estrogen and progesterone), and these changes may affect your libido, desire and pleasure. Lower estrogen levels, for example, can cause reduced blood flow to your genitals. The reduced blood flow can negatively affect your ability to become aroused. It can also hinder your body’s ability to produce natural lubrication and sex may be less enjoyable. It may even be harder to have an orgasm. Your pelvic floor muscles (the muscles that contract during an orgasm) begin to weaken and according to Dr. Jen Gunter, author of the book Menopause Manifesto, it’s not uncommon for women to need a vibrator to achieve an orgasm after menopause where they didn’t before.

In fact, in a 2024 study, the researchers found that women between the ages of 19 and 80 reported improved sexual, genitourinary, and mental health after using a vibrator a couple of times a week for at least five minutes over a span of three months. The study shows that the use of a vibrator helps the process of arousal, which increases blood flow and alleviates vaginal dryness, a common symptom of perimenopause. It can also help manage symptoms of pelvic organ prolapse and boost your mood too, due to the release of those feel-good hormones, dopamine and oxytocin. So if you’ve never experimented with a vibrator before, now might be a good time to start.

Use a lubricant and/or vaginal moisturizer

To address discomfort during sex, you can use a lubricant. A lubricant may also be used during solo play with or without a sex toy. It reduces friction and just makes everything feel more comfortable and pleasurable. When using a lubricant, you always need to make sure that it is compatible with silicone sex toys or with the type of preservative you are using. You can read more about choosing the right lubricant for you here.

If you are dealing with vaginal dryness, which includes symptoms like irritation, itchiness and a burning sensation, you may use an over-the-counter vaginal moisturizer. Note that a moisturizer does not substitute for a lubricant, but rather needs to be applied every 1 to 2 days to make you more comfortable all the time.

If a lubricant and moisturizers are not enough for you, you can also ask your doctor about topical estrogen placed directly in the vagina, either as a cream or an estrogen ring.

Exercise your pelvic floor muscles

We know that regular exercise can improve your sex life but there is one specific type of exercise that targets those muscles that are solicited during orgasm: pelvic floor exercises, otherwise known as Kegels. Those exercises increase blood flow to the vagina, strengthen the muscles, making it easier to climax and may even make your orgasms more powerful.

Have sex regularly

Regular sexual activity, alone or with a partner, stimulates blood flow, keeps your muscles toned, and helps with natural hydration of your vagina. Now that’s one at-home treatment that’s easy to get onboard with.

Change your mindset about menopause

Photo credit iStock / Diamond Dogs

We all dread it, even if we don’t talk about it. But what if we reframed this period of transition in our mind as the “coming into-your-own phase of your life” as opposed to a “WTF-is-happening-to-me phase of your life”? It would help to talk about it more, in the public space and with our friends and partner. Not just hearing about the parts that suck but the positive and hopeful stories as well. Cultural representation in movies and TV series showcasing women in their 50s and older as thriving women having fun as opposed to grandmas still servicing everyone else wouldn’t hurt either. In other words, more Sylvie Grateau in Emily in Paris, and more Jane Fonda in Grace and Frankie please. We need to be exposed to more badass older women. Also, seeking out information and educating yourself can be empowering. Menopause merely means the end of fertility, not the end of pleasure.

A study published in the Journal of Sexual Medicine found that “for middle-aged women who are at the onset of menopause, the biological/hormonal changes characterizing menopause do not negatively affect sexual life. Any negative reported effects on sexuality are more likely due to anticipation or negative representations of sexuality around menopause than to biological or hormonal effects. The effect of menopause at this point in women's lives may thus be more symbolic than biological, expressed as a form of anticipation of old age.” In her book the Menopause Manifesto, Dr. Gutney mentions that research has shown that women who believe that sexual enjoyment will decrease with age are twice as likely to have decreased sexual desire compared to women who don’t share that belief.

Finally, many women say that they had the best sex of their life after menopause, when the kids had left the house and they had more freedom to explore who they are, what makes them happy and what gives them pleasure, and that they finally had the confidence to assert themselves. As reported by the Daily Mail, the actress Naomi Watts declared, “I personally think sex becomes more pleasurable when you take out the fear of like making babies... when you know it's not the right time... like what is that expression... ‘closed for business, open for pleasure!’...It feels more, ‘I'm going to do this for myself’”.

 Of course, all these “tips” on how to improve your sex life during menopause do not constitute an obligation to do any of those things if you don’t want to. The goal is not to pile on more on that ever-expanding list of things to do. But if having a healthy sex life is important to you, know that it is very much possible, even during and after menopause.