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Daring Menopause
Libido, Desire, and the Pelvic Floor at Menopause: A Full Guide
Odile Bagot addresses libido, delayed desire, self-pleasure, and the role of the pelvic floor at menopause, without taboo.
Summary
🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.
What you will learn in this episode
In this episode, Odile Bagot addresses sexuality at menopause without taboo: libido, desire, self-pleasure, and the role of the pelvic floor in pleasure. You'll understand why female desire doesn't work the way we imagine, and how to restart a sex life that's been on pause.
- The two conditions for a fulfilling sex life after menopause
- Why female desire is "delayed," contrary to popular belief
- The SMIC method for getting back in the saddle after a pause
- How to safely use self-pleasure and sex toys
- The role of the pelvic floor in continence and pleasure
💡 Key figures
Sexual desire can start to decline as early as 20 months before the final period, influenced by multiple biopsychological and relational factors, not just hormonal ones.
Source: Society of Obstetricians and Gynaecologists of Canada, Clinical Practice Guideline No. 422d, « Menopause and Sexuality », Journal of Obstetrics and Gynaecology Canada.
___
Randomized controlled trials show that testosterone treatment via transdermal patch improves sexual desire in menopausal women, an effectiveness recognized by several international scientific societies.
Source: same clinical guideline, JOGC.
Two conditions for a fulfilling sex life after menopause
According to a study Odile often refers to, comprehensive support for sexual difficulties after menopause only works if two conditions are met: a satisfying sex life before menopause, and a good relationship with your current partner. If things weren't great before, they won't improve at menopause, but they won't get worse either.
Female libido, a multifactorial topic
In men, libido is highly hormonal (linked to testosterone). In women, it's more complex: women also produce testosterone (adrenal glands and ovaries), which continues to be secreted for a while after menopause. Hormonally speaking, a menopausal woman has no major reason to have libido issues, provided that vaginal dryness linked to estrogen deficiency is treated. Feeling desirable also plays a role: taking care of your body and being at peace with it fosters desire in others.
Delayed desire: the key to understanding female sexuality
Contrary to popular belief, female desire doesn't arise spontaneously like it does in men (whose arousal can lead to erection within seconds, according to Geneva-based sexologist Willy Pasini). In women, desire often appears during foreplay, not before. Waiting for the urge to come "just like that" before starting usually doesn't work: you need to put yourself in a receptive state and let desire emerge gradually.
The SMIC method for restarting a paused sex life
"Minimum indispensable consensual sex" (SMIC) is a classic behavioral therapy technique in sexology for couples whose sex life has stopped (due to illness, childbirth, or a long pause). The principle: choose a time of the week together (often the weekend), start from scratch, prepare (shower, exfoliation to wake up nerve endings and stimulate dopamine), use lubricant. If it doesn't work the first time, no worries, try again the following week. Aim for at least once a week, otherwise desire "dulls" again.
Self-pleasure and sex toys, useful tools
Masturbation and sex toys are a good way to maintain sexual function, whether alone or after a long pause as a couple. A small, gentle toy makes resuming easier without apprehension, including for women in advanced menopause where penetration can be more delicate.
Sex toy safety: silicone + water-based lubricant
Important rule: with a silicone toy, always use a water-based lubricant, never a silicone-based one, or you risk interactions that can cause infections or yeast infections. Medical-grade silicone is now considered free of endocrine disruptors (no study shows any leaching), unlike other plastics.
Syncing the couple's rhythms
With age, men often need shorter foreplay (erections are harder to sustain over time), while women need more time to lubricate. Lubrication actually comes from deep inside the vagina (not from the Bartholin's glands at the vulva) and takes time to reach the vulva, about 10 cm to travel, a delay that's even longer at menopause, even with hormone therapy. Applying lubricant directly to the vulva shortens this perceived delay and helps sync timing with your partner.
The pelvic floor: rehabilitation, sensation, and pleasure
The pelvic floor acts as a "safety net" for urinary continence, but it also plays a role in sexual pleasure. Some women, especially after childbirth, can no longer contract it voluntarily: in that case, "reflex" solutions like Kegel balls or electrostimulation help retrain it. For those who have control, regular training (vaginal weights, connected devices, rehab with a professional) strengthens it. Kegel balls can also help "reclaim" this area after a period without sexual activity, restoring sensation.
Female pleasure is mostly clitoral
Always expecting a vaginal orgasm can lead to a long, frustrating wait: female pleasure is mostly clitoral in origin. A toy designed for clitoral stimulation, used with lubricant, remains a helpful tool at any age.
When to see a sex therapist
When a sexual difficulty really becomes a problem in the couple, or in case of disagreement between partners, it's possible to talk to your gynecologist, a midwife trained in sexology, or consult a sex therapist directly. Important point: women often (wrongly) feel solely responsible for a sexual issue, when the cause could be, for example, premature ejaculation in their partner.
Appetite comes with eating. Contrary to what we imagine, desire fades if you have less sex.
🔎 Useful definitions
Delayed desire: a characteristic of female sexual desire that often appears during foreplay rather than before, unlike the more immediate male mechanism.
___
SMIC (minimum indispensable consensual sex): a behavioral therapy used in sexology to help a couple restart their sex life after a long pause, by scheduling dedicated moments.
___
Pelvic floor rehabilitation: a set of techniques (manual, with vaginal weights, electrostimulation) aimed at strengthening or restoring sensation and control of the pelvic floor.
🎯 Practical actions
- Address vaginal dryness first, if present, before focusing on libido
- Don't wait for desire to come spontaneously: get into a receptive state and let desire emerge during foreplay
- If your couple's sex life has been paused for a long time, try the SMIC method: schedule a dedicated moment, without pressure to succeed right away
- Always use a water-based lubricant with a silicone toy
- Choose sex toys made of medical-grade silicone, checking their origin rather than buying at random
- Apply lubricant directly to the vulva to help sync timing with your partner
- Practice pelvic floor rehabilitation (alone or with a professional) if you can't voluntarily contract your pelvic floor, using vaginal weights, a connected device, or electrostimulation
- Use Kegel balls (medical-grade silicone, progressive weights) to reclaim this area and restore sensation, especially after a period without sexual activity
- See a sex therapist, gynecologist, or trained midwife if a sexual difficulty persists or creates disagreement in your relationship
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Summary
🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.
_____
⭐ The Daring Menopause series is made possible by the support of Puissante, a French brand dedicated to women's well-being and pleasure. Theepisode 8 is dedicated to them, featuring their famous Coco as well as their full range of products for intimate health.
What you will learn in this episode
In this episode, Odile Bagot addresses sexuality at menopause without taboo: libido, desire, self-pleasure, and the role of the pelvic floor in pleasure. You'll understand why female desire doesn't work the way we imagine, and how to restart a sex life that's been on pause.
- The two conditions for a fulfilling sex life after menopause
- Why female desire is "delayed," contrary to popular belief
- The SMIC method for getting back in the saddle after a pause
- How to safely use self-pleasure and sex toys
- The role of the pelvic floor in continence and pleasure
💡 Key figures
Sexual desire can start to decline as early as 20 months before the final period, influenced by multiple biopsychological and relational factors, not just hormonal ones.
Source: Society of Obstetricians and Gynaecologists of Canada, Clinical Practice Guideline No. 422d, « Menopause and Sexuality », Journal of Obstetrics and Gynaecology Canada.
___
Randomized controlled trials show that testosterone treatment via transdermal patch improves sexual desire in menopausal women, an effectiveness recognized by several international scientific societies.
Source: same clinical guideline, JOGC.
Two conditions for a fulfilling sex life after menopause
According to a study Odile often refers to, comprehensive support for sexual difficulties after menopause only works if two conditions are met: a satisfying sex life before menopause, and a good relationship with your current partner. If things weren't great before, they won't improve at menopause, but they won't get worse either.
Female libido, a multifactorial topic
In men, libido is highly hormonal (linked to testosterone). In women, it's more complex: women also produce testosterone (adrenal glands and ovaries), which continues to be secreted for a while after menopause. Hormonally speaking, a menopausal woman has no major reason to have libido issues, provided that vaginal dryness linked to estrogen deficiency is treated. Feeling desirable also plays a role: taking care of your body and being at peace with it fosters desire in others.
Delayed desire: the key to understanding female sexuality
Contrary to popular belief, female desire doesn't arise spontaneously like it does in men (whose arousal can lead to erection within seconds, according to Geneva-based sexologist Willy Pasini). In women, desire often appears during foreplay, not before. Waiting for the urge to come "just like that" before starting usually doesn't work: you need to put yourself in a receptive state and let desire emerge gradually.
The SMIC method for restarting a paused sex life
"Minimum indispensable consensual sex" (SMIC) is a classic behavioral therapy technique in sexology for couples whose sex life has stopped (due to illness, childbirth, or a long pause). The principle: choose a time of the week together (often the weekend), start from scratch, prepare (shower, exfoliation to wake up nerve endings and stimulate dopamine), use lubricant. If it doesn't work the first time, no worries, try again the following week. Aim for at least once a week, otherwise desire "dulls" again.
Self-pleasure and sex toys, useful tools
Masturbation and sex toys are a good way to maintain sexual function, whether alone or after a long pause as a couple. A small, gentle toy makes resuming easier without apprehension, including for women in advanced menopause where penetration can be more delicate.
Sex toy safety: silicone + water-based lubricant
Important rule: with a silicone toy, always use a water-based lubricant, never a silicone-based one, or you risk interactions that can cause infections or yeast infections. Medical-grade silicone is now considered free of endocrine disruptors (no study shows any leaching), unlike other plastics.
Syncing the couple's rhythms
With age, men often need shorter foreplay (erections are harder to sustain over time), while women need more time to lubricate. Lubrication actually comes from deep inside the vagina (not from the Bartholin's glands at the vulva) and takes time to reach the vulva, about 10 cm to travel, a delay that's even longer at menopause, even with hormone therapy. Applying lubricant directly to the vulva shortens this perceived delay and helps sync timing with your partner.
The pelvic floor: rehabilitation, sensation, and pleasure
The pelvic floor acts as a "safety net" for urinary continence, but it also plays a role in sexual pleasure. Some women, especially after childbirth, can no longer contract it voluntarily: in that case, "reflex" solutions like Kegel balls or electrostimulation help retrain it. For those who have control, regular training (vaginal weights, connected devices, rehab with a professional) strengthens it. Kegel balls can also help "reclaim" this area after a period without sexual activity, restoring sensation.
Female pleasure is mostly clitoral
Always expecting a vaginal orgasm can lead to a long, frustrating wait: female pleasure is mostly clitoral in origin. A toy designed for clitoral stimulation, used with lubricant, remains a helpful tool at any age.
When to see a sex therapist
When a sexual difficulty really becomes a problem in the couple, or in case of disagreement between partners, it's possible to talk to your gynecologist, a midwife trained in sexology, or consult a sex therapist directly. Important point: women often (wrongly) feel solely responsible for a sexual issue, when the cause could be, for example, premature ejaculation in their partner.
Appetite comes with eating. Contrary to what we imagine, desire fades if you have less sex.
🎯 Concrete actions
- Address vaginal dryness first, if present, before focusing on libido
- Don't wait for desire to come spontaneously: get into a receptive state and let desire emerge during foreplay
- If your couple's sex life has been paused for a long time, try the SMIC method: schedule a dedicated moment, without pressure to succeed right away
- Always use a water-based lubricant with a silicone toy
- Choose sex toys made of medical-grade silicone, checking their origin rather than buying at random
- Apply lubricant directly to the vulva to help sync timing with your partner
- Practice pelvic floor rehabilitation (alone or with a professional) if you can't voluntarily contract your pelvic floor, using vaginal weights, a connected device, or electrostimulation
- Use Kegel balls (medical-grade silicone, progressive weights) to reclaim this area and restore sensation, especially after a period without sexual activity
- See a sex therapist, gynecologist, or trained midwife if a sexual difficulty persists or creates disagreement in your relationship
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