As women step into the postmenopausal years of their life, they feel less burdened by not getting menstrual periods or becoming pregnant. This might sound heavenly phase of life, isn’t it? It can be good but women can expect many physical and psychological changes that can affect their intimacy with their partners. But, still, there are ways for menopausal or post-menopause women to get enjoyable and pleasurable sex, either alone or with their partners. This article provides insight into female sexual pleasure, the effect of menopause on sexual pleasure, and some tips/treatments to make sexual pleasure achievable after menopause. [1, 4]
What is Meant by Sexual Pleasure for Women?
Female sexual pleasure is hard to be noticed as there is no such clear signal or a well-defined event that indicates female sex climax as found in men. The components of female sexual pleasure include:
1. A desire for sex or physical attraction towards the partner.
2. Sexual arousal on stimulation or even sexual thoughts- Each part of the women’s body has different stimulating points just like the brain. These particular points must be known to the male partner. Upon touching these points, the heart rate, blood flow, and blood pressure rise in these areas. The sexual and de-stressing hormones just as testosterone, dopamine, and serotonin are released by the body, which makes women enjoy the entire sexual activity. These can even result in vaginal lubrication.
3. Sexual satisfaction or orgasm (aka female climax)- It is the series of rhythmic muscular contractions that happens inside of the vagina/womb or on the pelvic floor. The sexual tension gets released at peak of the orgasm when the female body gets warm and the blood pressure and heart rate increase. Soon after this, the female body feels relaxed and all the vitals get back to normal. This can come through nipple stimulation, penetrative sex, clitoral stimulation, or masturbation. Female sexual satisfaction can be achieved even without an orgasm or climax.
Female sexual pleasure comes in with emotional and psychological satisfaction. 
Sexual Pleasure after Menopause
Menopause and advancing age can affect the desire in women to have sex and when it happens, the other components of female sexual pleasure also get affected.
During menopause, women experience a drop in their female sex hormone estrogen. The outer genitalia and the vagina of females have a lot of estrogen receptors. When there is a loss of estrogen, the vaginal or genital tissues tend to shrink up. The vaginal canal becomes less stretchy and even becomes dry. Moreover, a decline in the levels of estrogen hormone also leads to reduced blood flow to the vagina.
As a result, the vagina becomes less sensitive to touch and less receptive to getting aroused. All of this makes sex less desirable among menopausal or post-menopause women. They report facing sexual difficulties such as showing less interest in sex, trouble having orgasms, or feeling downright uncomfortable as well as painful sometimes while having sexual intercourse. On top of all this, the menopause accompanying emotional toll could also make them lose interest in having sex or not get pleasure even if they try to do any sexual activity.
Additionally, menopause comes to older women who are more likely to experience health issues. If they are already suffering from any chronic illnesses or injuries, their energy level could be low and they might experience physical pain and lower self-body image- all of which affect their sex drive. [1, 2, 3]
How can Problems in Sexual Pleasure Post-Menopause be Treated?
Menopause results in vaginal dryness, itching, or pain/discomfort. These side effects can be resolved safely by using prescribed estrogen treatments that are directly put into the vagina as a cream, pessary, or vaginal ring, alongside hormonal replacement therapy. The topical estrogen products can help increase moisture and lubrication in the vaginal lining, allowing penetrative sex to be comfortable back again.
If pain at the time of sexual intercourse is not letting women feel pleasure from sex, the doctor recommends a vaginal examination to determine the cause of pain and treat their condition accordingly. Some of the conditions that can cause painful intercourse includes a pelvic mass, endometriosis, ovarian cysts, sexually transmitted infections, scar tissue from surgery, and vaginitis. Furthermore, if there are post-menopause vaginal changes noticed in women like the dry, fragile vaginal tissues, don’t ignore them and let things turn painful instead treat the thin vaginal lining and make it healthy again. This can be done usually within a month.
Another impact menopause can have on the sex life of women is their reduced sexual desire or lagging libido (sex drive) which can be addressed by increasing receptiveness to sex and treating mental or emotional turbulence with drugs or relaxation techniques.
Lastly, if there is any sexual dysfunction bothering post-menopause women, they must not get embarrassed and give up on sex. Healthcare providers can help address these concerns with their integrated treatment approach. [3, 4]
Self-help Tips to Deal with Sexual Pleasure Problems after Menopause
- Have a healthy personal relationship and open communication with your partner.
- Have a sex-related talk without any inhibitions with your partner, doctor, or counselor. It is a good way to work through some of the challenges that you might be experiencing post-menopause.
- Look at sex as an enjoyable activity and not as a task or sin.
- Allow your partner to explore your body physically.
- Do not divert your thoughts on anything or sexual climax, just focus on what is being done to your body.
- Read erotic books.
- If having stress or anxiety, manage stress through relaxation techniques this way brain would not have to process two different feelings (sexual pleasure and stress/anxiety) at a time. It could help you feel different about sex.
- Your partner must understand and accept your menopause as a physical limitation and act accordingly.
- Do kegel exercises to strengthen pelvic floor muscles.
- Try doing sex regularly at different positions to control penetration, and keep your hormonal levels up and sexual tracts healthier and lubricated. 
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