Pelvic Floor Health, Intimacy & Menopause: What You Need to Know

by Foria Main
Sep 22, 2026

Talk Pleasure to Me

Pelvic health physical therapist Dr. Nikki Berner explains how your pelvic floor affects intimacy and what to know as your body changes during perimenopause and menopause.

Talk Pleasure to Me is our series where we talk to experts on sex, relationships, and caring for your body (& mind) so you can get inspired on your pleasure journey and learn from the best.

Dr. Nikki Berner is a pelvic health physical therapist of 14 years, founder of The Fem Method Pelvic Health, and women's health educator. An IVF mom, cancer survivor, endo warrior, and former Division I athlete, she specializes in helping women navigate pregnancy, postpartum recovery, pelvic floor dysfunction, and midlife health. Dr. Nikki is known for blending evidence-based education with humor and real-life perspective, making pelvic health approachable for women everywhere.

How is Pelvic floor health connected with intimacy?

Your pelvic floor is actually really connected with intimacy. In fact, one of the five main functions of the pelvic floor is sexual function. The pelvic floor helps with blood flow, sensation, arousal, and it is even responsible for the quality of your orgasm. One really important thing to remember is for the pelvic floor to function optimally it has to be able to squeeze and relax. So more squeezing isn't always better.

What should I do if I experience discomfort during intimacy?

First things first, don't just push through it. Pain is your body giving you information, not something you just need to tolerate. I would start by figuring out where the discomfort is and what it feels like—burning, dryness, deep pain, muscle tightness, etc. This can give us a lot of information about what is actually going on. Foria has several great products to assist with improving pleasure such as the Awaken Arousal Oil, Juicy Pure Lube, and Intimacy Melts. If the discomfort is persistent, seeing a PFPT or your healthcare provider can be really helpful.

What may be the causes for discomfort during intimacy?

There are a lot of possibilities, which is why we can't just always blame hormones. Hormonal changes and vaginal dryness can absolutely contribute to discomfort, but so can pelvic floor muscle tension, irritation, infection, changes in blood flow, positioning, and even your nervous system being on high alert. That's why it is important to have a toolbox of products that can help support you in all of these areas—whether that is Foria's Daily Blend that helps you stay calm and regulated, the Everyday Vulva Moisturizer that is part of your skincare routine, or the Vibrance Melts that provides internal moisture and daily comfort, keeping these as part of your daily routine will help your body feel supported and ready for intimacy.

Can I still have a comfortable and satisfying sex life after menopause?

Absolutely! Menopause can change things, but change doesn't mean the end of pleasure. We may need to change the way we approach intimacy, leaving more time for arousal, addressing dryness or tissue changes, working on pelvic floor function, trialing different lubricants, and maybe even getting creative with positions, but pleasure doesn't need to fall to the wayside. One change that tends to be shocking for my patients is discovering that the once tried and true way to achieve orgasm isn't working as well anymore. This may take some new exploring on how pleasure feels in your current body. My favorite way to do this is through intimate massages using soothing oils. If this sounds like you, have no fear, you do not have to say goodbye to your orgasm. There is a very satisfying sex life waiting for you on the other side of exploration.

Is it common for sensation to change during perimenopause and menopause? Why does that happen?

Yes! And this can often be really surprising for women. Hormonal changes can affect blood flow, tissue sensitivity, and lubrication but there is also a pelvic floor and nervous system component. Our muscles and nerves need good blood flow and mobility to function well, this includes the ones involved in pleasure. Sometimes sensation can feel decreased, different, or it takes longer to build. This doesn't mean your ability to experience pleasure is gone, it may just mean your body needs more time or a different kind of stimulation. Remember, strong healthy pelvic floors = strong healthy orgasms.

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