How Menopause Affects Sex

You’ve reached menopause when you’ve gone 12 consecutive months without having a menstrual period. Before you reach that milestone, you may experience perimenopause for several years. During perimenopause, you may notice changes that impact your sex life.

You may have less sexual desire, pain during intercourse, and increased vaginal dryness. Reduced sexual contact can affect your self-confidence, your relationship, and even your stress levels. It’s important to note that not all women experience all, or even any, of these symptoms, but many do have some combination of them.

Other possible symptoms include:

Vaginal dryness

One of the more common problems with menopause is vaginal dryness. Your body produces less estrogen during and after menopause, and that can lessen the blood supply to your vagina. Less blood supply and less estrogen can mean less lubrication during sex, which may be uncomfortable or even painful.

Using lubricants during sex or vaginal moisturizers may help. Avoid lubricants such as petroleum jelly that are not water soluble. They can lead to bacterial infections and also weaken the latex used to make condoms.

Vaginal laxity and atrophy

The natural process of aging causes you to lose muscle mass and elasticity in your skin, and that includes the skin and muscles in your vagina. You may have pelvic prolapse because of weaker muscles in your pelvic floor, and the tissues in your vagina may change leading to vaginal atrophy.

Vaginal atrophy is when the walls of your vagina thin out, and it narrows and shortens due to the lack of estrogen. It can also happen if you don’t have vaginal intercourse often over a long period of time.

Lack of sexual desire

If you find that you simply aren’t in the mood for sex, there can be multiple causes. Lower estrogen can lead to a lower sex drive, and if you feel uncomfortable about your other symptoms, you may feel self-conscious about having sex.

Dryness, atrophy, and prolapse can all lead to painful sex.


There are treatments for all of the symptoms of perimenopause and menopause that can affect your sex life. You may find that you need a combination of treatments to get comfortable with intimacy and sex again.


Pelvic floor muscle exercises can help stop you from leaking urine, which can be disconcerting if it happens when you sneeze, but may be alarming if it happens during sex. You may find yourself avoiding sexual contact or not enjoying it if you’re worried about incontinence.

Commonly called Kegel exercises, pelvic floor muscle exercises can help prevent incontinence and can also help prevent pelvic prolapse, where your organs slip out of place.

Hormone replacement therapy

There are different approaches to hormone replacement, and the one that is likely to work best for you depends on many factors, including which hormones are at lower-than-normal levels, as well as what kinds of symptoms you’re experiencing.

Vaginal rejuvenation

Dr. Ku offers ThermiVa® vaginal rejuvenation, a procedure that uses radiofrequency heat to promote collagen growth in your vaginal tissue. The treatment brings about a tightening effect, and some patients say it also increases sensitivity.

You’ll probably need a series of ThermiVa treatments, such as three treatments over the course of three months, to enjoy the full results. Dr. Ku recommends maintenance treatments once each year thereafter.

If your sex life is being negatively affected by perimenopause or menopause, book an appointment online or by phone with Dr. Ku at Precision Plastic Surgery. You may discover that there are treatments to help restore your desire for sex, improve your intimacy, and allow you to enjoy sexual contact again.

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