Sexual Health During Menopause

Changes in sexual health are a common part of the menopause transition, yet they are often not discussed openly. Many women notice changes in comfort, desire or confidence that can affect intimacy and relationships.

These changes are not something you have to simply accept. With the right advice, support and treatment, many women experience significant improvements in comfort, confidence and sexual wellbeing.

Pelvic health physiotherapy works alongside your GP, menopause specialist or gynaecologist to help address the physical changes that may be contributing to symptoms.

How can menopause affect sexual health?

Declining oestrogen levels can lead to changes in the vaginal tissues and pelvic floor muscles.

These changes may include:

• Vaginal dryness
• Reduced elasticity of the vaginal tissues
• Pain during intercourse
• Pelvic floor muscle tension
• Reduced confidence with intimacy
• Changes in bladder symptoms during sexual activity

These symptoms are common and can affect women differently.

Why do these symptoms occur?

Reduced oestrogen can make the vaginal tissues thinner, drier and more sensitive. In response to discomfort, the pelvic floor muscles may become tighter or more protective, which can further contribute to pain during intercourse.

Some women also reduce sexual activity because they anticipate pain, creating a cycle of muscle tension and anxiety that can be difficult to break without support.

How can pelvic health physiotherapy help?

A pelvic health physiotherapist provides a confidential and supportive environment to discuss symptoms that many women find difficult to talk about.

Treatment may include:

Pelvic floor assessment

Your physiotherapist can assess:

• Muscle strength
• Muscle relaxation
• Coordination
• Tissue sensitivity

This helps identify whether the pelvic floor muscles are contributing to discomfort.

Pelvic floor rehabilitation

Treatment may involve:

• Relaxation techniques
• Gentle stretching
• Breathing exercises
• Improving muscle coordination
• Gradual rehabilitation where appropriate

Education and self-management

Advice may include:

• Comfortable positioning
• Returning to intimacy gradually
• Managing symptoms during flare-ups
• Lifestyle advice to support pelvic health

Where appropriate, your physiotherapist may also discuss the role of vaginal moisturisers, lubricants or local oestrogen therapy, working alongside your GP or menopause specialist.

Taking a holistic approach

Sexual health is influenced by physical, emotional and hormonal factors.

Pelvic health physiotherapy forms one part of a multidisciplinary approach that may also involve menopause specialists, gynaecologists, GPs or psychosexual therapists where appropriate.

Regaining confidence

Sexual wellbeing is an important part of overall health at every stage of life.

Whether you are experiencing discomfort, changes in confidence or uncertainty about what is happening to your body, our pelvic health physiotherapists provide expert, compassionate support tailored to your individual needs.