What happens to your ability to orgasm after menopause?
In the last few months I’ve talked to three women in my social circle who say that orgasm has completely stopped once they started menopause, though it was pretty easy before. For one woman it’s been ten years now, after having a great sex life when she was younger. And I’ve had several emails along these lines:
I have had absolutley NO problem getting to climax during intercourse, at least once if it multiply times (when I am greedy). We have been happily married for 26 years. For the last month I have been totally unable to orgasm. I am totally excited and almost there…but never get there. I know it is totally a ‘brain’ thing and I am in the moment. So do you have any suggestions as to what the problem may be?
Now, with this particular woman there may be any number of things going on, especially interpersonal ones, that have changed her ability to orgasm.
But can we look today just at her age? Because I get these types of questions especially from women approaching 50.
I can happily tell you (if it’s not TMI) that as someone who has gone through menopause, and is now sitting at year 32 of marriage, orgasm does not stop after menopause.
This month we’ve been doing a Fact-Checked-It-For-You series on the blog, looking at different things we believe about sex that may not be true.
When Keith and I used to speak at marriage conferences, I remember we were once paired with a couple where the woman talked about how orgasm stopped after menopause. At the time I was young, and far from menopause, so I didn’t say anything. But that sounded rather suspicious to me.
Since then we’ve done all kinds of research, and I’ve hit menopause myself. I’ve also scoured gyneological journals and talked with all the physician friends I know. And they all say the same thing: orgasm can become harder after menopause, yes, but there is no medical reason that you can’t orgasm at all.
Let me repeat that.
Orgasm can become harder after menopause,
but there is no medical reason why you can’t orgasm at all.
Whew.
A few years ago I remember meeting up with Dr. Carol Peters-Tanksley, a gynecologist who has guest posted for me before, when I was speaking in Austin, Texas. We were in the food line, and I thought I’d take the opportunity to quiz her on this question that I get, over and over. Here’s what she said:
The orgasmic peak postmenopausal women experience may not feel quite as dramatic as in earlier years, but it can be intensely satisfying. If there’s one encouragement I have for postmenopausal women when it comes to sex, it’s SLOW DOWN! Longer foreplay, more conscious attention to what feels good, alternating between lighter and more intense stimulation – you’ve earned the right to take the time and enjoy it! You have every reason to continue to enjoy orgasmic sex for as many years as you wish.
So that’s a little bit encouraging!
But if it’s totally possible to orgasm, then why do so many women stop? I’m going to paraphrase her for a minute, mixed in with some other stuff I’ve read.
Why is Orgasm Difficult After Menopause?
Menopause affects several things:
- Our hormone levels change
- Blood flow to the genital area reduces (and it’s blood flow that causes things to enlarge and become aroused)
- Lubrication diminishes
What this adds up to is that:
- Women take much longer to get aroused (because of hormone levels)
- When we are aroused, we aren’t as “wet” (because of lubrication issues)
- When we are aroused, it often isn’t as intense, and it’s harder to cross that threshold (because of blood flow issues)
Now, I realize that’s a vast oversimplication of how arousal after menopause works (and I know they’re all linked to hormonal changes, not changes on their own), but bear with me for a minute. What Dr. Carol is saying is that this doesn’t add up to an inability to orgasm; it just means that it may be more challenging.
Why Can Some Women Orgasm After Menopause and Some Women Can’t?
So here’s the weird thing: these hormonal and blood flow changes happen to everyone. And yet some women have no problem with orgasm after menopause, and some women do. In our survey for The Great Sex Rescue, we definitely found a drop-off in orgasm rates after age 50, but it certainly wasn’t everyone, and most who frequently orgasmed before menopause still reached orgasm often.
And yet these women weren’t saying that they only sometimes had an orgasm. They were saying they never did. How can that be?
I have a theory about this.
For some, Orgasm After Menopause Becomes More Brain Focused than Body Focused
One of my friends who is really struggling described it this way:
It never used to be an issue for me at all! But now I’m finding that when my mind wanders I can’t get my mind focused again and arousal just stops. It’s like I have to concentrate. And my husband keeps saying, ‘Did I lose you? Where are you?’
I know that she and her husband have always had a great and active sex life, sort of like our letter writer there. But now she’s finding that her main battle is keeping her brain engaged.
For some of you, that doesn’t sound so weird, because you’ve been battling to keep your brain engaged for years already! In fact, that’s one of the huge things I talk about in our Orgasm course–how we have to concentrate in order to feel aroused.
Some women, though, never really struggled with orgasm earlier in their marriage. And now they do.
So here’s where my special theory comes in:
Sheila’s theory about orgasm after menopause
I think that women who struggled with orgasm earlier in their marriage, but figured it out, often don’t have as much of problem with orgasm after menopause, because for them orgasm is more brain focused already. Women whose bodies were responsive right out the gate when they got married, though, often struggle with orgasm after menopause because their sexual response was more tied to their body’s natural propensity towards arousal than their brain, and now their body isn’t cooperating.
In other words, some women have a hard time EARLY in their marriage. But because of the work they did figuring out how to orgasm and how to handle arousal, menopause isn’t as big a deal. Some women have an easy time EARLY in their marriage, but then when menopause comes, they have to relearn everything. They have to learn to make sex more brain focused than body focused.
They have to learn all of those things many women already had to learn–about how to keep your mind focused; how to think sexually confident thoughts while you’re making love (like “I can turn him on!”, or “X makes me feel great!”); how to focus on certain body parts to enjoy the feeling.
So What Do You Do to Help with Postmenopausal Orgasm?
1. Keep your mind focused
Your body isn’t going to just carry you along anymore. You have to carry your body along. This means paying attention to what your body is feeling, and allowing yourself to increase that feeling. It means learning mindfulness, and learning to stay focused on your body rather than entertaining stray thoughts and figuring that your body will kick in when it’s supposed to. When our minds wander, often our bodies don’t kick in.
So ask yourself, “what feels good right now? What wants to be touched?” And then tell him! But as you concentrate on what feels good, you will increase the blood flow to that area.
It’s kind of like just reversing the order. When arousal was easier, the blood would flow, you’d feel aroused, and you’d think, “this feels great!” But now, you’re paying attention to the slightest changes, and as you feel yourself getting more excited, and focus on body parts, you actually increase arousal.
2. Use a lubricant
These make sex feel luxurious! I talked last week about the Femallay melts, and I do really recommend them.
3. Take our orgasm course
If you’re still having issues, please take our orgasm course! It will help you learn what some of your blocks may be, and gives you exercises to do to focus on arousal and help get you over the edge.
The Orgasm Course is Here to Help You Experience Real Passion!
Figure out what's holding you back. Open the floodgates to orgasm.
4. Talk to your doctor about topical hormonal creams
These aren’t lubricants, but instead creams that can help with blood flow to the area. If the problem is more that arousal starts but then comes to a standstill, then these creams can help you overcome that hurdle.
Your doctor may have other ideas that can help you with balancing hormones too.
5. Relearn how to have sex after menopause
The commonality between my letter writer and all of my friends is that sex was really easy for them beforehand. I know there are some women who stop orgasm after menopause who struggled with sex earlier, too, and who never quite managed to figure it out, but often the problem seems worse for people who thought they had it all figured it out. They thought they were good at this, and now it doesn’t seem to work anymore.
Go back to square one and figure out how it works for you now, as if you’re starting all over again. Don’t think, “but this should work! This always works!” Your body is different now. That doesn’t have to be a bad thing. But you may have to relearn what helps, and that may mean taking a LOT of time on foreplay.
I know menopause can be really, really lousy. I’m finding sleep is really hard! But when we think of it as relearning rather than just trying to get back to what it was, that really can help.
Everything is likely new right now, because your body is different. Don’t give up because things have changed. It’s a new phase of your life, and there are really, really good things about this phase. So take a deep breath, realize that you are not a failure and there’s nothing wrong with you, and make a new start.
The Orgasm Series:
- You Are Not Broken if Orgasm is Elusive
- The Orgasm Podcast
- 5 Things that Make it More Likely that She Will Reach Orgasm
- What Sex is Like for Women Who Don't Orgasm
- How Do I Not Feel Self-Conscious about what it Takes to Reach Orgasm?
- Figuring out What's Holding You Back from Orgasm
- 10 Things Husbands Who Are Great Lovers Do
- 5 Ways Husbands Can Bridge the "Orgasm Gap"
- The Orgasm Course Launch
- Start Your Engines Podcast: When your wife has difficulty with orgasm
I have learned so much about female anatomy from you.
I’m 47 and have been experiencing perimenopause for a year now. In less than 2 months, I’m getting married to a wonderful man. Since I’ve been celibate for over 20 years, I honestly don’t know what to expect when it comes to having sex. I never had an orgasm in my first marriage which was during my 20s. I plan to buy some lubricants and I am taking the Orgasm Course, which I have to do slowly because it’s a lot of interesting information to take in.
10 years into perimenopause (I’m super sensitive to hormone changes) and still cycling at 52. All my friends feel sorry for me. However, I’m trying to take advantage of the long, slow change by paying attention to my body. Hopefully, this will help me when I finally move into menopause.
There’s newer research showing that estrogen decline through perimenopause is associated with mood changes – including depression. Research is also finding more and more body structures with estrogen receptors – that are impacted by estrogen decline.
In other words, pre- and post- menopause sexual function may require a lot more support than just telling women to think positively and to take a deep breath.
Perhaps this post could add advice to find a doctor who specialises in menopause?
I totally agree! As a 57 year old menopausal woman, I found that hormone replacement therapy was a lifesaver for me. Estrogen, progesterone and testosterone all decline as we age. Finding a sympathetic dr. Who will help can be life-changing. Some women need testosterone replacement to raise libido and responsiveness. It’s not all in our minds ❤️
This! Systemic HRT is not risky as was previously thought – in fact according to my doctor, it’s actually riskier to NOT have systemic HRT as far as the risk of depression, risk of Alzheimer’s and dementia, genitourinary problems, loss of bone and muscle mass, etc. And the creams do not absorb well and work for most women according to my hormone doctor. In my case, I could barely function or get out of bed until I got to a hormone specialist and got on testosterone pellets and oral progesterone. Now I feel like I am in my 20s again. I’d love to see Sheila interview someone like Dr. Mary Claire Haver or Dr. Kelly Casperson who are really speaking out about how bad it is and how risky it is for women’s long term health when women don’t get proper menopause treatment – and not just for sexual health.
I was looking forward to this but I already know of the things you mention. Many of us are already doing the things you suggest.
I would like to add…
1. Those of us who are in our 50s are the first generation to use hormonal birth control long term. Many of us used it during the whole of our childbearing years except when we wanted to get pregnant and were breastfeeding. Some of us don’t even know exactly when menopause hit because birth control was giving us “withdrawal bleeding”.
I wonder what long term “supplementing” of our hormones has done to our arousal system? Did our bodies allow our natural system to atrophy over time. Is menopause combined with stopping birth control robbing us of all of those hormones rather than simply reducing them to minimal? And for some of us birth control interfered with our arousal.
2. Antidepressants cause a lot of difficulty with arousal. Many of us have been on antidepressants for years. I even stopped taking them for over a year to try to get my libido back. My family suffered and I suffered because I needed my medication.
Many women are prescribed antidepressants to help them manage the mood changes which can be associated with menopause. This can make orgasm very difficult.
The reasons for difficulty with orgasms is multi factorial. Regardless of what “experts” say, every body is unique. There may be some women who will need medical intervention to orgasm… especially after years of medical intervention.
Thank you for all you do. This conversation is important.
In some ways we have been a long term science experiment with all of these medications.
I sometimes feel like, despite the immense benefits of the medications which I have needed, they stole my sexuality. And had significant effects on my marriage.
For a comprehensive overview of the issues in menopause, albeit with a slant toward surgical menopause, try the site surmeno.blogspot.com.
Yes, I know, “blogspot.” This site, however, is a curated collection of relevant articles from medical journals covering multiple disciplines, government research, etc.
The section (available via the table of contents) describing the wide-ranging effects of estrogen deficiency are quite eye-opening, as lack of estrogen affects way more than fertility.
It also points out that the human body can convert estrogen to testosterone, and vice versa, so menopausal women who get testosterone shots to boost libido are typically having that T converted to the estrogen that their various tissues so desperately need. In other words, it’s estrogen deficiency that has to be fixed first, then progesterone, then, finally, and only if needed at that point, testosterone.
Good info also on finding doctors, getting needed test and treatments, the whole smash.
(Moderator: I’ve been having trouble submitting comments on this post, so this is my third attempt. If they’re all in the queue for some reason, feel free to keep only one.)
As a 60 year old woman, I had experienced the challenges many of you are sharing. I heard about a product from a very reliable source so I decided to try it out, even though it is a bit pricey. I’m not usually one to risk money as we live modestly. But I really wanted to find help and hope in this area.
This product lived up to the claims and the reviews others had shared. I strongly recommend trying it out. You can get a 7 day supply for just shipping cost, but when I tried the 7 day sample, it really wasn’t long enough to experience the longer term effects.
This product is called Julva and was developed by a female doctor who experienced some issues of her own so she researched and formulated a natural product which truly has changed my husband and I’s intimate life. His response to me purchasing and trying this was “It’s worth a whole lot more than you paid!”
Here’s the website: https://drannacabeca.com/collections/vaginal-dryness
And for the record, I am NOT associated with the company other than as a customer. I’m that satisfied that I want to help other women find help!
Blessings