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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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Testimonial by Alexandra B.

Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

-- Alexandra B., 5/20/2015 via Yelp!

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by Mary L.

I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

Read more: Testimonial by Mary L.

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

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 Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

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