Menopause may make climaxing a little tougher — but we’ve got expert tips to help.
Hot flashes, trouble sleeping, and mood swings are all annoying side effects we’re told to expect from menopause. But there’s one pretty major symptom people — even medical professionals — often don’t warn you about: difficulty orgasming.
Around half of women 50 and up have some form of orgasmic dysfunction, meaning that even if they’re aroused and stimulated, they have trouble reaching climax, says Lauren Streicher, M.D., a professor of obstetrics and gynecology at Northwestern, citing soon-to-be-published data from the Kinsey Institute, where she’s a senior research fellow. And the main reason why may surprise you. It’s not one of the usual suspects — the symptoms like vaginal dryness or decreased libido that get lots of attention. The main culprit, Dr. Streicher tells us, is the nerves in the clitoris, which become less sensitive as we get older.
This occurs naturally over time as our hormone levels fluctuate, and sometimes as a result of certain conditions like diabetes or medications like SSRIs, a widely used type of antidepressant.
“A woman may have been able to orgasm from licking or touching or stroking previously, but because of this loss of sensation, that may no longer be enough,” says Dr. Streicher, who’s a medical advisor for Midi, a virtual clinic for women 40 and up.
Of course, vaginal dryness plays a role, as well: “Obviously, if there’s no lubrication and the sex is painful, it’s just not gonna happen,” Dr. Streicher says. As does waning estrogen levels: The hormone is an important part of “priming the pump,” so to speak. It helps trigger the glands in your cervix and vaginal walls to release moisture and it’s a vasodilator, meaning that it increases the blood flow to the pelvis and clitoris, which helps with orgasm.
Tips for achieving orgasm after menopause
Unfortunately, this issue isn’t usually addressed. “The majority of women don’t talk about it with their doctors, and their doctors don’t bring it up,” says Dr. Streicher.
But we’re here to change that. Thankfully, there are lots of things you can do if you’re not able to finish in bed like you used to. Dr. Streicher’s first tip is to make sure you’re getting the right type of stimulation you need down there. Things that used to do the trick might not work so well anymore, because when you hit menopause certain types of nerves become less receptive — particularly the ones that respond to touch. These nerves are smaller and more easily damaged than the ones that respond to vibration, says Dr. Streicher.
“So the first tip is if you aren’t using a vibrator, you need to start,” she tells us.
Her second tip is to increase blood flow to the clitoris. You can try a warming lubricant, which should get the blood flowing to all the right places. (Although some doctors warn that these formulas might irritate some people and aren’t meant for regular use — so ask your OB-GYN first.)
Is there medication to help older women orgasm?
Another thing that might help is topical estrogen. These creams are often prescribed to women who have atrophic vaginitis, a common menopausal condition that causes dryness, burning, itching, and frequent urination. It’s also excellent at getting blood pumping to your pleasure center when it’s applied directly to the clitoris.
Now, there’s also the little blue pill — and its topical counterpart — to consider. Although Viagra is not FDA-approved for women, some doctors, including Dr. Streicher, will prescribe it off-label. Viagra’s a vasodilator that’s very good at directing blood to the genitals, but there haven’t been many studies on how it affects women.
“For the pill, the data’s very mixed,” she says. But there have been more promising results from a cream version that’s currently being developed and is expected to win regulatory approval for women, Dr. Streicher says. In the meantime, women can get a hold of topical Viagras that are compounded, meaning they’re custom-made, but you’ll need a prescription and you’ll need to go to a trusted source. The FDA doesn’t require compounded medications to be approved, so it’s harder to ensure they’re quality and safety. (There’s one available through Midi, says Dr. Streicher, who as we mentioned earlier, is affiliated with the healthcare provider.)
The bottom line is, yes, this part of getting older sucks — but if you miss that big O, there are still plenty of things you can do about it. And more and more people are starting to realize that this is an issue that needs to be studied, Dr. Streicher says.
“For a long time, there’s been this idea that women over 50 or 60 don’t care about orgasms,” she says. “I think now people are starting to wake up a bit and realize that, yes, it’s important that postmenopausal women experience pleasure, too.”
