Sex After Menopause: The Golden Years?

Sex after menopause can be challenging. My website, MiddlesexMD, and my medical practice are dedicated to addressing those challenges, so topics like dry vaginal tissue, pain with intercourse, loss of libido get a lot of attention.

But for once, let's turn the picture on its head. Let's look at postmenopausal sex from the sunny side of the street.

Sure, menopause isn't for the faint of heart. It's a hormonal roller coaster with a chaser of unpleasant side effects. Sex can become collateral damage during all the turmoil.

But the big picture? The view from the top of the hill? Not so bad at all. In fact, depending on your inner resources and resolve, both sex and life after the big M can look pretty darned sweet. Some women even report experiencing a resurgence of desire, sort of golden age of postmenopausal sex.

Several elements tend to coincide during those postmenopausal years that contribute to a more serene, predictable life and the potential, at least, for a renewal of romantic zest. For example:

1. More time; less stress. Retired or not, you're probably past actively building a career. The kids are independent and maybe out of the house. You aren't completing financial reports while sitting at basketball practice. You can linger over a pinot grigio and actually listen to the Tchaikovsky Concerto in D Minor without the distracting din of kids fighting.
2. No periods; no pregnancies. A lot to celebrate here. The years of birth control (and worry about the Whoops! factor), the discomfort and nuisance of menses—all in the rearview mirror. You can sleep in and take the triple gate-hook locks off the bedroom door. Canoodling can last as long as you want.
3. Financial freedom. Generally speaking, the hamburger years are over. Maybe you can afford steak, a night out, a nice bathrobe or even a romance-inducing cruise—all of which can make you feel relaxed, sexy, and vital, and more connected to your honey.
4. Fewer crazies. As the hormonal ride levels off, you'll feel more stable, mature and confident. You know what you want, sexually speaking and otherwise, and you know how to ask for it. You're coming into your own—no one is the boss of you.
5. Synchronicity. With maturity, the sexual needs of men and women tend to converge. Men slow down and value emotional connection. Women become more assertive. It can be a great time for playful exploration on all levels.

Granted, aging comes with challenges, and they can be unpredictable. But growing older and staying sexy is more about your attitude and the resources you bring to bear than what's happening below your neck.

"So here's the big reveal," writes Barbara Grufferman in this article. "After 50, we're at a sexual crossroads, and need to make a choice: We could go through menopause, shut down that part of ourselves, lock the door and throw away the key. Or we could embrace this new life with a sense of freedom and fun.…"

That's the thing: it's a choice. There are no wrong answers (unless they hurt your partner). Instead, you have lots of options. Barriers to good sex are very fixable, both for men and women.

Here's a list of simple things you can do to enjoy these golden sexual years to the full:

1. Preheat the oven. You are responsible for your own arousal, so get to know your body and what it likes. Read erotica. Play with toys. Then teach your partner. Don't wait passively for Prince Charming to ring your chimes.
2. Just do it. Sometimes you have to begin in order to get aroused. Start the kissing and cuddling. It's quite possible that your brain will catch up. "If you've been ignoring, neglecting or denying your sexual self for a while, then you must consciously decide that you want sex in order to even let yourself feel desire," writes Grufferman.
3. Sex leads to more sex. "Women who have regular sexual activity have less sexual dysfunction [and fewer] complaints," says Dr. Madeline Castillanos, a psychiatrist and sex therapist in New York City. It's that "just do it, you'll like it" thing again.
4. Take your time. You don't have to hurry, and you don't even have to please your lover. Turning you on is a big turn-on for him, too. So you can relax and let go of the worn and useless sense of duty about getting him and yourself off expeditiously.
5. Engage in outercourse, says Dr. Sheryl Kingsberg, a psychologist with University Hospitals Case Medical Center in Cleveland. Involve all the senses; practice luxurious, languid, voluptuous sex that may or may not actually require penetration. Most of all, have fun doing it.

According to the experts, the most dependable predictor of good sex after menopause is good sex before menopause. And if it wasn't so great before, time's a-wasting. You can apply your hard-won life skills and your intimate knowledge of your partner to begin addressing the issues that stand in the way of intimacy and a solid sex life.

Barb DePree, MD, has been a gynecologist for 30 years, specializing in menopause care for the past 10. Dr. DePree was named the Certified Menopause Practitioner of the Year in 2013 by the North American Menopause Society. The award particularly recognized the outreach, communication and education she does through MiddlesexMD, a website she founded and where this blog first appeared. She also is director of the Women's Midlife Services at Holland Hospital, Holland, Michigan.