Can Orgasms Disappear After Menopause?

The body goes through several changes leading up to, and during, menopause. While the changes are normal, they can leave many people wondering if they will ever be able to experience sexual pleasure or orgasm again. Luckily, with some small changes, many women go on to have pleasurable sexual experiences post-menopause. Let’s explore how.

How does sex change after menopause?

Menopause is the time in life when a person's menstrual cycle stops. This is usually due to a natural reduction in the hormones estrogen and progesterone. However, it also happens after the surgical removal of the uterus and ovaries. For people experiencing non-surgical menopause, menopause typically occurs between the ages of 45 and 55, but may occur earlier.

The drop in hormones during and leading up to menopause — known as perimenopause — can cause many adverse symptoms that may affect sexual functioning, including:

• Reduction in sexual desire
• Reduction in sexual arousal
• Decrease in vaginal lubrication
• Thinning of the vaginal wall
• Tightening of the vaginal canal
• Painful sex
• Incontinence

Not only do the changes in hormones affect sexual functioning, but they are also responsible for other factors that can contribute to a decline in sexual desire and arousal. Such symptoms include:

• Night sweats
• Sleep disturbances
• Hot flashes
• Anxiety
• Mood changes
• Changes in body appearance

These changes may leave people experiencing menopause feeling like they may never enjoy sex or experience an orgasm again. But many people experiencing menopause do go on to have enjoyable sex lives.

How does menopause affect orgasms?

The hormone estrogen plays a major role in sexual functioning. It promotes vaginal lubrication, maintains vaginal elasticity, increases sexual desire, and promotes blood flow to the vulva, clitoris, and vagina. During menopause, estrogen levels naturally drop, and these sexual functions tend to drop too — causing many issues that can affect the ability to orgasm or the intensity of the orgasm.

• Decreased vaginal lubrication. The reduction of vaginal lubrication can affect sexual pleasure and orgasm, as friction during sex can prevent people from becoming aroused enough for orgasms.
• Decreased vaginal elasticity. When the vagina loses its elasticity, the lining can become swollen and irritable, and the opening to the vagina can become narrow. This can make sex and intercourse very painful, making many people avoid sex altogether.
• Decreased blood flow to the genitals. Blood flow to the genitals — particularly the clitoris — is an essential part of orgasm, as it increases sensitivity and pleasure. When this decreases, it can make it harder to orgasm as less pleasure is derived from the stimulation of the genitals.

Can orgasms really disappear?

No, it is a misconception that people cannot orgasm once they've reached menopause. While many menopausal and perimenopausal people experience a decrease in the intensity of orgasms or difficulty in achieving orgasms, many people still experience a fulfilling sex life that includes orgasms. There are likely several reasons for this misconception, many due to the sociocultural beliefs about women, aging, and sexuality.

Difficulties to orgasm during menopause – what to do:

If you are experiencing a decrease in the intensity of orgasms or difficulty in achieving an orgasm, there are a few tips that you can try.

Use lube and vaginal moisturizers

To help reduce friction and pain during sex, use lubricants and vaginal moisturizers to lubricate the vulva and vagina. While lube and vaginal moisturizers are similar, they vary in function. Lube should be used on demand before and during partnered and solo sex for short-term relief. Vaginal moisturizers, on the other hand, are intended to be used over an extended period to help rehydrate and increase the elasticity of the vaginal tissue. They are inserted into the vagina and are available over the counter as creams, gels, or suppositories.

Have longer foreplay

As we age, blood flow to our genitals, which is essential for sexual arousal, slows down. Therefore, allowing the body to become naturally aroused requires more time during foreplay. If you and your partner have been together for an extended period and have established sexual routines, it may be necessary to communicate your need for additional foreplay to them.

Try new things

To counter the decrease in desire and arousal, consider adding new elements to your sexual routine, such as erotica and pornography. To help bring blood flow back to the clitoris and genitals, you may want to explore vibrators and other sex toys that provide added stimulation needed to achieve an orgasm. You can also focus on other forms of intimacy, such as giving your partner a massage or setting aside time for cuddling.

Do I need to seek professional help?

If you have tried the tips above and are still experiencing trouble having pleasurable sex and orgasms, contact your healthcare provider. Sexual dysfunctions are best treated holistically and may require you to seek the help of multiple professionals, including a gynecologist and sex therapist. A gynecologist may be able to assist you by prescribing your hormone replacement therapy, a medication that replaces some hormones naturally lost during menopause. A sex therapist can help to challenge any thoughts, values, or beliefs which impede healthy sexual functioning and offer suggestions to your individual needs.