Navigating Sexual Health in Perimenopause
It’s a topic not often discussed—but it should be. Many women experience changes in intimacy during perimenopause and menopause, and it’s more common than you might think. But here’s the good news: you don’t have to resign yourself to discomfort or frustration.
At Empowered Wellness, we believe sexual health is a vital part of your overall well-being, and that includes pleasure, intimacy, and confidence.
🌸 Why Sexual Health Changes Occur in Perimenopause
During perimenopause, estrogen levels begin to decline. This can lead to:
Vaginal dryness or discomfort during sex
Decreased libido and arousal
Emotional shifts in confidence or stress
These changes are biological, not personal, and they’re not a reflection of your desirability.
Strategies to Support Sexual Wellness
1. Hydration & Lubrication
Over-the-counter vaginal moisturizers and lubricants are proven to reduce dryness and ease discomfort from mild to moderate symptoms.
2. Pelvic Floor Strengthening
Pelvic floor exercises can improve blood flow, circulation, and tissue elasticity, reducing pain during intimacy.
3. Hormone Therapy
Local vaginal estrogen (creams, tablets, rings) enhances lubrication, tissue thickness, and pH balance. A history of breast or gynecologic cancers is not a contraindication to local, vaginal estrogen therapy.
Systemic estrogen therapy may improve overall sexual function.
4. Testosterone Options
Testosterone therapy can improve libido and sexual health in postmenopausal women with hypoactive sexual desire dysfunction (HSDD).
5. Lifestyle & Communication
Three frequently used psychological interventions are behavior therapy, cognitive behavior therapy (CBT), and mindfulness therapy can help to identify causes of low desire and provide techniques to strengthen intimacy and emotional connection.
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https://pubmed.ncbi.nlm.nih.gov/39250810/
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https://www.auanet.org/guidelines-and-quality/guidelines/genitourinary-syndrome-of-menopause
https://pubmed.ncbi.nlm.nih.gov/37619252/
https://www.nejm.org/doi/full/10.1056/NEJMcp2313307
https://www.mayoclinicproceedings.org/article/S0025-6196(17)30799-1/fulltext#tbl2