Written by
Dr. Rachel Pope, Chief Medical Officer and Co-Founder
Hi, I’m Dr. Rachel Pope I co-founded MiM because I believe that every person should feel seen and heard and have a say in their care.
Menopause Myths Busted: Why Your Sex Life Can Still Thrive
Maintaining Intimacy Despite Vaginal Dryness
Roughly a quarter of menopausal women fear their partner might leave them due to decreased sex drive.*
Beyond hot flashes, mood swings, and sleep disruptions, menopause often brings vaginal dryness. This can make physical intimacy uncomfortable and painful, impacting sexual desire and, ultimately, your relationship health.
Menopause doesn’t have to mean you have to wave goodbye to your sex life. In fact, this can be a vibrant, healthy and fulfilling chapter. Here’s what you need to know to keep your sex life thriving.
What Causes Vaginal Dryness During Menopause?
As estrogen levels decline during perimenopause and menopause, the vaginal tissues become thinner and more fragile. This leads to dryness, irritation, itching or burning. Low estrogen also reduces vaginal elasticity and secretions. While frustrating, vaginal dryness is a normal part of the transition. Finding the right treatments can improve your overall well-being and help maintain a connection with your partner.
Tips for Managing Vaginal Dryness
Painful sex can easily get in the way of your sexual health and intimacy, but it doesn’t have to.
Here’s our take on how to treat vaginal dryness:
Use a vulvar moisturizer or serum: Apply at night or during the day – or both. Look for natural ingredients like coconut oil, honey, or olive oil and stay away from anything with fragrances or warming properties.
Use lubricants: Apply a safe lubricant generously before and during sex. Reapply as needed. (See our Lube section to understand what kind of lube to look for!)
Stay active: Exercise keeps blood flowing to the pelvic region, stimulating moisture production. Who knew!
Manage stress: Anxiety and tension can interfere with arousal and lubrication. Practice relaxation techniques. Mindfulness is especially good for intimacy. Check out Dr. Lori Brotto’s book, “Better Sex Through Mindfulness.”
Communicate: Let your partner know what hurts or feels good so you can adjust accordingly.
Consider vibrators: Using a small vibrator can help stimulate moisture production before sex. 80% of women only climax due to clitoral stimulation! Therefore, a vibrator can help to get you there.
Avoid irritants: Steer clear of douches, fragranced soaps, and laundry detergents that contain dyes or perfumes.
Prescription estrogen: Low-dose estrogen creams, tablets or rings can replenish vaginal estrogen to regain lubrication. Discuss options with your doctor or health care provider.
Talk to A Menopause Specialist
Two issues tend to affect women’s sex lives during perimenopause and menopause the most: decreased sexual desire and pain.
Decreased sexual desire is often the result of hormonal fluctuations.
Pain is commonly the result of menopausal genitourinary syndrome which causes dryness and the narrowing of the vagina.
However, it’s important to be examined by a menopause specialist who is experienced with vaginal and vulvar changes. They can rule out any vulvar skin conditions like lichen planus, lichen sclerosus, eczema and psoriasis and may order a biopsy to confirm.
You Can Bring Sexy Back
I promise you there’s hope.
I recently had a patient - let’s call her “Karen**” - who described extreme tenderness, burning and a sense of “rawness” when sitting, walking or simply going about her life. Sex had become painful, and their usual store-bought lubricant wasn't enough. An exam revealed vulvar and vaginal changes consistent with perimenopause/menopause.
I recommended using an all-natural vulvar moisturizer on a daily basis, vaginal estrogen three times a week, and a silicone-based lubricant during sex. At her follow-up visit, she shared an enthusiastic, “All women should be doing this!” Everything was back on track in the bedroom.
Remember, vaginal dryness does not mean you have to sacrifice intimacy. With some experimentation and open communication, you can still enjoy a satisfying sex life during menopause and beyond.
Author Note: This blog post is intended for informational purposes only and should not be interpreted as medical advice. Please consult with your healthcare provider for personalized recommendations.
*Source: https://www.independent.co.uk/news/uk/home-news/menopause-divorce-reduced-sex-drive-b1889562.html
**names are fictional
The Takeaways
Explore Your Options
There are a number of simple actions you can take to maintain sexual intimacy and ease discomfort.
Rule Out Skin Conditions
Schedule an exam with a menopause specialist to ensure a skin issue isn’t creating the issue.
Talk to Your Partner
Your comfort and wellbeing matter most so it's important to have an open, honest conversation with your partner.
Whatever you’re worrying about, we’re already talking about.
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