Rediscovering Passion: Navigating Sexual Health During Menopause

What’s something half of us will experience if we stick around long enough? Menopause! Yup, that’s what we’re talking about. Menopause is not just about hot flashes and mood swings (though those can be tough!). It’s a natural phase of life, hitting in our late 40s to early 50s. But without the right know-how and support, it can throw us for a loop – especially when it comes to sex and intimacy! As a pelvic health expert, I’ve seen it all. It’s crucial to tackle these changes head-on with a whole lot of compassion and with proper information.

A couple rediscovering sex and intimacy during menopause.

Understanding Menopause and Sexual Health

Let’s get technical for a minute… Menopause is defined as the point when the menstrual cycle (i.e. “periods”) has not been happening for 12 consecutive months, signaling the end of a woman’s reproductive years. This natural biological process typically occurs between the ages of 45 and 55, though it can happen earlier or later. During menopause, the ovaries reduce their production of estrogen and progesterone, leading to a variety of symptoms that can affect sexual health.

One of the most common complaints among menopausal women is vaginal dryness. The decrease in estrogen levels causes the vaginal tissues to become thinner, less elastic, and less lubricated. This can result in discomfort or pain during intercourse, often referred to as dyspareunia. Additionally, the vaginal pH changes, making it more susceptible to infections, which can further exacerbate discomfort.

Another significant change is the reduction in libido or sexual desire. This can be due to hormonal fluctuations, but also to the physical discomfort associated with vaginal dryness and other menopausal symptoms like hot flashes, night sweats, and fatigue. Emotional factors, such as stress, anxiety, and depression, which can accompany menopause, also play a crucial role in diminishing sexual desire.

Let’s dive deeper into these topics – and other sexual health symptoms – below!

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Image of dried up flowers, signifying vaginal dryness as a symptom of sexual health in menopause.

Vaginal Dryness in Menopause

Vaginal dryness is absolutely uncomfortable. It is also one of the most manageable symptoms of menopause! There are many ways to Over-the-counter lubricants and moisturizers can provide immediate relief. Water-based lubricants are often recommended as they are gentle and effective. However, for longer-lasting effects, vaginal moisturizers that maintain hydration of the vaginal tissues can be used regularly.

For more persistent or severe cases, local estrogen therapy may be beneficial. This involves the application of estrogen directly to the vaginal area using creams, tablets, or rings. Local estrogen therapy helps to restore the thickness and elasticity of the vaginal tissues and improves lubrication, reducing discomfort during intercourse.

**Note: this information is not meant to be used as medical advice or a diagnosis. Please see a medical provider to help navigate this transition period most effectively for your own health!

Image of a banana and a grapefruit, signifying sex during menopause.

Enhancing Libido and Sexual Desire

The decline in libido – or not feeling up for sexy time – during menopause is normal. It’s a complex issue influenced by by physical and emotional factors at play during menopause. Focusing on correcting vaginal dryness can help sexual desire a little (comfortable sex is more enjoyable!). However, there are additional ways we can help enhance libido and sexual satisfaction.

Communication with a partner is essential! Open discussions about changes in sexual health and desires can help to lessen anxiety and improve intimacy. Sometimes, couples may benefit from seeking the guidance of a sex therapist or counselor to navigate these conversations and explore new ways to connect sexually. (Especially because all of these changes are so new, and they’re ushering you into a new phase of life. That’s big stuff – therapists can help with that.)

Lifestyle changes can also have a positive impact on libido. Regular exercise, a healthy diet, and adequate sleep contribute to overall well-being and can enhance sexual desire. Exercise, in particular, increases blood flow, boosts mood, and reduces stress, all of which are beneficial for sexual health!

In some cases, hormone replacement therapy (HRT) may be considered. HRT involves the administration of estrogen and progesterone to alleviate menopausal symptoms, including low libido. However, HRT is not suitable for everyone, and the decision to use it should be made in consultation with a healthcare provider, considering the potential risks and benefits.

A woman in menopause who is having trouble connecting with her husband.

Emotional Well-Being and Sexual Health

Menopause is often accompanied by emotional changes that can impact sexual health. Your hormones are shifting and changing! The hormonal fluctuations during this period can lead to mood swings, anxiety, and depression. We all know how mood can impact sex… But how can we help boost our moods?

Addressing emotional health is key for maintaining a healthy sexual relationship during menopause. Mindfulness practices, such as meditation and yoga, can help manage stress and improve mental health. As mentioned, counseling or therapy can also provide support and strategies for coping with emotional challenges that come with this major life event.

Building a strong support system is also important. You’re not going through menopause alone! Talking with friends, joining support groups, or participating in online forums can provide a sense of community and understanding. Knowing that others are experiencing similar challenges can be comforting and reduce feelings of isolation.

Image of a pelvic floor anatomical model from a doctor's office

The Role of Pelvic Floor Health

If you’re new here, let me break down the basics: The pelvic floor muscles play a significant role in sexual health! These muscles support the bladder, uterus, and rectum (think: the muscular underwear of the pelvic area). They are involved in sexual function and sensation. Weakness or dysfunction in the pelvic floor can lead to issues such as urinary incontinence and decreased sexual satisfaction.

Pelvic floor exercises, commonly known as Kegel exercises, can help strengthen these muscles and improve their function. Regular practice of Kegels can enhance blood flow to the pelvic region, increase sexual arousal, and improve the ability to achieve orgasm. A pelvic health physical therapist (Hi! That’s me!) can provide guidance on the correct technique and develop a tailored exercise program.

In some cases, biofeedback or electrical stimulation may be used to aid in pelvic floor rehabilitation. These techniques can help individuals become more aware of their pelvic floor muscles and improve their ability to contract and relax them effectively. I recently broke down ways to take care of your pelvic floor, if you want more info here! Visit this article for the breakdown: Pelvic Health Guide for A Pain-Free Summer.

Image of an older couple dancing.

Exploring Sexuality and Intimacy in Menopause

Menopause can be an exciting opportunity to explore new aspects of sexuality and intimacy. It’s a new physical and emotional landscape! With the changes that occur, it is essential to redefine what sexual satisfaction means and to be open to different forms of intimacy.

Non-penetrative sexual activities can be fulfilling and enjoyable. Focusing on sensual touch, massage, and oral sex can provide pleasure without the discomfort associated with vaginal dryness. Using sex toys and exploring different types of stimulation can also enhance sexual experiences.

It is also a time to prioritize self-care and self-love. Taking time to understand one’s own body and what brings pleasure can be empowering. Masturbation is a healthy way to explore sexual desires and can help maintain vaginal health by promoting blood flow and lubrication.

Image of a medical model of a uterus, being used by a doctor to explain changes during menopause.

Seeking (Professional) Menopause Support

It is important to seek professional help if menopausal symptoms significantly impact sexual health and quality of life. A healthcare provider specializing in menopausal health can offer personalized advice and treatment options. Gynecologists, endocrinologists, and pelvic health specialists can work together to address the various aspects of menopausal sexual health.

Regular check-ups and open communication with healthcare providers ensure that any issues are promptly addressed. It is also essential to be informed about the latest research and treatment options available, as advancements in menopausal health continue to evolve.

A woman enjoying menopause.

Embracing Menopausal Change and Celebrating Sexual Health

Menopause is a natural part of aging! While it brings challenges, it also offers an opportunity for growth and self-discovery. If we reframe it as an opportunity to re-learn our bodies, it can be an exciting opportunity! Embracing the changes that come with menopause can lead to a deeper understanding of oneself and a renewed appreciation for sexual health.

Celebrating sexual health during menopause involves acknowledging the changes, seeking appropriate treatments, and exploring new avenues of intimacy and pleasure. It is a journey that requires patience, compassion, and an open mind.

Image of a woman holding a water bottle.


As a pelvic health expert, I have seen how menopause can transform a woman’s sexual health. By addressing the physical symptoms, enhancing emotional well-being, and exploring new dimensions of intimacy, it is possible to maintain a fulfilling and satisfying sexual life during and after menopause.

The key is to approach this transition with an open heart and a willingness to adapt. Menopause does not signify the end of sexual pleasure. Rather, it is a new chapter that, with the right support and resources, can be just as vibrant and fulfilling as any other stage of life!

If you’re in the Seattle area, I can help! I know you might be nervous, and unsure whether pelvic floor physical therapy is right for you. That’s why I offer two FREE ways to speak to me, and my expert team in our Seattle clinic. You can either speak to us over the telephone or come into our clinic. You can get answers to your questions, get personalized advice, and learn about the safe, proven, and natural ways we can treat your problem fast and naturally!

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