Written by: Genevieve R. Moore PhD
“Use it or lose it.” This piece of time-worn wisdom is said about everything from your brain to your muscles. But did you know that it also applies to your most intimate of body parts?
It’s true! Although many people don’t think of their genitals in terms of exercise & fitness, research shows that regular sexual activity helps to keep the vagina healthy, flexible, and strong. And — just like exercise — it becomes even more important to “use it” as we get older.
If you’re approaching menopause, you might be hearing this sort of thing from a variety of sources — friends, social media, TV doctors, or your own doctor. And since sexual pleasure for its own sake is so often shamed in our culture, the “use it or lose it” folks often explain that an active sex life has important health benefits: cardiovascular health, stress relief, boosted immunity, better sleep, pain reduction, pelvic floor strength and reduced incontinence...
But if you’ve lost touch with your sexual desire — whether due to lack of a partner, life stress, sexual pain or other challenges — it can be tricky to relight the fire without a little extra help.
Which is where cannabinoids could help. Many peri- and post-menopausal women report that cannabinoids have revolutionized their sex lives — with or without a partner.
Menopause & Estrogen
Remember your old frenemy, the menstrual cycle? During our reproductive years, our ovaries pump out estrogen every menstrual cycle right before they ovulate. As women’s periods become less frequent, so do these estrogen boosts.
What was estrogen doing?
- Keeping up the blood flow. Estrogen dilates your blood vessels, and increased blood flow to your vagina helps it stay healthy and lubricated.
- Raising your libido. Many reproductive-age women have an increased interest in sex right around the time they ovulate — when their estrogen levels are highest.
- Keeping the pH low. Estrogen tells your vagina to secrete glycogen, which feeds beneficial bacteria. These lactobacillus bacteria make lactic acid, which keeps the pH low and protects the vagina from malicious microbes. (Note: These aren’t the same lactobacillus you find in yogurt, but they are very closely related.)
- Protecting the urinary tract. Estrogen receptors are spread throughout the vagina, bladder, urethra and pelvic floor. Up to 70% of women with urinary incontinence experience its onset at menopause. Estrogen also helps protect women from urinary tract infections.
How Menopause Affects Your Sex Life
Unfortunately, without regular bursts of estrogen, your sex life can become a little bit more complicated.
Peri- and postmenopausal women often discover that their libidos take a nose-dive. Sex might not feel as good when the skin lining your vagina gets thinner and produces less lubrication. Also, with fewer acid-producing lactobacilli, postmenopausal women are more susceptible to infections. To make matters worse, without estrogen, vaginas become densely innervated with pain-perceiving nerves and other nerves that further cut off the blood flow.
Sexual pleasure is just one of many things a woman can lose when her vagina atrophies. Genitourinary syndrome of menopause — a condition where the vaginal tissue becomes thinner, drier and more inflamed — affects more than half of postmenopausal women. As it gets worse, it can become painful to sit, walk, or urinate. It also ups your risk for incontinence.
How to Address this Problem
Menopause is not a disease or disorder — it’s a natural condition. When estrogen exits stage left, the transition period will be easier if you can bring in new supporting characters, stage right.
For your vagina, that means finding new ways to keep your blood flowing and your skin healthy. That’s why the first thing a doctor will typically suggest is to stock up on moisturizers and lubricants. Most women find that moisturizers applied three times a week will help their vaginal skin stay moist, while lubricants help keep up regular sexual activity.
Why is regular sexual activity so important? It triggers your vulva and vaginal tissues to swell with blood — delivering oxygen and carrying away toxins. Sex keeps vaginal skin healthy and improves its elasticity and natural lubrication, and can even boost levels of androgens and other hormones.
The evidence agrees: Women who are sexually active experience less vaginal atrophy — and those benefits come whether or not a partner is involved.
So… once you purchase a good moisturizer and lubricant (pH balanced, of course), where do you go from there? Moisturizers and lubricants might make it more possible for you to have sex, but what if you’re having trouble getting turned on? What if sex is starting to feel less pleasurable... or even painful? What extra tools are available?
Get your Blood Pumping: Cannabinoids & Other Methods
Best-case scenario: Even if you have a well-lubricated sex life nearly as active your pre-menopausal years, your vagina probably receives less oxygenated blood than it used to. Without estrogen, you should find new ways to get the blood pumping through your pelvis.
Menstruation, sex, and menopause are the top three reasons that women use cannabis for self-care. In addition to treating other symptoms of menopause, more and more postmenopausal women are loving the juice cannabis adds to their sex lives.
Why is cannabis so effective at spicing things up in the bedroom? The natural compounds in cannabis, cannabinoids, are potent vasodilators — they relax blood vessels, increasing blood flow.
When plant-derived cannabinoids are applied directly to your vulva, they encourage blood to flow into the tissues.
This increased blood flow can do amazing things in the bedroom. Many women who use cannabinoids on their vulvas report stronger, more pleasurable orgasms, while others experience an overall boost in their sexual sensations. If you want to hear more about the personal experiences of women who have tried topical cannabinoids, start here.
What else increases blood flow to your vagina? It turns out that clitoral stimulation and sexual fantasy can increase blood flow to the vagina in ways that pelvic floor contractions and exercise cannot.
If you haven’t already, experiment with sensual materials that can wake up your fantasies — vibrators, romance novels, or whatever form of pornography inspires your imagination. If you have a partner, explain to them that this is for your future health, and see if they want to get involved.
Partnered or not, experiment with extending your foreplay into full-body sensual massage and gentle oral and manual stimulation. If you want some hard evidence that these activities are pumping restorative blood through your vagina, feel around — your clitoris will get perky and your inner labia may expand, especially with extended lubricated massage and suction.
Extra Perks Cannabinoids Bring to the Bedroom
Cannabinoids like CBD and THC do much more for your vagina than just increase the blood flow and your ability to feel pleasure. They can soothe inflammation and feelings of pain — both of which might increase as estrogen decreases. Cannabinoids also encourage your muscles to relax, which can further alleviate penetration-related pain. How?
- Fights inflammation: Both CBD and THC have proven anti-inflammatory properties — and inflammation levels increase for women with genitourinary syndrome. CBD acts on the same target as NSAIDs, decreasing your body’s production of inflammatory prostaglandins. Meanwhile, THC helps prevent your immune system from releasing the inflammatory proteins called cytokines.
- Reduces pain: Some of the increased pain postmenopausal women experience during penetration comes from an increased density of pain-perceiving nerves. Cannabinoids fight back by desensitizing these nerves. Both CBD and THC target nerve receptors that help decrease the sensation of pain (TRPV1 and CB1, respectively).
- Relaxes muscles: Another source of pain in the bedroom could come from overly-tight pelvic muscles. Cannabinoids help relax muscles in two ways. First, when they desensitize pain receptors, they prevent nerves from triggering muscle contractions. Second, CBD and THC have been shown to reduce maximum level of contraction in muscles.
Similar to localized estrogen creams and suppositories, localized application of cannabinoids delivers the compounds exactly where they are needed, while keeping their bloodstream levels low.
Rebooting your Sexuality
Sexual activity is most effective against genitourinary syndrome before the symptoms of vaginal atrophy get severe. However, it’s never too late to start showering your lady parts with personal attention and increased blood flow.
If you’re waking up your vagina after a period of hibernation, start slow. Don’t jump into penetration if you’re experiencing pain or inflammation. Instead, try to increase blood flow to your sensual zone — with vibration, fantasy and/or topical cannabinoids — and just focus on the pleasant sensations you might experience.
This exercise doesn’t need to lead anywhere — you can get the benefits of increased oxygenation to your vagina without intercourse, orgasm, or a partner. However, you might find that allowing some extra time to become sexually aroused can make masturbation and intercourse more enjoyable.
For further support, consult with a doctor, physical therapist, or sexological bodyworker to develop a pelvic rehabilitation plan. They can suggest pelvic floor exercises and vaginal dilator techniques after they determine which muscles need to be strengthened or relaxed.
Many women find that the benefits of reviving their sexual organs extend beyond the pleasure zone: Incontinence and other urinary issues might improve with proper rehabilitation.
Although regular use of moisturizers and sexual lubricants are often just as effective, many doctors will prescribe hormonal therapy for women with moderate or severe symptoms of genitourinary syndrome.
Topical estrogen is most frequently prescribed, since it helps keep the overall levels of this hormone low in your body. Hormone replacement therapy can be very effective for treating the symptoms of genitourinary syndrome, but they are generally only prescribed for short-term use — and many women cannot take them for medical reasons.
Whether or not you are on hormone therapy, we encourage you to talk with your doctor about incorporating cannabinoids into your sexual health routine. (Feel free to share this article with your doctor, as well as our other articles on cannabinoids and sexual health.)
We want to be clear about one last thing… What your body needs most right now is for you to have the patience and freedom to feel AS GOOD AS POSSIBLE.
Don't just grab that bottle of lube and rush through your sexercises. Numerous studies show that it's the quality of the sex that confers many of sex’s health benefits. Now is the time for you to experiment and learn how to maximize pleasure.
You might find that the blood-pumping, pleasure-promoting and pain-relieving properties of CBD and other cannabinoid products are perfect for improving the quality of your sexual life. Or you might discover other ways to increase your stimulation before and during sex. Either way, you won’t know until you try.
More articles by: Genevieve R. Moore PhD