Dr. Meserve, what are your top three sex tips for people who have gone through menopause?
Advocate for your sexual health. If you have any concerns about your sexual health - pain, decreased interest, decreased ability to orgasm, or lack of pleasure, speak to a qualified expert about possible solutions. It’s unlikely a health care professional will ask you about this aspect of your health, so you’re going to have to take the lead and demand the guidance you need.
Talk to your partner about what works for you when it comes to intimacy. A partner can’t be a mind-reader, so it’s important to have open discussions about the types of touch and actions that bring you pleasure and the types that turn you off.
If you’re starting a new relationship, remember to practice safer sex. Even though you can’t become pregnant anymore, you can still contract sexually transmitted infections. Use barrier methods (condoms) until both partners have been checked for HIV, Hepatitis C, chlamydia and gonorrhea. I tell my patients they can have a romantic dinner where they exchange their blood tests and share STI status.
What changes to their sex life are people likely to experience after menopause?
Sexual health is most certainly multifactorial - meaning a woman’s enjoyment and interest in sex may depend on how she feels about the relationship, how she feels about her body, how her day was, if the children are home, and if her libido exists. In general, these are the physiologic changes about which every woman:
The loss of estrogen after menopause can cause vaginal dryness which can make sexual intercourse uncomfortable and in many cases painful
The loss of estrogen can cause insomnia and fatigue which can negatively impact mood and libido.
The decrease in testosterone after menopause can lead to decreased libido.
A male partner’s erectile dysfunction may affect a woman’s experience, so make sure that is being addressed by his physician.
It’s not all bad: the lack of concern for pregnancy can be quite freeing!
Are there any tools/products/toys you recommend?
Lubricants can be very helpful in reducing friction and discomfort during intercourse.
Vaginal estrogen can be prescribed for women to increase natural lubrication. Vaginal moisturizers can be used by women who choose not to use vaginal estrogen.
Vaginal dilators can be used in cases where the vaginal canal has become smaller.
Pelvic floor physical therapy is a little known but extremely helpful treatment for painful intercourse.
How about communication tips, so that someone can inform their partner about what’s going on with them?