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Navigating Sex and Menopause

What the HECK is menopause anyway right!!!!

Most people aren’t sure. For some it’s a period of misery defined by hot flashes, weight gain, and negative changes, but do women really understand what is happening and why?

Menopause is the cessation of your menses (period) and a woman is considered to have transitioned through menopause once she has had no period for 12 consecutive months. That means, if after 8 months of having no period it magically appears one month, then the timer of those 12 months starts again. 

During this time, the sex hormones decrease, most notably estrogen which causes a few things to happen:
1. Changes to the pH of the vagina. It goes from a more acidic environment of 3-4 on the pH scale, to a more alkaline environment, 5-6 on the same scale.
2. Collagen production is decreased and there are changes to the vaginal and vulvar tissues. 
3. General changes to the tissues of the vulva and vagina. 

Why are these things mentioned above important? Because they set the stage for a host of other things. The tissue changes and ph changes contribute to vulvar atrophy, tightening of the vaginal opening and canal, shrinking of the clitoris and changes in sensation, vaginal dryness, changes to the pelvic floor, urinary urgency, urinary frequency, increased incidence of UTIs, vaginal dryness and painful intercourse. 

These changes can come with great emotion, frustration and psychological impact and cause many women to avoid sex all together. So what can we do to address this: 

1. Your GYN can make recommendations for hormonal or non-hormonal options that may be appropriate for you.
2. Pelvic floor physical therapy can address the issues surrounding sexual dysfunction by offering education on tools and strategies to address vaginal tightness, pelvic floor tightness or weakness, pain and improve overall mobility and tolerance for sexual activity. Some of the tools used might be vaginal dilators and pelvic wands. 
3. Lubrication to decrease pain with intercourse. For some women this may be enough if there are not significant vulvar and vaginal changes. And no, using lubricant does not mean that you are “less of a woman”, infact, you might find using lubricant to be a pleasant surprise. Some lubes I recommend include: Slippery Stuff, Intimate RoseMomentum silicone lubricantGoLove CBD oil lubricant
4. Vaginal/ Vulvar moisturizers are like lotion for the genitals and unlike lubricants which are only used for sex, can be used everyday to add moisture to the tissues and decrease irritation. Some examples are: JulvaIntimate Rose vaginal moisturizer
5. Utilize the services of a mental health provider or more specifically a sex therapist if you are finding that these changes are affecting you or your relationship negatively. 

This list is by no means exclusive and we know that this is definitely a topic that needs more attention. 

If you have any questions, please email


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