Sexual wellbeing and intimacy during and after menopause

There’s a myth that because you’re going through the menopause, that your sex life is over, but this does not have to be the case. If you want to enjoy the pleasure that is available to you in your body, either alone or with a partner, it is all still there after the menopause.

While some of the hormonal changes of menopause may change the way you experience sex and your body, there’s lots you can do to create a happy and pleasurable sex life that feels right for you.

It’s still possible to get pregnant during perimenopause so, if you need to, keep having conversations about contraception. If you use barrier methods with your partner, it’s important to keep using condoms as less lubrication and thinning vaginal walls during menopause can make you more vulnerable to contracting a sexually transmitted infection.

Further information about STI's

Vaginal dryness, discomfort or pain

If your vagina becomes dry, painful or itchy as a result of the menopause, your GP can prescribe oestrogen treatment that's put directly into your vagina as a pessary, cream or vaginal ring. This can safely be used alongside HRT.

The oestrogen cream will increase moisture and lubrication in the lining of your vagina, making walking, exercise and penetrative sex more comfortable again.

Wearing cotton underwear and only washing your vulva with water will help to keep your vagina healthy.

You'll usually need to keep using vaginal oestrogen, as your symptoms are likely to return when treatment stops. However, side effects are very rare.

You can also use over-the-counter vaginal moisturisers or lubricants in addition to, or instead of, vaginal oestrogen.

Sexual desire or ‘libido’

All women experience menopause differently, and many women experience changes in their sex life as they go through the menopause. You may have heard about menopause impacting women’s ‘libido’ or sexual desire.

Some women may enjoy sex more because they no longer worry about what other people think and feel a sense of freedom as they age. Others may find they no longer feel sexual desire or no longer want to have sex and that can be really upsetting.

There are lots of reasons why you might not want to have sex during menopause.

This might include:

  • vaginal dryness and discomfort that makes penetrative sex uncomfortable or painful
  • reduced sex drive due to decreased hormones
  • night sweats that affect your sleep and energy for sex
  • emotional changes that can make you feel too stressed or upset for sex

As with all other symptoms of menopause it’s important that you seek advice when you need it as there is a lot that can be done to help you. Don’t be afraid to speak to someone at your local GP practice as there are treatments that can help you get your sex life back on track.

Stress and anxiety

If you’re feeling stress and/or anxiety then it can be hard to experience feelings of sexual desire. Your brain finds it really difficult to process these two different feelings at the same time.

Managing stress can help with many different menopause symptoms but could really help make a difference about your feelings around sex.

Further information about managing stress

Talking to your partner about sex

If you have a partner, communicating how you feel about sex can feel difficult, but it’s a good way to work through some of the challenges you might be experiencing.

Think about the kind of sex life that you want. Having sex because you feel like you have to is not likely to result in a satisfying experience for you or any partners you have.

A meaningful sex life does not have to look a certain way. Exploring and learning about what feels pleasurable for you at this time in your life can be fun and you get to decide what you want to experience in your body. Simply being affectionate can be a good way of helping you feel connected to your body and close to your partner.

Further information for partners of those going through the menopause