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how to orgasm after menopause
Image courtesy of iStock
As part of our whole body approach here at Femina PT, we look at a woman's ability to enjoy a good orgasm as an indicator of not just good pelvic health, but overall physical, mental, and emotional wellbeing as well. When Jennifer Geddes was penning an article for Parade on the subject of how to orgasm after menopause, she wanted to know more about the role pelvic health plays in the postmenopausal "Big O" puzzle so she reached out to me for my take. Here are some snippets from the article with my comments mixed in. A link to the original article is included below.

Heather Jeffcoat, DPT

Tips From the Experts on How to Orgasm After Menopause

And why it often comes down to "use it or lose it"

Let's presume you are a postmenopausal woman whose overall health is good. You eat right, get enough exercise, and live a mostly pain-free, comfortable life. Even with all that going for you, chances are your sex life has slowed down a bit from when you were younger. This is only natural, but it doesn't mean you have to shun sex altogether or enjoy it any less when that moment arrives.

As the article states:

No more periods, cramping, bloating or PMS to ruin your mood—or your plans between the sheets? It may sound divine, but entering the menopausal phase of your life can also come with a few downsides.

In short, take stock in the freedom this gives you to explore this new phase of life! Sure there are other challenges, but try to see the glass as half full, not the other way around.

But having an orgasm after menopause isn’t impossible. In fact, there are loads of ways to address the common symptoms of menopause that many women face so you can get your love game back on track and enjoy having sex with your partner again. 

THE BIG QUESTION:

Can a Woman Have an Orgasm After Menopause?

If the answer were "no", there wouldn't be much point to this artice, right? So just know that you can still do it, only perhaps with a slightly different mindset and approach.

Just because you may be entering menopause or you’ve already completed this stage doesn’t mean your ability to achieve orgasm has gone out the window. Whether you were used to vaginal orgasms in your pre-menopause life or, like most women, your climaxes arrived via clitoral stimulation, the ability to have an orgasm still exists.

So now that you know you can still do it, find out what's been holding you back and what you can do about it!

Reasons Orgasming After Menopause May Be Difficult

As mentioned in this "must read" article on our blog, more than 80% of those with menopause report physical and psychological changes the period before, during and after the last menstrual cycle with 77% of respondents experiencing changes in their genitals (vulva, vagina, pelvic floor) that affected their lifestyle, emotional well-being, and sexual function. The Parade article lists some of the effects of these changes that can include:

  • Less desire
  • Vaginal dryness (and elasticity) which equals pain
  • Urinary issues, including leakage, incontinence or the need to go
  • Trouble sleeping, stress and anxiety
  • Mood swings and irritability
  • Worry about aging and the changes it brings to the body

The hormonal effect - or lack thereof

A woman’s sex steroid hormones are also in decline during menopause, says Julianne Arena, MD, an OB-GYN specializing in traditional and integrative healthcare. “One of these is estradiol, a form of estrogen that not only protects the bones and heart, but also the vagina,” she explains. As women get older, the vagina’s tissue and the clitoris have less estrogen and these factors can make having an orgasm challenging, she adds.

This might lead you to think that hormone replacement therapy may be the answer to your lack of orgasms - but is it worth the reported risks? Here is a great article that looks at hormone replacement therapy from all sides. Long story short, it's a temporary fix at best for most women.

How to Orgasm After Menopause

Let's face it - life tends to slow down for many people once they pass the 50 year mark. For postmenopausal women, this could mean that you have more time to enjoy the sexual experience. Sure you may not get in all those "quickies" you used to when you were younger, but you can use this newfound way of experiencing sex to draw out the pleasure in a more relaxed, timely way. You may just need to find a new mindset and learn to not place so much emphasis on quantity, but rather quality.

Jennifer gets into some of the more specific tips that can benefit many women in their quest:

  • Lube up. Use a lubricant to fight vaginal dryness or a vaginal moisturizer every two to three days.
  • Try massage oil. A product called Zestra has also been shown to help the majority of women who used it in clinical trials.
  • Make time for you. If you're past 50 and still keeping a fast paced schedule, strive to create pockets of time during your week for a warm bath, a yoga session, reading or whatever brings you joy.
  • Work your pelvic muscles. "A stronger pelvic floor can mean more intense orgasms", says Heather Jeffcoat, DPT, a doctor of physical therapy and the author of Sex Without Pain. “But muscle weakness in this part of the body isn’t just about doing Kegels all the time—there has to be a balance between flexibility and strength.” Her advice: Speak with a pelvic health physical therapist who can set up a program to match your needs.
  • Watch the alcohol. While a glass of wine can certainly be relaxing, too much alcohol can work against you.
  • Get creative. Variety is the spice of life, or so the saying goes. Head outside to do the deed on a private beach, or book a room at a romantic inn.
  • Cut back on sex toys. “It sounds counterintuitive, but some women will need to stop using the vibrator for a while due to clitoral trauma,” explains Dr. Cabeca.
  • Talk about it. If what used to work for you isn’t cutting it, chat with your partner.

Curious about pelvic floor physical therapy for menopause?

Approximately half of all women can expect to live 40% of their lives in the post-menopausal stage. It makes sense to develop a solid strategy for optimal health, the earlier the better – and regular physical therapy can be an important component of that plan. 

A pelvic floor therapist can help break the muscle tension cycle with manual therapy and teaching you self-treatment to maintain gains at home. By releasing pelvic floor tension, you free pelvic floor muscles, allowing for pain free sex. Pelvic floor therapists can also screen for musculoskeletal dysfunction in the spine, hips and pelvis; educate about sexual ergonomics and help you find positions that reduce pain during intercourse. Pelvic floor therapists can also provide you with self care programs which can reduce dryness and irritation in the tissues of the vulva, labia, and vaginal canal.

See this article entitled How Pelvic Floor Therapy Can Help, and this article with more info on pelvic floor physical therapy for menopause.

In closing, there are a number of things you can do to make intimacy more pleasurable. The article concludes:

Keep at it. Don’t give up! “Blood flow is improved with frequent ‘exercise’—which means if you don’t use it, you will lose it,” offers Wesley. Why not get busy tonight?

I agree, why not?!? 
Heather

Continue reading the full article on how to orgasm after menopause at Parade.com here, and click here if you're ready to see one of our trained and licensed pelvic floor physical therapists.

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What Our Patients Have to Say

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Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by Rosanna R., age 35

Heather has affected my life in the MOST POSITIVE way and I am forever grateful. My husband refers to her as the "sex doctor" so you can only imagine how happy he is with my therapy outcome.

After the birth of my son I suffered from "Vaginismus", however, at the time I just thought I was broken. My "broken vagina" affected me physically but it was an emotional struggle as well. Many women in my life also suffered with pain from sex after their babies were born so I knew I wasn't alone. They told me they "just got used to it" but I couldn't see myself living that way.

Sex wasn't just painful, it was literally impossible - IT DIDNT FIT!

Read more: Testimonial by Rosanna R.,...

Testimonial by J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

Read more: Testimonial by J.H.

Testimonial by Ann V.

I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition, which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her guidance and techniques i was able to be cured from vaginismus in only 2 1/2 short months!!! I couldn't believe how quickly their program worked for me! I am forever grateful and thankful from Heather, and Laureen! They are the absolute best at what they do!

Read more: Testimonial by Ann V.

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