Originally published on October 3, 2023 by Vital Physiotherapy & Wellness, now part of the Bravella Health network. Original author: Yasma Ali-Hassan.
By: Yasma Ali-Hassan
Here at Vital, we specialize in helping you maintain optimal health and wellness through every stage in life – including your menopause journey! Our main goal is to make sure you feel your best in each aspect of your life which means we can’t forget about your sex life.
-holistic approach
-when you think about menopause, most women think about hot flashes-
Before we get started – let’s quickly breakdown the stages of menopause and how to know which stage you’re in.
Perimenopause is the time leading up to menopause. For most people that happens somewhere between 35-45 and lasts about 7 years. Perimenopause is when your reproductive hormones (estrogen, progesterone and testosterone) are starting to fluctuate. That’s why you might start to see signs like changes in your period cycle, hot flashes, night sweats, sleep troubles, weight gain or mood changes.
Menopause is the one-year anniversary since your last period (yay!). Depending on the person, this might be between the age of 45 or 55 but could be earlier or later.
Postmenopause represents the rest of your life following menopause! Once you have reached postmenopause you will no longer have a period and your reproductive hormone levels stabilize. During this time, you might experience hot flashes, sleep troubles, urinary incontinence, weight gain, hair loss and dry skin.
Let’s talk about sex!
No matter what stage of menopause you’re in, you might have noticed some changes in your sex life. Some questions we hear A LOT are:
“Is sex supposed to feel uncomfortable or painful?”
“Why am I not self-lubricating?”
“Why does it feel less sensitive?”
We’re here to remind you that these concerns are absolutely normal and that there is nothing wrong with you. Through each stage before and after menopause, changes in the tissues in your vagina and vulva are expected! As your estrogen levels change, there’s a decreased blood flow to the vagina which affects your ability to self-lubricate and also causes thinning of the muscles in the vaginal wall (known as atrophy). As a result, you might start feeling like the tissue is drier, less elastic and easily irritated. The tissues of the vagina and vulva might also feel less sensitive to sexual stimulation. A combination of all these changes means that sexual activity may feel uncomfortable, painful and overall less pleasurable.
You also might ask yourself, “Why am I not in the mood for sex?”
Totally normal! Seeing changes in your libido (aka your sex drive) is extremely common during these times. You might feel like the things that used to arouse you, just aren’t working anymore. It’s common to feel like you just can’t get yourself “in the mood”, even if you want to have sex. Or you might feel like you don’t want to have sex altogether, which is completely fine! These changes to your libido vary from person to person; they can be linked to reproductive hormones as well as other factors like sleep and stress.
It’s no surprise that a combination of these changes can have a negative impact in the bedroom. The good news is that you’ve come to the right place – good sex is something we take pride in here at Vital. That’s why we have come up with a list of all the key ingredients you NEED in order to take charge of your sex life.
The Ingredients:
A good perspective
As a society, we need to break the bad habit of viewing menopause as something that makes you “less sexual”. Menopause is a natural transition that everyone with a vagina will experience at some point. The changes in your body that come with menopause do NOT make you any less sexual or desirable. The way you perceive your body and mind will affect your sex life. The best tip that we have to offer is to be kind to yourself. Don’t underestimate the role of self-image, confidence and empowerment on sex.
Stress management
There’s a good chance that you have a lot going on in life right now. Maybe you’re transitioning your kids into adulthood, taking on new work responsibilities or caring for aging parents. It’s important to remember that life outside of the bedroom can influence your sex life. Finding ways to manage stress will only make things better. Your stress-relief strategies can include yoga, finding a new hobby, spending time outdoors or setting work boundaries. The options are endless!
Your new best friend: Lube
Whether or not you are experiencing dryness during sexual activity, lube is a handy tool. The best thing about lube is how versatile it is! You can use it for penetrative, non-penetrative sex and for solo use. Some benefits of lube include enhancing pleasure, decreasing pain and reducing friction. We know that shopping for lube can be overwhelming given all the options – don’t be afraid to test different types out and find out what works best for you! A good place to start is with water-based lube especially if you have sensitive skin. Need a suggestion? Here’s one of our favourite lubes.
Moisturizer
Yes, there’s moisturizers for your privates; No, it isn’t the same thing as lube.
Moisturizers for the vagina and vulva are very similar to other moisturizers we use on the rest of our body since they are meant to be absorbed by the tissue. Their role is to keep your vagina and vulva moisturized throughout the day and to prevent dryness or discomfort. Unlike lube, they are not meant to be used before sex. These moisturizers can come in the form of creams, gels and oils and can be applied internally or externally. You don’t need a prescription to buy moisturizers for your vagina and vulva unless you are specifically looking for ones containing estrogen which you can discuss with your physician.
Spice things up!
The things that you used to enjoy in the bedroom might not bring you as much pleasure as they used to. Now you have the perfect excuse to experiment and try something new! Using sex toys, watching videos or spending more time with foreplay can all be great ways to promote excitement and satisfaction in the bedroom. Visiting a sex shop is an excellent way to get inspired and explore the endless options available.
Pelvic physiotherapy
We’re here to help – this is what we do. Some of the ways pelvic physiotherapy can be beneficial to you:
Provide education and support that will help you understand the anatomy and function of your pelvic floor
Pelvic floor relaxation techniques to address pain during sex
Mindfulness and breathing exercises to help you become more connected to your body
Supporting you through your entire menopause journey and helping you achieve all your goals related to health and wellbeing
References
Pelvic Health Solutions (2019) https://pelvichealthsolutions.ca/knowledge-base/menopause
Freeman, E. W., Sammel, M. D., Lin, H., Gracia, C. R., Pien, G. W., Nelson, D. B., & Sheng, L. (2007). Symptoms associated with menopausal transition and reproductive hormones in midlife women. Obstetrics & Gynecology, 110(2 Part 1), 230-240.
What is Menopause? (2021) https://www.nia.nih.gov/health/what-menopause
Welcome to Postmenopausal Life (2023) https://healthcare.utah.edu/womenshealth/gynecology/menopause/postmenopause
Vital physiotherapy & Wellness and Fraser Pelvic Health Facebook live (2019) https://www.facebook.com/vitalphysiotherapytoronto/videos/2252986308277156
Sheela Zelmer Women’s Health (2023) https://linktr.ee/sheelazelmer
