While the end to monthly menstrual periods may be welcome, perimenopause and menopause bring other, less desirable changes—hormonal and emotional fluctuations, and physical changes associated with the decline in estrogen levels. Some women may feel sexually liberated, free from worry about the risk of pregnancy. Others may feel a sense of loss associated with changes in their sexuality, or they may lose confidence. About half of post-menopausal women report experiencing vaginal dryness, soreness and/or pain during intercourse.

A variety of solutions including estrogen therapies, antibiotics and applied creams are available to help you overcome these challenges so you may continue to enjoy an active sex life. Estrogen tablets and creams can be effective, and because they are applied to the surface of the skin or inserted in the vagina, they do not enter the bloodstream and therefore they don’t pose the same risks as HT taken orally. Vaginal moisturizers can increase vaginal moisture and fluid. Vaginal lubricants can help reduce immediate irritation during intercourse but have not proved to have any long-term therapeutic effect. Surgical intervention may be an option for more serious cases. Hormone therapy may also be recommended for women who have had a hysterectomy (often called ‘surgical menopause’). Engaging in sexual intercourse can help keep the sexual organs functioning and healthy.

View helpful sexual assessment aids for you and your partner.

It can take time to restore both sexual function and confidence after your body undergoes the changes associated with menopause. Open communication with your partner and counselling support from your health-care provider are important strategies for working through these issues.

Treating sexual concerns can be challenging. Sexuality is a biopsychosocial (biological, psychological and social) function and requires more than just medical expertise to understand. Physicians aren’t always well-trained in assessing sexual dysfunction and many of the historical studies used as reference are based on male perceptions of sex. Maintaining positive feelings about your sexual partner and protecting your mental wellbeing can help protect against sexual dysfunction—though estrogen levels can indirectly affect sexual motivation, psychosocial factors such as these are more influential.

Learn more about common sexual dysfunctions.

Learn more about healthy female sexuality at Sex and a Healthier You.

Visit NAMS Online Resource on Sexuality at Midlife.

Find out more


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