Intercourse Post-menopause

Anonymous
I am just about 53 and have been in menopause 4 years - it all happened early because of ovarian removal surgery. I have been on HRT for the last two years, which has well alleviated most of the worst symptoms of the change.

But, things are quite dry down there these days - and I have been voluntarily celibate for the last 12 years, so I have no idea what intercourse would be like given the changes that have happened to my body during peri and post menopause.

For those who are well in menopause and still have an active sex life including vaginal intercourse, is it possible for this to be a painless experience?

Does lube make up for what used to happen naturally?

Are there special creams to use to make things more naturally moisturized? Can they be used along with oral HRT?

Thank you in advance for any and all answers/suggestions. I am contemplating dating again, but have some anxiety about this issue. I used to really love sex and I suspect most men in midlife will still want some, but I could live without it especially if it's painful and there really is no cure for that. I'm wondering about real life experiences of sex in menopause i.e., are women enduring it or can it actually still be pleasurable and wonderful with the menopause body.


Anonymous
I'm 57. It's been about 15 months since I last had a period, so I was relatively late to menopause. I don't take HRT but I do use a topical estrogen cream, inserted in my vagina 2x/week. I do it because without it sex is uncomfortable with a lot of post-coital spotting, and I get frequent UTIs. Lube is just not enough. When I use the cream regularly, sex is comfortable as long as plenty of lube is used, no spotting, fewer UTIs. I don't know if you can use the estrogen cream when you are on HRT. This is a good conversation to have with your GYN.

That said, the estrogen cream doesn't do anything to bring back libido. I too used to really enjoy sex. In menopause, I can still achieve orgasm, but it takes a long, long time. My DH thinks that's great! But I just don't care about sex at all anymore and usually would rather be doing something else. (I don't masturbate anymore either.) My DH is still very interested though, so I go along to get along. It's really important to him. Sigh.
Anonymous
I use an estrogen suppository, although I haven't had really severe dryness issues.

I'd get yourself to a gynecologist stat. There are a lot of different options, but I was just reading recently that as far as vaginal tissue goes, earlier intervention is better to keep everything healthy (not just for sex, but also for comfort/avoiding pain, avoiding UTIs, etc.)
Anonymous
I’m 57 and have just been using lube for the past couple years I’ve been in menopause. But recently, I’m finding it is really not enough. Next I’m going to try a vaginal moisturizer to see if that helps. If not, I’ll talk to my doctor about other options. I’m nervous about estrogen because I have propensity for blood clots.
Anonymous
One star. Do not recommend.
Anonymous
Anonymous wrote:One star. Do not recommend.


Anonymous
Anonymous wrote:I use an estrogen suppository, although I haven't had really severe dryness issues.

I'd get yourself to a gynecologist stat. There are a lot of different options, but I was just reading recently that as far as vaginal tissue goes, earlier intervention is better to keep everything healthy (not just for sex, but also for comfort/avoiding pain, avoiding UTIs, etc.)


+1 Also, I stopped getting up at night to pee after I start of the estrogen suppositories. The genitourinary tissues rely on estrogen for their structural integrity.

This article has a good discussion about the benefits of vaginal estrogen therapy.

https://www.nytimes.com/2023/08/22/science/menopause-vaginal-atrophy.html?unlocked_article_code=XrhlBV7xGD1oWBPAJ-lZ5-kgEav4grdnD7zq5sNUfj36V2AMHYe9jK2tQNPRRzyYLxRTw6RrB5qS5fEgmLvSXhO280lv7SNK_dMaCHEgoz10icokJK2KfMrGiGGh1ocr5gZY_bJsc1FFx80v99ygSoabyoxWdAnMmksF2v-i6KXqmgIUJCDZYdwWjm-XhIAuSqZgpKgS4mKD525UCC4GG9RpgC6pqGaIgTPYGf8MFMa_CU39nDo1ral3NKNsmWNiYai6JyckWU4wloTAyU5UG5oiheIV0b8EolhzebWhMYbhl2h4GFuFZ6ALBRrA1X7z1h9VtG9iD07m3h5WEe3gkbALdro&smid=nytcore-ios-share&referringSource=articleShare
Anonymous
There are non-hormonal treatments too. This one uses a laser technology to rejuvenate the skin (also good for pelvic floor issues):

https://merakskincare.com/vaginal-rejuvenation-northern-virginia/
Anonymous
Anonymous wrote:
Anonymous wrote:I use an estrogen suppository, although I haven't had really severe dryness issues.

I'd get yourself to a gynecologist stat. There are a lot of different options, but I was just reading recently that as far as vaginal tissue goes, earlier intervention is better to keep everything healthy (not just for sex, but also for comfort/avoiding pain, avoiding UTIs, etc.)


+1 Also, I stopped getting up at night to pee after I start of the estrogen suppositories. The genitourinary tissues rely on estrogen for their structural integrity.

This article has a good discussion about the benefits of vaginal estrogen therapy.

https://www.nytimes.com/2023/08/22/science/menopause-vaginal-atrophy.html?unlocked_article_code=XrhlBV7xGD1oWBPAJ-lZ5-kgEav4grdnD7zq5sNUfj36V2AMHYe9jK2tQNPRRzyYLxRTw6RrB5qS5fEgmLvSXhO280lv7SNK_dMaCHEgoz10icokJK2KfMrGiGGh1ocr5gZY_bJsc1FFx80v99ygSoabyoxWdAnMmksF2v-i6KXqmgIUJCDZYdwWjm-XhIAuSqZgpKgS4mKD525UCC4GG9RpgC6pqGaIgTPYGf8MFMa_CU39nDo1ral3NKNsmWNiYai6JyckWU4wloTAyU5UG5oiheIV0b8EolhzebWhMYbhl2h4GFuFZ6ALBRrA1X7z1h9VtG9iD07m3h5WEe3gkbALdro&smid=nytcore-ios-share&referringSource=articleShare


PP here. The suppositories are pricey. I get the best discount with the manufacturer’s savings card.

https://www.imvexxy.com/savings-information/
Anonymous
It isn't just the dryness but the overall "stretchiness" that is an issue as well. Am 56 and we use plenty of lube and I do the estrogen suppositories twice weekly (I use the tablet inserts since I find the creams messy). Because I am not as "stretchy" I find that certain positions I used to like are now just too uncomfortable. Another thing to realize is that 50-something men often have issues sustaining a thoroughly stiff "stiffy" so you have an object that is slightly limp pressing against an opening that is less "giving". You have to both be willing to laugh about what's working and what isn't, and be willing to shift to other options (e.g., oral) when the situation warrants.
Anonymous
Thank you for the honest responses. I do see a wonderful gynecologist, and I’ve noticed my last few pelvic exams/pap smears were very uncomfortable - not his technique but my ability to tolerate it. I haven’t asked him about this issue because I have been celibate and it wasn’t any kind of priority.

I have a great pelvic floor owing to never carrying to term or giving birth - I gave up after multiple miscarriages.

But I’m guessing I would experience discomfort on account of the dryness - I do still masturbate once or twice a week because it helps relieve tension and helps me sleep, but I need more external stimulation to get motivated and while I occasionally get moist it is nothing like before.

I think I will probably just embrace continued celibacy unless a wonderful unicorn of a man lands in my lap without any effort on my part. And of course if he’s a wonderful unicorn of a man, he’ll happily settle for oral sex and be the primary provider when he’s not cleaning the bathroom and kitchen, that is. Ha!
Anonymous
Maybe I'm wrong, OP, so others correct me, but I don't think you should let this stop you from looking for a romantic relationship. From what I understand (at least in my experience) sex becomes less important as we get older anyway. You deserve companionship if you want it.
Anonymous
Is it true that receiving oral is also much less enjoyable, along with PIV? Is there a reason for this?
Anonymous
I'm 55 and have been in menopause for 5 years. I have developed vaginal atrophy which means that not only has any lubrication completely vanished, but the vagina actually shortens and the vaginal walls lose elasticity and shrink in. This results in extreme pain and bleeding for me during PIV, but also my DH just can't fit anymore. He says it feels like he's being pushed out. I have tried the suppositories, dilators, pelvic therapy, estrogen but finally gave up. Now we just find other ways to be intimate. My gyn says this is a fact of menopause that is not discussed much.
Anonymous
Anonymous wrote:I'm 55 and have been in menopause for 5 years. I have developed vaginal atrophy which means that not only has any lubrication completely vanished, but the vagina actually shortens and the vaginal walls lose elasticity and shrink in. This results in extreme pain and bleeding for me during PIV, but also my DH just can't fit anymore. He says it feels like he's being pushed out. I have tried the suppositories, dilators, pelvic therapy, estrogen but finally gave up. Now we just find other ways to be intimate. My gyn says this is a fact of menopause that is not discussed much.

Did your Gyn discuss starting you on HRT?
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