10 amazing ways to ensure pleasurable sex during perimenopause.
Most of us know that menopause comes with a few challenges when it comes to sexual health, but what a lot of women don’t know is that those issues can actually begin during perimenopause — the months and years before menopause happens. Even for women who think they’re prepared for “the change of life,” changes in their sex drive and sexual comfort can be surprising and even a little disheartening.
Fortunately, you can do many things to regain sexual pleasure during the years leading up to menopause (and during menopause, too). At Women’s Health Services, we make it our mission to help patients at our Arlington, Texas, practice find solutions to their sexual health needs at every stage of life. In this post, our team offers some simple tips to help you.
ALSO: 100 Viral Sex Bucket List Ideas To Explore In 2025 (FULL LIST)
Quick facts about perimenopause
Perimenopause is when your body slowly “shifts gears” from the child-bearing years into the menopause years.
Lasting from 2-10 years, perimenopause ushers in a decline in estrogen, fewer ovulations, and changes in your periods, including periods that are unusually heavy or that occur less often.
Many of the symptoms associated with menopause begin during perimenopause. These include symptoms like:
- Hot flashes
- Night sweats
- Moodiness and irritability
- Heavy sweating
- Difficulty concentrating
- Sleep problems
Changes in sexual desire and changes in your vaginal health can occur, too, largely due to the decrease in estrogen levels.
Many women find their desire to have sex is much lower during perimenopause. Vaginal dryness and irritation often make sexual intercourse uncomfortable or downright painful. Understanding why these changes are occurring can help you feel more confident about finding a solution that helps.
What you can do
Too often, women are embarrassed or reluctant to discuss their sexual health with their doctor. But making sure women enjoy healthy, satisfying sex lives is part of what an OB/GYN does, and the sooner you talk to our team, the sooner you can start to feel more confident about your own sexual health. In the meantime, these tips can help.
1. Use lubrication
There are many personal lubricants, and one could be perfect for you. Lubricants replace your natural moisture, reducing friction so sex is more comfortable and more pleasurable.
2. Try a vibrator
Combine your lubricant with a vibrator to stimulate blood flow and ramp up your own natural lubrication. Using your vibrator 2-3 times a week could make sexual intercourse more comfortable, too.
3. Change up your routine
If penetration is painful, look for other ways to be intimate. Adding something new can be a great way to enhance the excitement for you and your partner, too.
4. Learn about hormone treatments
Hormone replacement therapy (HRT) using bioidentical hormones replaces some of the estrogen your body no longer produces. More estrogen can improve your vagina health, including increasing natural lubrication inside the vaginal membranes.
5. Focus on foreplay
When you’re in perimenopause, stimulation and excitement can take longer. Be patient with yourself and look for ways to increase the time spent in foreplay to help you get in the mood on your own timeline.
6. Get some exercise
Exercise improves your overall wellness and cardiovascular system, meaning better blood flow to your vagina. Plus, it helps you feel more confident, and it’s a great stress reliever, too.
7. Catch those Zs
When sleep is lacking, your stress level soars and more stress can quickly lead to less sexual excitement and pleasure. Try these sleep tips from the Academy of Sleep Medicine website, and if you can, indulge in a nap in the early afternoon.
8. Have sex more often
Having sex promotes lubrication in and around your vagina. Once you find a solution that eliminates pain and dryness, make sex a regular part of your routine. No partner? A vibrator works, too.
9. Try Pelvic Floor Therapy
The muscles that support your bladder and vagina can get weak or tight. Both can make sex uncomfortable.
There are exercises that can help you retrain your pelvic floor. They’re called Kegel exercises. But you need to know the right ones to do since they can make tight muscles even tenser. Ask your doctor for a referral to a pelvic floor physical therapist for the right diagnosis and treatment.
If your vagina is narrow, your therapist may also suggest dilator therapy to stretch the muscles around your vagina slowly. The dilators are tube-shaped devices that come in different sizes.
10. Try Yoga and Meditation
Yoga and meditation may help your libido and your orgasms. That’s partly because they tend to lower stress, anxiety, and depression. But mindful activities can also help you become more aware of the subtle changes in your body.
