With no need to worry about getting your period, becoming pregnant or being walked in on by your kids, your postmenopausal sex life should be fantastic, right? It can be good, but don’t expect it to be the same type of sex you were having in your 20.

Your estrogen takes a nosedive during post menopause (defined as when you haven’t had a menstrual cycle in 12 months) and the years leading up to it, called peri-menopause. This change has a huge impact on your sexual function. It can lower desire and make it harder for you to become aroused. It can also make the vaginal canal less stretchy and you may experience dryness, which can cause intercourse to be painful. More than a third of women in peri-menopause, or who are post menopausal, report having sexual difficulties, from lack of interest in sex to trouble having an orgasm.

Additionally, with age you’re more likely to experience health problems. Chronic illness and injuries can deplete your energy, cause physical pain and lower your body image — all of which affect your sex drive.

But you should advocate for your sexual health. If you have any concerns about your sexual health – pain, decreased interest, decreased ability to orgasm, or lack of pleasure, speak to a qualified expert about possible solutions. It’s unlikely a health care professional will ask you about this aspect of your health, so you’re going to have to take the lead and demand the guidance you need.

Talk to your partner about what works for you when it comes to intimacy. A partner can’t be a mind-reader, so it’s important to have open discussions about the types of touch and actions that bring you pleasure and the types that turn you off.

If you’re starting a new relationship, remember to practice safe sex. Even though you can’t become pregnant, you could still contract sexually transmitted infections. Use barrier methods (condoms) until both partners have been checked for HIV, Hepatitis C, chlamydia and gonorrhea.

Sexual health is most certainly multifactorial – meaning a woman’s enjoyment and interest in sex may depend on how she feels about the relationship, how she feels about her body, how her day was, if the children are home, and if her libido exists. In general, these are the physiologic changes about which every woman:

  • The loss of estrogen post menopause can cause vaginal dryness which can make sexual intercourse uncomfortable and in many cases painful.
  • The loss of estrogen can cause insomnia and fatigue which can negatively impact mood and libido.
  • The decrease in testosterone after menopause can lead to decreased libido.

Discomfort During Sex

Lubricants can be very helpful in reducing friction and discomfort during intercourse. Vaginal estrogen can be prescribed for women to increase natural lubrication. Vaginal moisturizers can be used by women who choose not to use vaginal estrogen.

Vaginal dilators can be used in cases where the vaginal canal has become smaller. Pelvic floor physical therapy is a little known but extremely helpful treatment for painful intercourse.

Partner Communication is Key

Talk about your own feelings without using the word “you” so that your partner doesn’t feel blamed. Practice what you want to say.

Communicating with your partner is crucial in setting realistic expectations about what you can do sexually and to achieve intimacy as you age. Living an overall healthy life — having good energy, getting enough sleep, being physically active and eating well — will go a long way toward helping you focus on and feel good about being intimate and sexual.


A woman’s hormone imbalance can increase the risk of health problems such as osteoporosis, blood clots and heart disease. And, while a healthy lifestyle can slow down the decline of hormone levels, the natural process of aging will eventually cause hormone imbalance in all women at some point in their lives.

Join our experts at Revital for a brief introductory call where we’ll explain how bioidentical hormone replacement therapy works to improve weight management, energy, mood and sexual desire.