Sex: The menopause remedy no one’s talking about

Biology has a twisted sense of timing. During menopause — just when desire often starts to wane — sex may be exactly what the doctor ordered, helping to ease common menopause symptoms like poor sleep and vaginal dryness. In fact, a 2025 study in the journal Menopause found that regular sexual activity — even as little as once every three months — may significantly reduce pain, dryness and irritation in menopausal and postmenopausal women.

Even better? You don’t need a partner to get the perks. A 2024 Kinsey Institute report of 1,500 women aged 40 to 65 found that more than 36% of menopausal women said masturbation helped relieve their symptoms. Intrigued by this all-natural, 100% free remedy? We are too. Read on for everything you need to know about taking menopause relief into your own hands — literally.

The biological reasons sex gets tricky during menopause

Perimenopause and menopause affect the whole body, so it’s no shock that they can torpedo sexual well-being too. For example, “night sweats can negatively impact sleep, which affects energy, exercise, overall well-being — leading to a decrease in sexual desire,” says Dr. Jill Krapf, ob-gyn and director of the Center for Vulvovaginal Disorders in Tampa, Fla.

Plus, during menopause, your ovaries stop churning out estrogen at their pre-menopause rate, which can cause your vagina to become, in the words of the Menopause Society, “dry and less stretchy.” The ramifications of that hormonal plunge can extend to the bladder and vulva too, possibly leading to something called genitourinary syndrome of menopause, or GSM for short, which affects up to 84% of postmenopausal women. Some telltale signs of GSM include vaginal dryness, burning and irritation — three symptoms that don’t help much when it comes to sexual enjoyment.

The science: Why sex and masturbation help with menopause symptoms

While there are definitely biological factors that may be working against your sexual pleasure in midlife and beyond, the truth is it’s still worth pursuing. “Not only is there a great deal of variability with sexual desire, most women report no changes in the quality of orgasm across the menopausal spectrum, with a subgroup even reporting that orgasms improved with age,” says Cynthia Graham, PhD, a senior scientist at Indiana University’s Kinsey Institute.

What does this have to do with menopausal symptoms? A lot.

Research shows that pleasure might be protective. A small study of 96 menopausal women found that those engaged in any sort of sexual activity (solo or partnered) reported fewer menopause symptoms — including vaginal dryness, hot flashes, anxiety and sleep issues. They also experienced better sexual function, with more ease around arousal, lubrication and orgasm — and less pain. Moreover, simply staying sexually active was linked to a 10% drop in overall menopausal symptom severity.

Here’s why:

Blood flow and vaginal health: “Engaging in regular sexual activity increases blood flow to genitals, which helps maintain health of the tissue,” says Krapf. That boost in circulation helps keep tissues oxygenated, elastic and more resilient — a natural counter to the thinning and fragility that can happen with menopause.

That’s exactly what the 2025 menopause study found. Researchers tracked over 900 sexually active women ages 40 to 79 and found that those who’d had sex in the past three months were significantly less likely to report daily vulvar discomfort — including irritation, dryness and pain — even after controlling for age, hormone therapy use and menopausal status. While the study couldn’t prove cause and effect, it does add to the growing body of evidence that regular sexual activity may be a safe, accessible and surprisingly effective way to manage common menopause complaints.

“Feel-good” hormones and mood: According to Graham’s research, about 27% of women in their 40s, 50s and 60s masturbate to relieve stress or anxiety, and about 18% say they do it to help them fall asleep. Why? Because it works. “Sexual pleasure and orgasm release tons of feel good hormones and neurotransmitters, like oxytocin and dopamine, which are essential for better moods and better sleep,” says Lori Davis, a certified sex counselor and nurse practitioner in Ithaca, N.Y. And when it comes to getting some sleep, sex and masturbation are often a great distraction. “Some people can’t sleep because of worrying thoughts and not being able to switch off their brain,” says Graham. “Anecdotally, sexual activity can help with that, too.”

Arousal and pelvic strength: Menopause can quietly weaken your pelvic floor — the sling of muscles that supports your pelvic organs — potentially causing bladder leaks and pelvic organ prolapse, where the vagina, uterus, bladder or rectum begin to shift out of place — all of which can make sex feel less appealing. Surprisingly, though, sex may help protect against this. In a study of women with pelvic floor disorders, many of them postmenopausal, those who were sexually active were significantly more likely to have strong pelvic floor muscles than those who weren’t — even after adjusting for age and menopause status. They also reported better sexual function, especially when it came to orgasm. While, again, cause-and-effect are not a given, researchers suggest that sex itself may help strengthen these muscles, thanks to the contractions that happen during arousal and orgasm — a feedback loop that’s well worth exploring.

Masturbation: Why more women aren’t doing it

“Masturbation works. It’s a natural menopause symptom-soother, there are no adverse effects and it’s completely free,” says Graham. “Everyone should give it a try!” But … they’re not.

“There’s still such a taboo around masturbation — particularly among women,” says Graham. Her own research on midlife women shows that only 10% use self-pleasure as a primary menopause symptom management tool despite its proven benefits. That reluctance, however, may be more about messaging than mindset. Graham also found that 46% would totally be open to trying masturbation for symptom relief — if their health care provider recommended it.

“Women are very open to trying something if it’s presented as effective. The problem is: very few physicians will raise this,” says Graham. In fact, a 2025 report of 700+ doctors found that just 16% of general practitioners and 45% of ob-gyns routinely ask about sexual problems during history-taking.

If your doc isn’t talking, Krapf encourages you to bring it up. “Because sexual health concerns often take time to discuss and address, I recommend making a visit specifically for this concern,” she says. And if you’re not satisfied, know that the International Society for the Study of Women’s Sexual Health (ISSWSH) has a directory of clinicians who have interest and expertise in female sexual medicine.

When sex hurts: Easing into pleasure again

While regular sex may help stave off dryness and irritation, pain during sex is still surprisingly common — affecting 13% to 84% of postmenopausal women. “Whatever you do, don’t push through sexual pain to please your partner,” says Davis. “That’s a surefire way to create more pain and avoidance.”

The good news: You’ve got options. “Lubricants and vaginal moisturizers can be great non-hormonal treatments for vaginal dryness and painful intercourse,” says Krapf. “And hormonal therapies — like low-dose vaginal estrogen — are often the most effective for genitourinary syndrome of menopause.”

Here’s what to look for — and where to start:

Lubricants

Best for short-term comfort during sex.

• Water-based lubricants are safe with toys and condoms. Research in the journal Obstetrics & Gynecology indicates this type of lube can help relieve pain related to postmenopausal intercourse — and it doesn’t appear to muck up the vaginal microbiome, either.

  • Good Clean Love Bio-Nude: “Once menopause hit I found that I needed to use lubricant. This is the only one I will ever be using,” writes one 5-star Amazon reviewer, who notes that her gynecologist recommended this option. “It doesn’t feel unnatural or sticky.”

  • Pjur Aqua Natural: “Long lasting, doesn’t dry out after a few minutes and unlike the silicone-based ones we used to buy, it washes out of sheets completely,” wrote one reviewer.

• Silicone-based lubes are longer-lasting, good for water play and compatible with condoms but not silicone toys. Just note: If a partner has erectile difficulties, these lubes can sometimes feel too slick, according to the Mayo Clinic.

  • Überlube: This lubricant is Davis’s top pick — and with 81% 5-star Amazon reviewers, lots of people agree. One wrote: “Menopausal? Get this now! … Slick, not sticky, lasts a long time and no need to rinse off! This was recommended by my gynecologist due to its gentle nature. I will never go back to another brand.”

  • Replens Silky Smooth: Another big hit with Amazon buyers — 84% of its reviews are 5 stars — including this one: “I can’t tell you how happy I am with this product! It feels like my natural moistness and I do not have to wash it off. I am a 76 year old woman and I’m so sorry I didn’t find this right after menopause. It has made intimacy with my husband pleasurable and painless.”

• Oil-based lubricants are not latex-safe, but they’re rich and soothing. And if you’re too embarrassed to buy lube, you can just use good old coconut oil from the grocery store.

  • Coconu Massage Oil: “I’ve used it as a massage oil, which was great. We’ve also used it in the bedroom and it was a game changer! I will definitely be purchasing again. Love that it is all natural ingredients,” wrote one 5-star reviewer.

  • Foria Intimacy sex oil: “Menopause is a drag and I want to get as much out of my intimacy as possible. Will keep purchasing,” wrote one Amazon reviewer. “It increases sensitivity and pleasure! I really love the warming and increased blood flow!”

Vaginal moisturizers

Best for daily dryness and tissue repair, these products are intended to be used three to five times a week.

• Hyaluronic acid-based moisturizers are great because the main ingredient is a naturally occurring substance in your body that acts like a sponge, helping tissues retain moisture. (Both of our picks are also recommended by Memorial Sloan Kettering.)

  • Revaree Vaginal Inserts: “Menopause causes not only vaginal dryness, but sets you up for bladder infections and other problems. This product helps all of this,” wrote one 5-star reviewer. “It takes about 2 to 3 weeks to see a big difference. No scent, no irritation, easy to use.”

  • Hydro Gyn: According to one Amazon reviewer: “I am menopausal, without TMI, it has helped tremendously with dryness. My hubby noticed a big difference. Very simple to use. I did not have any adverse effects.”

• Vitamin E-based moisturizers help protect and repair cell membranes — including the delicate tissue of the vaginal lining.

  • Carlson Key-E Suppositories: “Happy to find these,” wrote one Amazon reviewer, who added that the product provided comfort and relief without the usual messiness of suppositories. “I’m very pleased with the results, especially since I typically experience irritation from allergies and sensitivity.” (Memorial Sloan Kettering likes this one too.)

  • Emerita Personal Moisturizer: One 13-year customer wrote: “My doctor recommended a vaginal moisturizer when I began having pelvic pain. She was correct in her advice. No more pain! I use it every night.”

Topical creams

Great for external vulvar irritation or itching. These are also typically intended to be used three to five times weekly.

• Vmagic Vulva Balm: “I was desperate for relief because of menopausal dryness, burning, irritation and discomfort,” wrote one 5-star reviewer. “Within a short period of time after applying it I felt a million times better. I use it morning and night.”

• Pharmapulse Vulvacare: “For anyone that is dealing with the mess that is menopause or atrophy, this salve is amazing! I highly recommend it, everything is back to normal. I use it nightly,” shared one happy user.

Hormonal options

Best for moderate to severe GSM.

• Low-dose vaginal estrogen is available as a cream, suppository, vaginal ring or vaginal tablet and is prescription-only. “It’s the most effective treatment for GSM,” says Krapf.

• DHEA suppository (Prasterone/Intrarosa) has been shown to reduce pain during sex by up to 30% more than a placebo, and improve tissue quality after 12 weeks of daily use. “It converts to estrogens and testosterone inside the vagina,” says Krapf.

Not sure where to start? It’s worth repeating that it’s important to make a dedicated appointment to talk with your provider about sexual health. And, again, search for menopause-savvy clinicians using professional directories through trusted orgs like the Menopause Society or ISSWSH. And consider an online-only menopause care clinic, as well.

And remember, there’s more to sex than intercourse. “It’s always best to avoid penetrative play that’s uncomfortable,” says Davis. “Focus on what feels good — like vulvar play involving the clitoris — and give yourself permission to enjoy that while you seek treatment.” Davis goes on to suggest introducing some touching into your routine. “The first step is simply to take turns with your partner, asking, ‘How would you like me to touch you for the next three minutes?’ This creates a beautiful space to explore wanting, consent, boundaries and the simple pleasure of touch in a safe way without the pressure to get turned on or be anything other than what you are in that moment.”

And, of course, there’s always self-care: “In our study, discomfort and masturbation was really low — not zero — but really low,” says Graham.

Make pleasure part of your menopause wellness plan

Whether you’re dealing with dryness, insomnia, a vanishing libido or simply want to feel more like yourself again, don’t overlook pleasure as part of your solution. “I think masturbation can definitely be part of your menopause treatment plan,” says Graham. “While it’s difficult for some physicians to include that, the more evidence-based data we have, the more likely this can happen.”

It’s low-risk, it’s enjoyable — and it’s one tool in your kit that works with your body, not against it. As Davis puts it: “Consider solo sex as an opportunity to tune into yourself, explore what feels right just for you and to release stress and tension in a safe and reliable way. Your body and mind deserve it, and they will thank you in the long run.”

Meet the experts

Jill Krapf, MD, ob-gyn and director of the Center for Vulvovaginal Disorders in Tampa, Fla.

Cynthia Graham, PhD, senior scientist at Indiana University’s Kinsey Institute in Bloomington and editor in chief of the Journal of Sex Research.

Lori Davis, a dual board-certified nurse practitioner and AASECT-certified sex counselor in Ithaca, N.Y.

Our health content is for informational purposes only and is not intended as professional medical advice. Consult a medical professional on questions about your health.

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