Why Can’t I Orgasm Anymore After Menopause?

Menopause is a significant milestone in a woman's life, bringing about several changes that go beyond just the end of menstrual periods. Many women experience changes in their sex lives during this time, including difficulties with achieving orgasm.

During menopause, lower estrogen levels can lead to reduced interest in sex, vaginal dryness, and decreased blood flow to the clitoris. These changes can make it more challenging to experience orgasm. But not all hope is lost. Enjoying a healthy and satisfying sex life during — and after — menopause is possible. It might just take some trial and error. 

Keep reading to learn more about how menopause may impact your ability to orgasm, and what you can do about it. 

Why can’t I orgasm anymore after menopause?

We won’t beat around the bush: menopause can be tough, both mentally and physically. It affects almost every organ and function in your body, which can directly or indirectly make it harder to orgasm.

A recent study published in the journal Menopause looked at over 5,300 sexually active women between the ages of 40 and 59. It found that menopause symptoms were linked to anorgasmia, which is a sexual dysfunction that makes it difficult or impossible to reach orgasm, even with sufficient sexual stimulation.

Orgasm is a complex physiological response that involves the coordination of multiple systems, including hormonal, neurological, and psychological factors. Diminished arousal, physical discomfort, and emotional distress caused by menopause symptoms make it more difficult to reach orgasm — or make you want to avoid sex entirely. 

All of this is due to a decline in hormone levels, particularly estrogen, progesterone, and androgens, which play a crucial role in the menopausal transition. These hormonal changes may have various effects on your sex life, such as reducing your sex drive and making it harder to get aroused. There are a few different reasons why this can happen.

Changes in sensation

During sexual arousal, the female body undergoes several physiological to prepare for sex. Chiefly, the clitoris and vaginal walls become engorged with blood, increasing sensitivity and lubrication.

Estrogen plays a significant role in this sexual response cycle. It acts as a vasodilator, so it brings blood flow to the blood vessels and nerves in the vagina and clitoris. As estrogen levels drop, changes in blood flow to the genital area can alter sexual sensation. The vulva and clitoris are also packed with androgen receptors. The drop in androgens with menopause leads to skin and organ changes in this region as well. In fact , pain at entry is thought to be related to changes in the vulva vestibule which is more responsive to the lack of androgens, such as testosterone. You might notice reduced sensitivity, which can make reaching orgasm more difficult.

Lower estrogen levels can also lead to thinning of the vaginal walls, decreased elasticity, and decreased natural lubrication. This can make intercourse uncomfortable or even painful, which can, in turn, affect sexual enjoyment and make orgasm harder to achieve.

Reduced libido 

Achieving a satisfying orgasm requires not just physical arousal but also a sense of desire, which is influenced by both physical and emotional factors. 

During menopause, physical symptoms such as hot flashes, night sweats, and fatigue can diminish sexual interest. Emotional changes like stress, anxiety, and mood swings can further affect sexual satisfaction and desire. Together, these factors can significantly impact your overall desire and enjoyment of sex. Lower levels of testosterone can also contribute to a lower libido, as the hormone modulates sex drive along with neurotransmitters like dopamine and norepinephrine. Basically, sex can become the last thing on your mind! 

How to orgasm after menopause

The good news is that orgasm and menopause can coexist. Pleasurable sex doesn’t have to go MIA in midlife, it might just require a new approach.

There are several approaches you can take to address these changes and enhance your sexual experience during menopause: 

• Lube: Using over-the-counter lubricants can help ease vaginal dryness and discomfort during sex. We're strong believers that everyone, regardless of age, should be using lube during sex. We designed the Intimate Elixir specifically for menopause, for instant lubrication and long-lasting moisturization. Meanwhile, our Pleasure Serum supports easier, longer, more intense, and more satisfying orgasms.
• Vaginal moisturizers: For longer-lasting relief, you can use vaginal moisturizers regularly to keep your vaginal tissues healthy and elastic.
• Hormone Replacement Therapy (HRT): For some women, hormone therapy might be a good option. Estrogen therapy can restore hormonal balance and help with menopausal symptoms that affect sexual function. Chat with your healthcare provider about the potential risks and benefits of hormone therapy.
• Vaginal estrogen: Vaginal estrogen is a local form of estrogen therapy applied directly to the vaginal tissues, usually via creams, rings, or tablets. It helps alleviate menopausal symptoms such as vaginal dryness and thinning of the vaginal walls, improving lubrication, sensitivity, and overall sexual comfort, which can enhance sexual function and pleasure.
• Other medications: Ospemifene (Osphena) and prasterone (Intrarosa) are two types of drugs commonly prescribed to counteract vaginal dryness and sexual discomfort in menopause. Some women may also benefit from antidepressants if they're experiencing more severe emotional symptoms of menopause, such as anxiety and depression.
• Pelvic floor therapy: Pelvic exercises can strengthen the muscles around the vagina. This can amp up sexual sensation and overall sexual health. It’s important to follow a pelvic floor therapy program with a trained physical therapist, as some exercises (such as Kegels) aren’t recommended for people with a tight or high-tone pelvic floor.
• Therapy: It's also really important to address any emotional or psychological factors that might be affecting your sex life. Chatting with a sex therapist or counselor can help you work through any relationship issues and offer strategies for improving intimacy, and communication, and finding new ways to enjoy sex.
• Overall lifestyle: Menopause can majorly overhaul your whole well-being. Regular exercise, a balanced diet, and good sleep habits can do wonders for your overall well-being and sexual health. Managing stress through relaxation techniques or mindfulness practices can also make a big difference.

FAQ

How can I get wet again after menopause?

During (and after) menopause it's really common to experience vaginal dryness because of lower estrogen levels. Using vaginal lubricants — like Vella’s Super Slip & Slide or Intimate Elixir — during sexual activity can provide immediate moisture and comfort. And if you use vaginal moisturizers regularly, they can help keep your vaginal tissues hydrated over time. You can also talk to a healthcare provider about vaginal estrogen therapy, which can help restore the vaginal tissues. It's also good to stay sexually active, have plenty of foreplay, and explore different types of stimulation to promote natural lubrication. If dryness continues to be a problem, definitely consider reaching out to a healthcare provider for personalized treatment options.