Guide
Sex After the Menopause: Comfort, Desire and Plenty of Fun
Comfort first, then fun: what the NHS and menopause experts say about dryness, desire and painful sex, and telling someone new.
Can Sex Still Be Good After the Menopause?
Yes. NHS inform, Scotland's NHS health site, calls the idea that the menopause ends your sex life a myth. The NHS lists vaginal dryness and a reduced sex drive among menopause symptoms, and there's plenty that can help, from lubricants and vaginal moisturisers to vaginal oestrogen and HRT: ask a doctor, nurse or pharmacist, the NHS says.
Back in the game after a long gap, a divorce or a bereavement? You may only now be finding out how your body has changed, and that's nothing to be shy about. This guide is for adults, 18+, who still fancy some fun.
Why Can Sex Hurt After the Menopause?
The NHS says the menopause can bring dryness, a burning feeling, irritation or itching in and around the vagina, and that these symptoms can also make sex feel painful. Age UK says changes in desire and sexual function are common as oestrogen falls.
You're in good company. Women's Health Concern, whose factsheet on vaginal dryness was reviewed by the British Menopause Society, says dryness after the menopause is very common, affecting over half of post-menopausal women aged 51 to 60. Yet it says only a quarter of affected women seek treatment.
There's no prize for putting up with it quietly.
Women's Health Concern factsheet reviewed October 2023. It doesn't name the study behind the figures.
What Helps With Dryness and Painful Sex?
Start simple and work up.
- Water-based lubricant
- For the moment itself. The NHS suggests using one in and around the vagina before sex.
- Vaginal moisturiser
- For comfort between times. The NHS says you can put it inside the vagina to keep it moist, and Age UK lists vaginal moisturisers among the treatments that may be prescribed.
- Vaginal oestrogen
- The NHS says it's only available on prescription, except Gina vaginal tablets and Ovesse vaginal cream, which you can buy from a pharmacy. Women's Health Concern says that, unlike conventional HRT, its effects are local, so the risks are minimal.
- HRT
- Age UK lists HRT (hormone replacement therapy) among the treatments that may be prescribed, and the NHS suggests talking to a doctor, nurse or pharmacist about HRT and the other options available.
- Testosterone gel or cream
- The NHS says it can help to improve a low sex drive for some women.
NHS inform says you can use over-the-counter moisturisers or lubricants as well as vaginal oestrogen, or instead of it. One catch if condoms are involved: the NHS says some oestrogen creams and gels can damage condoms and diaphragms and stop them working properly, and that with latex condoms you should use a water-based or silicone-based lubricant rather than an oil-based one.
What Can You Do About a Low Sex Drive?
The NHS counts a reduced sex drive among the symptoms of the menopause, so a dip is nothing to feel odd about. If it bothers you, the testosterone gel or cream above is worth asking about, since the NHS says it can help some women.
It's also fine to see what a little novelty does: a flirty message, a new play partner, an evening that isn't planned to the minute. None of it needs a prescription.
How to Raise It With a New Play Partner
Early, briefly and with a smile. You're not confessing anything: you're handing over the instructions, and grown-ups generally appreciate a manual. Say it on the site or over a drink, well before the moment arrives.
A few lines to borrow:
- "I'll want lube, and plenty of it. Humour me."
- "I like a slow start, so don't rush me."
- "If anything hurts, I'll say, and we'll try something else."
- "Condoms with anyone new. That's not up for debate."
Anyone who sulks at any of that has told you what you need to know. If you'd rather warm up with words first, over 60s chat is a relaxed place to start, and our guide to meeting safely covers your first meet-up.
A Word for the Men
If she reaches for the lubricant, take it as an invitation, not a verdict. The NHS lists vaginal dryness as a menopause symptom, so it's no reflection on you. Slow down, ask what feels good, and if something hurts, stop and try something else.
Bring condoms and use them. NHS inform says less lubrication and thinner vaginal walls during the menopause can make a woman more vulnerable to catching an STI. If your own body has questions, our guide to sex after 60 covers erections, pharmacies and more.
When Should You See a GP?
- When dryness has lasted a few weeks and the things you've tried yourself aren't working. That's the NHS's own advice.
- When symptoms or bodily changes are getting in the way of your sex life. NHS inform says your GP is the person to see.
- When you've been diagnosed with a health condition and want to be sure sex is safe. Age UK says it's sensible to check with your doctor.
- When you'd like to talk through HRT, vaginal oestrogen or testosterone. The NHS suggests a doctor, nurse or pharmacist.
For lubricants, moisturisers and the two pharmacy brands of vaginal oestrogen, a pharmacist is the obvious first stop. The MHRA, the UK's medicines regulator, says Gina tablets have been sold without a prescription since September 2022, following a consultation with a pharmacist.
Questions About Sex After the Menopause
Why does sex hurt after the menopause?
The NHS says menopause symptoms such as vaginal dryness, burning, irritation or itching can make sex feel painful. Women's Health Concern says dryness affects over half of post-menopausal women aged 51 to 60.
Can I buy vaginal oestrogen without a prescription?
Two brands, yes. The NHS says vaginal oestrogen is only available on prescription except Gina vaginal tablets and Ovesse vaginal cream, which you can buy from a pharmacy. The MHRA says Gina is for post-menopausal women aged 50 and over who haven't had a period for at least a year.
Is it normal to lose interest in sex after the menopause?
It's common. Age UK says changes in desire are common as oestrogen falls, and the NHS lists a reduced sex drive among menopause symptoms. The NHS suggests talking to a doctor, nurse or pharmacist about HRT and the other options.
What's the difference between a lubricant and a vaginal moisturiser?
The NHS suggests a water-based lubricant in and around the vagina before sex, and a moisturiser inside the vagina to keep it moist when dryness is the problem.
Do I still need condoms after the menopause?
With anyone new, yes. NHS inform says it's important to keep using them, because less lubrication and thinning vaginal walls can leave you more vulnerable to STIs. Our guide to sexual health over 60 explains where to get condoms free.
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