Sex after Menopause

Truth #1: Your Vagina Is Not Going to Shrivel Up Like a Prune
While the vagina does go through some changes during menopause due to loss of estrogen, much of the changes that happen are undetectable to the eye. In other words, there’s no such thing as “shriveling,” and you most certainly won’t look like a prune. “Many women don’t notice the changes at all,” says Hope Ricciotti, MD, a gynecologist who teaches at Harvard Medical School and is a health expert at BeWell.com.

Even better news: Since blood flow to the vagina lessens after menopause, consider having sex to keep it at its best. “The vagina is a ‘use it or lose it’ place,” explains Dr. Ricciotti. “The act of having intercourse stimulates blood flow to the vagina and keeps it healthy.”

Truth #2: Invest in a Good Lubricant
One of the realities of sex after menopause is vaginal dryness. It happens to almost every woman, says Sari Locker, a sex expert and author of The Complete Idiot’s Guide to Amazing Sex. “For a healthy, comfortable sex life after menopause, lubrication is key.”

If you’ve never had to use lubricant before, don’t be shy about starting! “Too many women are intimidated about using lubricant, because they think that they will have to use a sticky tube of old-fashioned, medical-style lubricant,” she says. “In fact, today’s modern, sensual, water-based lubricants can actually enhance sex in addition to making it more comfortable. For example, Play More Lubricant provides women with a smooth, slick feeling that is not sticky and feels natural.”

Truth #3: Your Body Image May Decline. 
“A lot of the changes that happen during menopause aren’t just physical, they’re mental as well,” says Elizabeth Boskey, PhD, MPH, CHES, a sexual health expert for About.com. “Menopause can change the way that women think about their bodies and their sexuality, and it can also affect their self-esteem. What can you do about it? Try little things, such as playing sexy music, to boost your sexual self-confidence. Here are 10 simple tips to get you started.

Truth #4: You Are Still at Risk for Sexually Transmitted Diseases
“Many postmenopausal women don’t realize that they are still at risk of HIV and other sexually transmitted diseases, and therefore don’t concern themselves about using condoms because they are no longer worried about pregnancy,” says Dr. Boskey. “This may contribute to the rising incidence of HIV in the over-50 age group.”

Truth #5: You May Have to Work a Little Harder for an Orgasm 
“You may be used to 30 orgasms a night, but the reality is that during and after menopause, you may have to work a little harder to have one or two,” says Dorree Lynn, PhD, a psychologist and sex educator who works with the AARP in Washington, DC, and the author of the forthcoming book Sex for Grownups: Dr. Dorree Reveals the Truths, Lies and Must Tries for Great Sex After 50.

Don’t let that get you down, she says. “Just remember, you can’t compete with the memory of your younger self,” she adds. “Fifty isn’t the new 20, its being 50 and loving every aspect of who you are and your breadth of experience.”

Truth #6: Your Sex Drive Might Go Down…or Up
Menopause can mean different things for different people, adds Dr. Lynn. And while some may experience a decrease in sex drive, other women find that with the right mindset, their sex drive may actually increase. “For some women, there is a burst of adrenaline that can encourage you to try new things, change your mindset and live through your 50s, 60s and beyond with vigor and an adventurous mindset.

Truth #7: Your Need for Intimacy May Increase 
“After menopause, women still want intercourse, but it becomes more intimate,” explains Dr. Lynn. Here’s her prescription: “Foreplay should start in the morning with wakeup kisses, gentle pats on the butt, hand holding and whispering sweet nothings during the day,” she says. “It’s all part of heightening the desire, pushing the sex drive, both partners taking more time and care to enjoy their sexual experience to the fullest.”

Truth #8: Your Vaginal Walls May Thin a Bit
“One of the biggest issues with sex after menopause is that declining estrogen levels can lead to thinning of the vaginal walls,” says Dr. Boskey. This, in combination with dryness, “can contribute to making sex more painful.” She suggests talking to your doctor about estrogen creams and therapies. “Estrogen therapies, including topical creams, have been shown to have a positive effect. Although, because of the potential for other health problems, any use of estrogens, including plant-based soy estrogens, should be discussed in detail with your doctor.”

Truth #9: Exercise May Help Rev Up Your Sex Drive
Dr. Ricciotti reminds her patients that one of the best ways to amp up your libido is to work on your health first, which means increasing how much exercise you’re getting. “I think of sex drive and function as part of holistic health,” she says. “If you are unhealthy physically or emotionally, sex drive will certainly suffer. Having energy from a healthy diet and regular exercise, along with good sleep and mental health, are key ingredients in a healthy sex drive.”

Truth #10: Your Sex Life Probably Won’t Change Dramatically
Here’s some comforting news: “The best predictor of having a good sex life after menopause is having a good sex life before menopause,” says Dr. Boskey. “Women who are happy with their premenopausal sex life are a lot more likely to be able to maintain that satisfaction post menopause.”

Sarah Jio is the health and fitness blogger for Glamour.com. Visit her blog, Vitamin G.