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Sex during menopause: how sex can change and stories from Mumsnetters

If you’re wondering how to keep things going in the bedroom during menopause, here’s everything you need to know plus advice and stories from Mumsnetters who’ve been there.

By Mumsnet HQ | Last updated Aug 24, 2022

couple lying on bed looking at one another

Ah, the menopause aka ‘the change’. Considering this is a natural and unavoidable life stage for women - when we stop menstruating, caused by a decline in oestrogen levels -  there’s a lot of misinformation out there. 

According to the NHS, the average age for a woman to reach menopause is 51. Some women’s periods suddenly stop while other women find their periods gradually decline. Menopause may be caused by medical intervention such as cancer treatments or surgery and you’re considered postmenopausal once you’ve been period-free for a year.

You’re probably aware of some menopausal symptoms - hot flushes and migraines, anyone? But do you know that this stage can also impact your sex life? 

Maintaining a healthy and happy sex life is important - both physically and psychologically. So we’re here to guide you through how to keep your sex life active during menopause and beyond. 

We know how important it is to hear other women’s stories so, as always, we also turned to Mumsnetters. Along with checking out what they were sharing on our menopause forum, we asked four Mumsnetters to tell us their own experiences of sex during menopause, which you can read at the end of this guide.

How does perimenopause affect sex?

“I remember feeling more randy during the perimenopause phase 10 years ago and I got over it. My husband thought his luck had changed, bless him. Now I’m just the same as I was before.” Maggiesfarm

Let’s start at the beginning. Perimenopause is the time leading to menopause as your body is making the transition. It can last for months or years and symptoms can vary in severity. Irregular periods are a major sign along with hot flushes and sweats, headaches, sleeplessness and vaginal dryness, none of which are particularly conducive to feeling sexy.

Many women experience reduced libido, desire or arousal, but others most definitely do not. As one Mumsnetter reports: “Perimenopausal and rampant here. Masturbating several times a day. Just goes to show how different we all are.” Well, quite.

Be aware that you can still conceive during perimenopause, even with irregular periods, so it’s important to use contraception if you’re not planning on getting pregnant. 

How does menopause affect sex? 

“Off sex for a while (55) but then the drive returned. 63 and still enjoy it just not nearly so often.” KnittingNanny

Just like perimenopause, every woman experiences menopause in their own unique way, but there are several typical symptoms. For some women, these may just be a continuation of what they’ve already experienced in perimenopause while, for others, they will be more extreme.

These include loss of libido, fatigue, body aches, migraines, mood swings, hot flushes, night sweats pain or bleeding during sex and vaginal dryness. Some women may also gain weight.

With all this going on, many women experience a dip in body confidence and self-esteem. So it’s hardly surprising if you don’t enjoy sex as you did before.

Does menopause lower sex drive in all women?

“56 and postmenopausal and my sex drive has fallen off a cliff! I used to love sex but now really can't be bothered and it just feels a bit silly and unrewarding. Prefer playing Scrabble online and making art these days.” Appolonia

As with most things menopause, there’s no straightforward ‘one size fits all’ answer. The truth is that, due to the decreased hormone levels we’ve already mentioned, a noticeable drop in sex drive is very common at this stage of life.

If your sex drive has gone AWOL, never lose hope because some women’s libido can return with a vengeance once they’re postmenopausal, as this Mumsnetter attests: “Sex drive definitely reduced during the change,  but randy as a teenager after it was all done.”

Can a woman have an orgasm after menopause?

“I'm 53 and have been on HRT for three years. My libido didn't decrease at all thank goodness, but reaching orgasm is now very difficult and when it does happen it takes forever.” CharlottesComplicatedWeb

Let this sink in for a moment: fabulous sex is NOT reserved solely for those who haven’t yet reached menopause. 

Granted, it may take longer to ‘get going’ once your oestrogen levels have dropped significantly and sex can feel different. But the good news is that it’s still possible to reach orgasm during and after menopause (i.e. for the rest of your life). 

You can improve your pleasure with small adjustments, such as using lubricant (water-based or oil-based) and trying different sexual positions. As one satisfied Mumsnetter confirms: “Postmenopausal here and have high sex drive and enjoyable sex. Everyone's different.”

How can I treat vaginal dryness during menopause?

“Yes, dryness is a problem (sandpaper sex!), but mine was solved by capsules inserted weekly.” KnittingNanny

Vaginal atrophy, or dryness, is common in menopause. Decreasing oestrogen levels cause the walls of the vagina to grow thinner, leading to itchiness and dryness.

Treatment options for tackling vaginal atrophy include HRT and topical oestrogen replacement creams, capsules or pessaries - but always speak to your doctor for advice first.  As this Mumsetter recommends: “You need Vagifem pessaries or Ovestin cream on prescription from your GP.”

When showering, avoid harsh soaps and use a gentle wash that won’t cause irritation. Moisturising is important too - and no, we’re not talking about frown lines. As this Mumsnetter advises: “I use Megs Menopause Moisturiser - it’s the best I've tried.” 

couple with feet sticking out of bed

How can I improve my sex life during and after menopause?

It’s the holy grail - how to keep things exciting and pleasurable in the bedroom during and after the menopause. While this can be a confusing, worrisome stage of life for many women, don’t give up on sex. Here are some tips for boosting your sex life, as tried and tested by Mumsnetters.

1. Experiment with different positions

“I love the fact that sex is decoupled from the risk of conceiving children. Allows me to feel so much more selfish and self-indulgent.” thepeopleversuswork

If you’re worried about discomfort, try going on top while your partner sits in a chair so that you’re more in control of proceedings and can take things at your speed. Doggie style can change the pressure inside your vagina and may feel more comfortable than other positions. Most importantly, go at your own pace and don’t worry if it takes time. 

2. Try other acts of intimacy with your partner

“Sex isn't just a physical act [...]. It's intimacy.” Birdsgottafly

If the thought of penetrative sex feels too overwhelming, engaging in intimate moments with your partner outside of the bedroom could be just as beneficial, especially to start with. Once you feel more comfortable, move onto some light foreplay. 

3. Keep things supple down there

“If you're dry, get some lube.” TheStuffedPenguin

Being unable to produce your own natural lubricant can lead to discomfort and pain during sex, but  lubricant can help. Choose water-based lube if you’re using condoms as oil erodes latex as well as keeping things ‘well oiled’ with a vaginal moisturiser.

Alternatively, try a natural remedy as this Mumsnetter recommends: “Coconut oil makes a great lube, as long as you’re not using condoms. I’ve tried all sorts but coconut oil acts as a moisturiser too. Doesn’t go sticky and smells nice. We get through vats of the stuff.”

4. Look into hormone replacement therapy (HRT) 

“HRT is brilliant for stopping our old bones and teeth from crumbling and maintaining lovely skin and hair. You wouldn’t just be taking it for the libido.” DangerCat01

A treatment that works by replacing missing hormones, HRT can relieve symptoms including reduced libido and vaginal dryness as well as other effects of menopause. HRT needs to be prescribed by your doctor as there are a few associated risks, and it comes in tablets, skin patches, gels, implants and pessaries.

5. Try herbal supplements

“Try maca root powder which really helped me in the early days (works by helping hormone production). Also Soy Isoflavones which are a plant-based oestrogen. I'm pretty much menopausal now and going to try HRT, but I’ve been perimenopausal for three years and these two really helped.” CallistoSol

If you don’t feel ready for HRT or you’ve been told that it’s unsuitable for you, a herbal remedy may ease your symptoms. It’s best to speak to your doctor or a pharmacist before trying anything, even supplements that don’t require a prescription. 

6. Cool down

“If I've had a glass or two of wine or eaten white pasta, I can be soaked in sweat for an hour. Pounding headache, heart palpitations, the works.” Mintjulia

Being sweat-drenched is unlikely to get you in the mood. Avoid hot flush triggers such as alcohol, caffeine and spicy food, and regulate your bedroom temperature with a room fan. Cool yourself down with a spritz of cooling spray which is easily popped in your handbag or bedside cabinet.

7. Stay fit and eat well

“I’m 48 and in perimenopause. I have had zero libido for a few years, but recently something has changed and it's slowly ebbing its way back in. The only change I have made is that I have re-joined the gym and am loving that again. I just feel like I have more energy again and we have had more sex in the last few weeks than in the last year!” User1473450164

Regular exercise and a healthy diet not only boosts your health and well-being, but it can also improve your self-esteem. This can only lead to a happier you in between the sheets.

8. Don’t be afraid to reach out

“I firmly believe that half the responsibility for that lies with the [partner]. You're in this together.” MrsFrankDrebin

Communication is key, so whether it’s your partner, a friend or even your GP, it’s important to have someone to turn to when you need it most. When it comes to sex, you should never feel pressured into doing anything you're not comfortable with.

You can also seek out a larger support network, including Mumsnetters on our menopause or relationships forums. 

STIs and UTIs during menopause

You’re vulnerable to developing both sexually transmitted infections (STIs) and urinary tract infections (UTIs) during menopause because, with less oestrogen in your system, bacteria levels can shift. Also, as your vaginal tissue thins, it becomes more prone to infection and injury. If you have difficulty completely emptying your bladder, there’s a higher chance of bladder infection too. 

It’s important to practise safe sex to protect you from STIs, even if you’re certain there’s no chance of getting pregnant. Always get tested if you have any symptoms of an STI. You can also get self-test kits to use at home. 

woman applying HRT patch

Four Mumsnetters’ experiences of sex during perimenopause and menopause

“Since starting perimenopause, I feel less sexy”

Jodie*, 43, has found that perimenopause has affected the physical side of her marriage. She says: “I’ve never been truly body confident but had no issues with my husband as we’ve been together for 25 years. Since starting perimenopause, I feel less sexy and often don't want to be touched. 

When I’m having a hot sweat, my clothes get soaked and a hot flush leaves me feeling faint. Neither option makes me feel sexy. We haven't been having much sex recently as I’m constantly exhausted. When I go to bed I want to go straight to sleep. My DH can’t understand the physical and mental changes that I’m going through and just assumes I no longer fancy him, because I don’t want to have sex constantly like we did as changes teenagers. Also, I worry that my DH finds me less attractive as even though I’m younger than him, I’m going through menopause and that makes me old. 

I feel conscious of the changes in my body. I’ve struggled with thrush, dryness and skin cracking that makes sex uncomfortable. Even when I’m aroused we need lubricant as my skin feels dry and thin. I also struggle to orgasm. I wish that I’d been prepared for the dryness, the need for lube and the fact that everything feels different. 

I’ve started taking herbal supplements including black cohosh for hot flushes and I’m happy to try anything that might help. But I find that when everyone else is wrapped up in cold weather,  I’m still in summer clothes. I’m glad to be working from home because I have no idea how I’d manage at work when I need to change clothes and constantly freshen up. I’d advise anyone going through this to talk to other women - you need a support network to help you deal with the physical symptoms and mental pressure.”

“I've learned to see it as a positive, empowering transition rather than a curse”

Although Annika*, 51, believes that difficulties caused by perimenopause contributed to the end of her marriage, she ultimately feels empowered by the changes this stage of life has brought. She says: “The effects of perimenopause on me have been mainly psychological rather than physical. I knew little about menopause and it was depicted by the media in such a clichéd way that it was difficult to find objective information. 

Before hitting perimenopause I was self-confident, in good shape and unembarrassed about sex. But during perimenopause, fatigue and mood swings became an issue. It’s possible my moods were instrumental in my marriage break-up as I wasn't nice to be around. 

My weight has steadily risen during perimenopause. Initially, this had an impact on my willingness to be intimate after my divorce as I didn’t want to be seen naked. Sex was pleasurable, but I was self-conscious about my appearance.

However, my sex drive never 'dried up' as we’re so often told it will and I would never apologise for still wanting and enjoying sex, despite my hang-ups.

These days, I’ve embraced self-care in a way that I never did before. I look after myself with exercise, sleep, meditation and good food. I’ve embraced my sexuality as an older woman and allowed myself to be happy with where I am now. When I was younger, my sex life was different, but I wasn’t as self-assured. I didn’t necessarily do what made me happy but what I thought my partner would like. 

Now I’m confident to do what I enjoy and to ask for what I want. In my fifties, I’m taking back my power. The social norms about perimenopause and menopause are inaccurate and negative. I've learned to see it as a positive, empowering transition rather than a curse.”

“Sex is less regular now and more about foreplay as it’s more comfortable for me”

Becky*, 39, finds sex painful since reaching premature menopause - the NHS says that 1 in 100 women experience this, which means menopause before the age of 40. 

She says: “Before I started going through this, sex was a nice time to bond with my DH. Now my vaginal area is so dry and tender that the skin tears easily. It's difficult to find pleasure when your DH is chafing your skin as he moves. 

My other symptoms include night sweats, difficulty sleeping, mood changes, heart palpitations, fatigue and a lack of libido. All this along with discomfort during sex make intimacy something I'd rather do without but that affects me psychologically. 

I haven't accessed any support other than a gynaecologist for the medical aspects of menopause. Sex in menopause feels like a taboo subject - something no one talks about. So I haven’t confided in anyone except my DH, briefly.  I’m very young to be going through this and I’m embarrassed that my body has aged before I’m ready and fear that my health may suffer. 

I also feel less feminine and worry that I can’t keep my husband satisfied. Sex is less regular now and more about foreplay as it’s more comfortable for me and we’ve been using lube and pessaries to help with dryness. They help to a small extent although my sexual sensation is lessened.

I’ve tried HRT in patches and tablets but my mood was poorly affected and I suffered insomnia. As a last resort, my gynaecologist has suggested a hysterectomy which makes me feel very sad as it’s the point of no return, especially when it comes to the prospect of having more children.

I wish I’d been prepared for what a challenge menopause is. You want to feel alive, sexy and confident and instead you feel ashamed and nervous. I hope I find a better balance so that my story can have a happier ending.”

“Sex is better for me now than before the menopause” 

Claire*, 37, experienced surgical menopause three years ago after she had to have a hysterectomy due to severe endometriosis which had damaged her womb, ovaries, fallopian tube and bowels. 

She says: “My self-esteem and body confidence were already low before menopause, due to my endometriosis symptoms, and although my DH and I did have sex, I was beginning to see it as a chore.

I had to have a total hysterectomy, removing everything along with my cervix. Afterwards, I was discharged from hospital without any information about HRT. I suffered anxiety, stress, low mood, hot flushes, heart palpitations, insomnia, fatigue, vaginal dryness and pain, and lost my sex drive. 

I resented my DH’s need for sex when I couldn't imagine ever wanting sex again. The lack of sex soon lead to a lack of all physical intimacy, which in turn impacted our emotional connection.

Fortunately my GP, who specialises in endocrinology, worked with me to ensure that I was on the correct HRT - oestrogen gel including testosterone. The change this made to my mental and physical health was significant. It enabled me to want to have sex again and to feel confident about my body and my needs. 

It also lessened my stress and anxiety and boosted my energy and confidence, all of which helped me feel more comfortable with intimacy.

I wish I'd known earlier that lack of libido was normal, and that I wasn't going mad, and that it could be treated successfully with HRT. What I would say to other women is don’t be afraid of HRT. It gave me my libido back and allowed me to enjoy intimacy with my DH again. Sex is better for me now than before the menopause.”

*not their real names

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