Can postmenopausal women alter their orgasmic response?

From the Guidelines

Postmenopausal women can alter their orgasmic response through various interventions, including pelvic floor physical therapy, vaginal lubricants, and hormone replacement therapy, as evidenced by the most recent study in 2024 1. To address changes in orgasmic response, postmenopausal women can try:

• Using water-based or silicone lubricants to reduce discomfort during sexual activity
• Hormone replacement therapy (HRT) with options including systemic estrogen or local estrogen
• Regular sexual activity, either with a partner or through self-stimulation, to maintain vaginal health and blood flow
• Pelvic floor exercises (Kegel exercises) to strengthen muscles involved in orgasm and increase sensation
• Spending more time on foreplay, exploring new forms of stimulation, or using vibrators to help achieve orgasm
• Addressing psychological factors like stress, relationship issues, or body image concerns through counseling to improve sexual satisfaction Additionally, pelvic floor physical therapy can be beneficial in treating pelvic floor dysfunction, which can improve sexual pain, arousal, lubrication, orgasm, and satisfaction, as noted in the 2024 study 1. Other options, such as vaginal androgens (e.g., DHEA) and selective estrogen receptor modulators (e.g., ospemifene), may also be considered, but their safety and efficacy in postmenopausal women, particularly those with a history of cancer, are still being studied, as discussed in the 2018 guidelines 1. Overall, a comprehensive approach that addresses physical, emotional, and psychological factors can help postmenopausal women alter their orgasmic response and improve their overall sexual satisfaction, as supported by the most recent evidence 1.

From the Research

Altering Orgasmic Response in Postmenopausal Women

• Postmenopausal women can alter their orgasmic response through various non-pharmacologic and pharmacologic approaches, as evidenced by several studies 2, 3, 4, 5, 6.
• A randomized clinical trial found that formal sex education and Kegel exercises can improve orgasmic response in postmenopausal women, with significant increases in orgasm scores compared to the control group 2.
• Estrogen therapy, including local vaginal therapy with estrogen creams, rings, or tablets, can also improve vaginal health and sexual functioning, including orgasmic response, in postmenopausal women 3.
• Alternative vaginal therapies, such as vaginal laser, lubricants, and phytoestrogens, may also improve sexual function, including orgasm, in postmenopausal women, although the evidence is limited and inconsistent 4.
• Hormone therapy with estrogen alone may slightly improve sexual function, including orgasm, in postmenopausal women, especially in those with menopausal symptoms or in early postmenopause 5.
• Non-invasive radiofrequency treatment has also shown promise in improving sexual function, including orgasm, in postmenopausal women, with significant improvements in sexual desire, arousal, and orgasm compared to vaginal estrogen therapy and vaginal moisturizer 6.

Factors Influencing Orgasmic Response

• The effectiveness of these approaches may depend on various factors, including the individual woman's symptoms, medical history, and preferences 2, 3, 4, 5, 6.
• The quality of the evidence varies, with some studies having methodological limitations or inconsistent findings 4, 5.
• Further research is needed to fully understand the effects of these approaches on orgasmic response in postmenopausal women and to determine the most effective treatments for individual women 2, 3, 4, 5, 6.