The Truth About Sex After Menopause


When I started my blog in May 2014, I had been re-singled for a year-and-a-half after a long marriage. I was dating up a storm and feeling at the top of my game intellectually, sexually, and simply as an empowered woman in the world. My experience ran counter to the conventional wisdom that women lose their desirability once they're of a certain age. So I decided to spread the word that midlife sexuality could be a bountiful time for women as long as they don't buy into the myth that they're going to be exiled to Crone Land.

But when I read a piece in HuffPost last month, written by a 60-year-old woman who reported a decline in her libido and changes in her physiology that made intercourse downright painful, I started to wonder if I'd become a Sexual Pollyanna. While I've noticed slight changes in my body due to perimenopause, I haven't had any noticeable problems with lubrication and vaginal atrophy, and if anything, I've experienced a spike in my sex drive.

Apparently, not every reader finds my experience credible. Here's one comment from a man named John:

There is a dramatic change in sex post-menopause. I have always thought that your stories of sex in the 50s were make-believe -- written as male fantasies of a sexual woman. That you are pre-menopausal now makes sense.

I was a bit taken aback to hear that my personal stories seem so incredible that they could only be fantasy. Still, his remark got me thinking: what will happen when I do go through menopause? Will my vaginal tissue thin to the point where I can no longer tolerate intercourse? Will my natural juices evaporate so that I require lube before I can even attempt any kind of penetration? Do these changes happen to every post-menopausal woman, or just some? Are there particular factors that cause some women to lose their sexual response while others retain theirs?


So I set out to gather data on midlife women's sexuality and invited post-menopausal women or partners of post-menopausal women to tell me the truth about their own experience. Of the 28 emails I have received to date, the responses are split down the middle: 50% rate their sex lives as significantly worse, while the other 50 percent rate their sex lives as different but still positive, or even better than pre-menopausal sex.

I will be including all the responses in upcoming blog posts, but some of the e-mails people wrote me were so informative and descriptive that they warrant their own post. This one, from 51-year-old Grace, is a wonderful story of how she got her groove back after menopause sapped her sexual pleasure.

I'm an RN of 20 years who in my opinion started menopause at 44 with all the associated symptoms (special-effects quality hot flashes, sleep disturbances, memory problems, emotional issues, jawline acne, stiff black single whiskers), and was totally done at 50 per labwork confirmation but that at the time my Mirena (which was removed when I was 49) kept me from having a period for six years. I am now 51.

I have worked half my career in women's health/OB and have read a lot about these issues, but there are some aspects of postmenopausal sexuality which have been a complete surprise to me. "Upsetting" would not even be the word. I should also preface by saying HRT is not an option for me because I had a pulmonary embolism after an outpatient hernia repair 12 years ago.

Lubrication diminished very gradually despite desire and being desired.

I knew that could happen. My job is stressful, but not that stressful, and my husband and I have been together for eight years, married for six. He calls me "the prettiest girl in school" and "babydoll"and makes me giggle, and he looks like an extra on Game Of Thrones. I hate KY and its ilk -- when it dries it reminds me of when boys in 5th grade used to paint Elmer's Glue on the back of their hands and allowed it to dry, then peeled it off, screaming like it was their own skin.

A woman OB friend turned me on to coconut oil and that has been quite helpful. At around the time my own lubrication was mostly gone, about a year and a half ago now, I began to have some discomfort with intercourse even with generously applied lubrication. That progressed pretty rapidly and it was palpable to me and noticeable to my husband that the landscape was changing in my vagina and outside, with my labia as well. Using the pain scale I would assess my patients with at work, my pain on intercourse was a deal-breaking 8 or 9 (sharp and burning, and I am not a pain complainer, and I love this crazy man) on a 1-10 scale before I decided to suck it up and see my nurse practitioner. (At this point, I was still able to orgasm as I had throughout my sexual life, not through intercourse alone ever, but no big deal to me or him, so okay, fine).

We discussed my symptoms and my history and I decided I was willing to take Osphena if she would let me. It's different from hormone replacement, so the risk of clots is still present, but lower, and since I am a non-smoker and somewhat active, I decided to try it. In about a month my pain had gone from 8-9 to ZERO most times, with pain being a 1 or 2 if I was stressed or worried or just not feeling it. That was great.

Then in December of last year the biggest shock of post-menopause occurred.

Over approximately a three-week time frame I became anorgasmic without the use of a vibrator, which has, no joke, the power of a chainsaw or a weed whacker or something. I was shocked and terrified because I was afraid it was some kind of neuropathy. I am a very well-controlled Type II diabetic of three years (I was a gestational diabetic in my pregnancy) and was trying hard not to blame myself. My research told me that anorgasmia is a thing that happens to some women after menopause. It is not as common as lack of libido, but not uncommon. I HAD NO FREAKING IDEA.

Nothing I read offered any hope of function returning. It seems to be a problem with blood flow similar to what is treated with Viagra in men. The "pink Viagra" which the FDA is considering is for libido, not for my issue. My libido is fine. One article (thank you to my lesbian sisters who were willing to share knowledge online) suggested trying a very high-powered vibrator, maybe made for body massage. We ordered one from a purveyor of sex toys and bought a "back massager" at Target.

The motor in the ordered one has already burned out (I let this man get very little rest), but the "massager" is massaging along. It is not quite the same, but it's better than being within a hair's breadth of fireworks, and somebody reaching down and pinching out the fuse with damp fingers.

If I ever get time I would love to write a book or be a speaker about this. It should not come as a shock to women, and not knowing certainly does not keep it from happening. Thank you for shedding light on an important aspect of all our lives as women.

The Truth About Sex After 50 is an ongoing series. If you're a post-menopausal woman (or partner of a post-menopausal woman) and you would like to share your story, please e-mail me at

*Grace is a pseudonym

Earlier on Huff/Post50:

Most Common Sex Myths About Boomers