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Talk About Sex & Menopause - Part 3

Updated: Mar 17, 2023

In the first two parts (here and here) of our series entitled Let's Talk About Sex & Menopause, we discussed a woman's anatomy, the sexual response cycle, libido changes during menopause, medical treatments for common issues with sex for menopausal women, and scheduling sex and mindfulness as ways to improve desire and arousal. This blog focuses on a few other ways to increase your sex life.

Sex educator Emily Nagoski has researched and written extensively on the brain mechanism that governs desire and arousal. One part of the mechanism is a sexual "accelerator" that notices all the sex-related information in the environment - everything that you see, hear, smell, touch, taste, or think that your brain processes as related to sex. The accelerator sends that turn-on signal that you felt during the hot and heavy, falling in love, spontaneous desire phase of your relationship. And it functions at a low-level subconsciously all the time. At the same time, your second part of the mechanism is a sexual "inhibitor," the brakes, and notices all the very good reasons not to be turned on right now. Everything that your brain processes as a potential threat contributes to the brakes - stress, depression, anxiety, exhaustion, concerns about pregnancy and STIs, and relationship conflict are some of the most common inhibitors.

Sex counseling/therapy is a practical and actionable approach to help women cultivate the sex life they deserve using education, at-home exercises, and personalized counseling. A sex therapist can work through a systematic examination of the factors in your life that have been blocking your access to arousal and desire (the inhibitors), and provide a supportive exploration of your unique turn-ons that can restore your sex drive (the accelerators). You can find a certified professional at the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) website.

An online resource you might find valuable is the app Rosy, which was developed by doctors and psychologists. Rosy is the first-of-its-kind platform for women struggling with sexual dysfunction. Resources on the app range from educational resources and self-help content to a library of erotica, which is also an evidence-based intervention for low desire. There are three membership levels with online sex therapy and a personalized day-to-day plan focused on your goals and experiences available at the highest membership level.

Vibrator use has been found by multiple research studies to have a positive effect on all phases of the sexual response cycle. Vibrators decrease the time to achieve orgasm, facilitate multiple orgasms, and improve sex-related anxiety. They also can improve urinary incontinence, pelvic floor muscle strength, as well as chronic unexplained vulvar pain, which also are common issues for menopausal women. Stimulation of the clitoris provides the easiest and strongest orgasm for most women so a vibrator that’s designed for that purpose is the best bet for a first timer and/or a menopausal woman experiencing pain with penetrative sex. If you enjoy the feeling of penetration as well as clitoral stimulation, you can explore penetrating vibrators. Silicone vibrators are softer and easy to clean. Look for silicone that is phthalate-free, super-smooth, non-porous, and food-grade. Use lots of lube with your vibrator. (See below for more information about lubricants.) Also look for a vibrator with varying intensities/speeds since you may enjoy a range of intensities at different times. Check out a woman-friendly, education-based, progressive sexuality & wellness shop (Awakening - with stores in Denver, Babeland, Dame, Early to Bed, Good Vibrations, SheBop, Unbound Babes, Wildflower, for example) for more advice when buying a vibrator. Don't put too much pressure on yourself to buy the "right" one - you can always get a different one later.

Just a quick word about lubricants. Regardless of which kind you choose, you should look for products without petrochemicals, parabens, phthalates, alcohols, artificial flavors and colors, or sugars. Be sure to clean up well after use of any lube to avoid vaginal infections. There are basically three different varieties of lube:

Oil-based lubes are longest lasting and incredibly slick but can be staining to clothing and sheets. Importantly, be aware that oil-based lubes break down condoms, other latex-based barrier method contraception, and latex sex toys. It can be used in the water, for massage, with non-latex sex toys and dilators, and for sex. You can try AH! YES OB Plant-Oil Lubricant. It's made with organic plant-oils, is hypoallergenic, and is designed to soothe and condition the skin instead of being washed off.

Silicone-based lubes are the slickest and last longer than water-based lubes but need to be reapplied more often than oil-based lubes. The clean up isn't as easy as with water-based lubes but simpler than with oil-based lubes. Silicon-based lubes are non-staining and can be used in the water. They are safe to use with condoms but should not be used with silicone sex toys. I recommend Überlube Silicone Lubricant.

Water-based lubes are an all-round lube. They require the least amount of cleanup, are non-staining, and are safe to use with condoms and with sex toys (including silicone-based products.) A downside is that they dry quickly so you'll have to reapply more often. I recommend Good Clean Love Almost Naked Personal Lubricant.

In summary, many menopausal women experience a decrease in desire and arousal, likely from a variety of external and internal factors. Studies have shown that a healthy sex life is important to the welfare of your relationship so you should prioritize finding what works best for you - lifestyle interventions, counseling, medication - to get your sex life back on track. Understand that the sexual response cycle doesn't have a "right" order - desire can follow arousal or even orgasm. Explore your body and how it responds to stimuli - seek to find the things that accelerate arousal and desire for you. Don't be afraid to set aside time for yourself and experiment. Don't let anyone tell you that decreased interest in sex and/or pleasure from sex is just part of getting older. You can have a satisfying sex life at any age...and you should!

Disclaimer - Information on this website is provided for informational purposes only. The information is a result of years of practical experience and formal training by the author. This information is not intended as a substitute for the advice provided by your physician or other healthcare professional or any information contained in any product label or packaging. Do not use the information on this website for diagnosing or treating a health problem or disease, or prescribing medication, or other treatment. Always speak with your physician or other health care professional before taking any medication or nutritional, herbal, or homeopathic supplement, or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your healthcare provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this website. Information provided on this website and the use of any products or services mentioned on this website by you do not create a doctor-patient relationship between you and any of the physicians affiliated with this website. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.

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