When they're working fine, you don't have to think much about your pelvic-floor muscles. They're the ones that support your bladder, rectum, uterus, and vagina — when they're strong enough. A weakened pelvic floor can cause a variety of problems, including incontinence, constipation, a feeling of heaviness in the pelvis, and pain during intercourse. Menopause takes its own toll on pelvic-floor strength, because reduced estrogen levels compromise tissue health and muscle tone. In fact, it's around this time that many women begin noticing symptoms of either pelvic-floor prolapse or uterine prolapse.
Pelvic-floor prolapse occurs when pelvic-floor muscles lose their strength and allow the organs they support to shift; the bladder falls toward the vagina or the vagina falls toward the rectum. Uterine prolapse occurs when the uterus drops into the vagina. In severe cases of prolapse, organs shift so much that you can feel bulges in the vaginal walls.
Surgery can help return organs to their proper positions, but prevention is a better idea. You can greatly reduce your risk of prolapse, and your need for surgery, by getting rid of excess body weight, quitting smoking, and doing daily Kegel exercises.
Daily Kegels are especially important for those who have been through pregnancy and vaginal childbirth, which are the most significant risk factors for pelvic-floor prolapse. You can't change your history, but you can bolster your internal support system.
Along with weakening pelvic-floor muscles, many women also suffer from lack of lubrication as they age. Vaginal dryness is one of the most common symptoms of menopause. Shifting hormones and decreasing estrogen cause a lack of genital lubrication that can make sex uncomfortable and even painful.
Luckily, there are many ways to help treat this issue and get your vagina lubricated and your sex-life back on track. Consider the following:
Self-stimulate regularly. Sex is built on a “use it or lose it” philosophy. The more you have sex and enjoy orgasms, the more you will improve your sexual response and the more in tune you’ll be with your sexual desires. Self-stimulation is particularly useful because you can spend as much time as you want exploring your body and discovering what feels good. Then, when you are with your partner, you can use all those tricks and touches you learned on your own. He will love seeing you so in touch with your body, and you will be more likely to reach orgasm and enjoy yourself.
Plenty of foreplay. As we age, our sexual response tends to slow down. We can’t go from 0 to 60 mph anymore. Instead, we need time to become aroused and connect with our partners to truly achieve sexual pleasure. You can do so by taking things slow and enjoying plenty of foreplay. Try positions that give you direct stimulation of the clitoris (such as woman on top) or positions that allow you to self-stimulate during the act (such as man from behind).