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how to orgasm after menopause
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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 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 Carolina J.

I had tried Pelvic Floor Physical Therapy before (with another PT) and I had a really bad (painful) experience. A friend of mine and fellow patient, told me about Heather, Laureen and Femina PT (née Fusion Wellness & Physical Therapy) and I decided to try again. I am so happy I did! Femina PT have, literally, changed my life. I was able to do again things I couldn't do for over 10 years!! Their bedside manners are impeccable, their knowledge and understanding make me feel comfortable to recommend this place to anyone in pain. Specially if you have Endometriosis. 100% recommended!!

-- Carolina J., 12/28/16 via Yelp!

Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

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