Why Are My Orgasms Less Intense During Menopause?

One of the most common complaints I hear from my patients in perimenopause and menopause is their decreased libido and arousal. That is why at Alloy we ask every patient about sexual satisfaction, concerns, or problems and offer them science-backed solutions.

Sexual problems during perimenopause and menopause are not rare!

I recently attended the International Society for the Study of Women's Sexual Health (ISSWSH). ISSWSH is the premier professional organization for the study of sexual health, and at the meeting, I got to hear from the world’s leading experts on the subject. Here are some facts:

Sexual problems at menopause are NOT rare. Up to 42% of women in perimenopause and 88%  of women in later menopause transition report sexual problems, including low desire, low arousal, orgasm problems, and/or sexual pain.  

Female Sexual Health problems can basically be broken down into the following four categories:

1. Physiological: hormonal loss, urogenital and gynecological problems, insomnia 

2. Emotional: new onset anxiety, depression, self-image issues

3. Social/Cultural: lack of sex ed, societal taboos surrounding menopause 

4. Relationship: partner issues, communication, and conflict

Each of these buckets can be deeply impacted by the menopause transition! A problem in one area makes the other areas worse, and can lead to a vicious cycle of sexual dysfunction. But, that cycle can be broken.

Quick anatomy lesson!

Do you know what your clitoris actually looks like? Most women (and, gasp, doctors) don’t! The small tip of the clitoris is the only part visible to the eye, but the full clitoris is a larger and deeper structure that extends down the sides of the vulva and wraps around the vagina. It is rich with blood vessels and over ten thousand nerve endings. It is VERY similar to the penis, and when a healthy clitoris is stimulated it plumps up and gets engorged with blood, as does the vagina. This leads to increased natural lubrication, pleasure, and, ultimately, orgasm. 

What is happening to your vagina and your clitoris at menopause?

All of your genital tissues are full of estrogen and androgen receptors and the dramatic decrease in hormone levels at menopause causes profound tissue changes. It is not just vaginal dryness. Just like in the vagina, the tissue in the vulva and clitoris becomes thinner, with less blood flow, less lubrication, and less sensitivity. 

Men have had sildenafil (you might know it as Viagra) for decades. Has anyone asked the female partners of these men on Viagra how they are doing? 

I told you the clitoris and penis are very similar in structure, and require the same things to reach a satisfying orgasm: healthy tissue, sensitivity to stimulation, and good blood flow. As we get older, orgasm can be harder to achieve. Because sildenafil has only been available to men, millions of men are having healthy erections while their female partners in menopause are suffering from vaginal dryness, pain with sex, and decreased sensitivity. Not surprisingly, this can create a host of sexual problems. 

Enter O-mazing Cream™! 

Topical sildenafil (the same ingredient in Viagra) in women increases blood flow, stimulates natural lubrication, and heightens physical sensations, leading to a stronger, more fulfilling orgasm. O-mazing Cream™, available by prescription, combines sildenafil, along with pentoxifylline and ergoloid mesylate, which work together to increase blood flow and stimulate neurotransmitters associated with sexual pleasure.

Tips for using O-mazing Cream™

Think of O-mazing Cream™ as a nice addition to your sexual experiences, whether with a partner or for self-pleasure. A pea-sized amount should be massaged into your clitoris and vulva about 15-30 minutes before sex to give it some time to kick in. In our hectic world, we need to stop and make time for our sexual health. Put the phone down, clear your mind, give yourself some self-love, or do whatever helps you get into the mood for sex. Make it a nice little ritual, a precursor to foreplay. I know what you’re thinking: “Can I receive oral sex after I apply O-mazing Cream™?” Go for it! Just let the O-mazing Cream™ kick in, and you’re good to go.

Don’t forget to keep your vagina and clitoris healthy!

You can use O-mazing Cream™ whether or not you’re using MHT or topical vaginal estrogen, but you may find it works better once the vagina is properly estrogenized. By treating the genitourinary syndrome of menopause symptoms, such as vaginal dryness, painful sex, incontinence, and frequent urinary tract infections, you improve the tissue quality of the vagina, vulva, and clitoris.