Senior Couple in Love

Some men complain their wives lose interest in intimacy around the time of menopause. Some women complain they can’t enjoy sex the way they used to. These changes can put a lot of stress on a marriage. But sex after menopause can be meaningful and satisfying.

A woman’s sexual response is a very delicate and interconnected thing. Physical discomfort, hormonal changes, stress – all that and more can affect her desire and ability to engage in intimacy. It may often be difficult to decide exactly which factor is most important.

As a gynecologist I’ve helped women with these problems for many years. And I know menopause does not have to be the end of desire: it can be the beginning! I will always remember one lovely lady I saw as a patient who married for the first time at age 56. She and her husband quickly enjoyed a healthy and enjoyable sex life. I believe you can too.

Here are some things you can do to maintain and even improve intimacy with your husband during and after menopause – physically, emotionally, and spiritually. You can enjoy sex after menopause.

Physical Intimacy

The decrease in estrogen that happens at menopause often leads to decreased lubrication and less elasticity in the genital tissues. This may lead to significant discomfort during intercourse for some women.

You may find that a lubricant such as Atroglide® or Replens® will make intimacy much more comfortable. Estrogen (by prescription) is the most effective way to increase the resilience of the vaginal tissue. Many women are able to take vaginal estrogen who cannot or choose not to take estrogen systemically (by mouth, skin patch, or gel). Vaginal estrogen is absorbed well locally, but usually results in much lower blood levels than other forms. Osphena® is a non-estrogen oral medication that can also help many women with vaginal symptoms.

Hot flashes, night sweats, and other physical symptoms of menopause may seriously affect your energy level, and as a result may affect your interest in intimacy. There is very little scientific evidence that soy products, black cohosh, or evening primrose oil decrease hot flashes, but trying them for a short time may help some women. If these symptoms persist, please talk with your doctor about both estrogen and non-estrogen medication options: there are several that are known to help.

All women produce a small amount of testosterone along with estrogen, and this level also decreases at the time of menopause. Taking extra testosterone may be helpful in a few circumstances, such as when a woman has had her ovaries removed. But be cautious: side effects are common, including weight gain, acne, and other skin changes.

Mental Intimacy

Much about sex happens in the mind, especially for women. Some find that sex is more enjoyable after menopause because of no anxiety about pregnancy, no worries about periods, or a long-term safe relationship with their husband. If that’s you, enjoy!

Other women find life stresses, fatigue, or marital challenges increasing during this time, and any of those can be a serious mood killer when it comes to intimacy. You may struggle with a negative body image, or feel “used up” when it comes to sexuality. Your identity as a woman may be challenged by illness, a sense of your own mortality, or the challenges of caretaking for multiple family generations.

For the sake of your marriage, let me encourage you to value this part of your relationship with your husband. God intended this to be a bonding and beautiful part of your union together, and it’s worth working to preserve. Sometimes just talking with your husband about the challenges you feel in this area will help both of you understand ways to mutually help each other. Sometimes simply “going slower” will make intimacy more enjoyable.

Fifty and older can become the most productive and effective period of your life. Your wisdom and experience make you more valuable than ever to your husband, your family, your community, your world. You may finally have a better sense than before of what God’s purpose is for you. All those factors should help fill your soul in a way that coming together with your husband can be especially meaningful.

Spiritual Intimacy

Feeling spiritually empty can leave you feeling like you have nothing left with which to engage in intimacy. On the other hand, having a filled-up soul can overflow into a meaningful, exciting, fulfilling sexual connection with your husband. Spiritual intimacy with your spouse can be powerfully bonding, and increase both your interest in sexual intimacy and the joy you experience as a result.

There are two important things you can do in this area. First, stay filled up. Actively guard your heart from things that drain you to the point of emptiness. And actively engage in things that fill your soul: time alone with God, time in nature, time for yourself. When you’re full, you’ll have a part of yourself available to share with your husband.

And second, choose to be spiritually connected with your husband. Pray together if he’s willing. Actively nurture the friendship between you. Make a conscious choice to move toward him whenever possible. Invest in your relationship by sharing about your dreams, regrets, and what you know of God’s purpose for your union. Sex may be a natural result of some of those conversations.

Sex doesn’t have to stop at menopause. It may take being intentional about this part of your marriage. But you and your husband can enjoy intimacy more than ever during what I hope are the best years of your life.

Need More? We have a great detailed ebook Dr. Carol’s Guide to Sex and Menopause. Check it out!

Your Turn: How has menopause affected intimacy in your marriage? Leave a comment below.

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