All women should be having orgasms in midlife and beyond, and here’s how to do it… by a

I’m going to tell you something few people will. In fact, it’s the final menopause taboo: something considered so private (or shameful?) that you’ll rarely – if ever – hear it discussed, even by your closest friends.

But it could change your life and improve your health. It is this: masturbation is medicine. And women, but particularly those who’ve gone through the menopause, should consider using sex toys, in my professional opinion.

You might be shocked. Or perhaps, if you think you’ve heard it all before, you’re even rolling your eyes. Not this claptrap again. But this isn’t about performing bedroom gymnastics. It’s about our overall health, because orgasms are good for us.

As Professor in Reproductive Science at University College London, my research involves all areas of women’s health, from menstrual cycles to fertility and menopause.

Most recently, I’ve been interviewing dozens of women over 50 for a book I’m writing about how to rediscover your mojo in later life. What I’ve found is that, while many are still sexually active – either alone or with a partner – some haven’t had an orgasm for a very long time. They’re not masturbating, nor are they having sex.

‘Women, but particularly those who’ve gone through the menopause, should consider using sex toys… in my professional opinion’

‘It’s easier, perhaps, to just put a lid on it all and scoff when they come across vibrators on the shelves in Boots and dismiss it as a young person’s game…’

One big study shows that, for some women, this happens because they’ve lost their partners through death or divorce. Others say their own ill health, or their partner’s, is a barrier to a healthy sex life. But for too many women, having an orgasm is simply no longer a priority, and it hasn’t been for years.

Outside my research I’ve had conversations with friends who shrug and confess they ‘haven’t been bothering with all that’, as they put it.

Even getting women to talk about this issue is difficult, as The Mail on Sunday’s resident GP, Dr Ellie Cannon, discovered. Last week she asked readers to write in about how important orgasms were to them, and whether – like Emma Thompson’s character in the movie Good Luck To You, Leo Grande – they had never had one.

Just two women got in touch – normally her postbag is bulging. One said that, aged 56, she loved her orgasms and hoped to continue them well into her old age. The other, a 79-year-old, admitted to using a sex toy for the past two years since her husband died.

I’m delighted for both of them. But I suspect they aren’t typical. So why didn’t more women write in? It’s unlikely that everyone else has zero interest in sex – in the last census, from 2021, just 28,000 people (0.046 per cent of the adult population of England and Wales) described themselves as asexual.

I suspect it’s that, for many women, getting rid of their periods means they move into what I describe as the ‘not giving a f***’ stage of their lives where they no longer feel they have to please anyone but themselves. Letting go of sex, and that pressure women feel throughout their lives to be desirable, can be a huge relief.

It’s easier, perhaps, to just put a lid on it all and scoff when they come across vibrators on the shelves in Boots and dismiss it as a young person’s game.

I understand how it feels – I really do – because I’ve been there myself. During my perimenopause, which started in my early 40s, I also had three small kids and sex was not high on my agenda. I didn’t really feel like it. But that’s a cruel trick of hormones, and for most women it isn’t true.

But you have to work a little harder at rediscovering it. Perimenopause, the state of hormonal flux most women go through before their periods finally stop and the menopause begins, throws a spanner in the works, both physically and emotionally.

It can last for up to a decade and is often a time of increased anxiety, mood changes, insomnia and a plummeting libido, not to mention physical changes which can make sex more painful and difficult. But the vagina is a muscle which needs to be exercised, like any other muscle, or it can lead to problems. It really is a case of use it or lose it.

‘It’s easier, perhaps, to just put a lid on it all and scoff when they come across vibrators on the shelves in Boots and dismiss it as a young person’s game.’

‘Doctors have been aware of these issues for decades – they aren’t new or unusual problems and you shouldn’t be embarrassed asking a GP about them if you’re suffering.’

For some women, the decline in levels of the sex hormone oestrogen can make the tissues inside the vagina thinner and less lubricated, a condition known as vaginal atrophy. The vagina becomes dry and itchy as it loses this natural moisture, making penetration uncomfortable. The muscle walls can weaken, causing broader problems with incontinence.

Without regular penetration, the vagina itself can contract. Doctors have been aware of these issues for decades – they aren’t new or unusual problems and you shouldn’t be embarrassed asking a GP about them if you’re suffering.

Some treatments, including certain types of hormone replacement therapy (HRT), are available. I’ll talk about these a bit later.

I remember my mum – who was single for many years and died in her 90s – coming back from seeing the GP once with some vaginal dilators. ‘He says I’ve got to stick these things up my vagina because it’s too tight,’ she told me. 

And even less openly discussed is what can happen to your clitoris, a muscular organ which might look like a bean from the outside but which stretches to the top of the vagina.

It contains thousands of nerve endings and, for some women, stimulating the clitoris is the only route to an orgasm. But as women age the blood flow to the nerve endings around the clitoris are reduced, which means it can become less sensitive and less responsive to touch. It can even recede – known as clitoral atrophy – in a small minority of women.

It’s hardly a surprise that, as a result, many women turn their backs on sexual pleasure during this period, then forget about it.

If you’re one of them, listen up: the benefits of regular orgasms include relieving these symptoms. Stimulation and orgasms can keep the tissues lubricated and relieves the dryness and itching naturally. They strengthen the pelvic floor muscles and maintain the anatomy of the vagina and vulva, and help retain (or regain) bladder control.

If there’s penetration of the vagina that can help stop it shrinking, too. There are also psychological benefits. An orgasm reduces stress and boosts the release of the hormone oxytocin, and neurotransmitters serotonin and dopamine, all of which boost feelings of wellbeing.

They can help you sleep at night because an orgasm floods the brain with melatonin, which is why you feel pleasantly sleepy afterwards. In the longer term, there is even research which suggests orgasms can lower blood pressure, protect against cardiovascular disease and help ease headaches.

And the more you orgasm, the better orgasms you’ll have and the better your vaginal health will be. The way I like to think about sexual wellness is that it’s a bit like happiness – sometimes you just need to work at it a bit harder and be creative. Achieving orgasm can be more difficult for women as they age, just like it is for men.

The key is discovering what works for you. Some women may find HRT – usually a combination of drugs that top up levels of female sex hormones oestrogen and progesterone – restores their libido. Official guidance also says that if this doesn’t work, testosterone can be used to prop up a sagging libido.

But I suggest you see how you feel when the menopause is finished. It can feel like a fog has lifted, a hallelujah moment.

Often your libido may resurface naturally without needing to dose up on drugs. And some women have reported testosterone makes them feel like randy teenagers. Is that what you want?

What I’d suggest to start with is lubrication, if dryness is a problem. Some products such as Sylk and Yes are available on NHS prescription. You can also ask your GP for vaginal oestrogen, which should alleviate any vaginal issues. But sex toys can equally help reawaken your body to pleasure.

As a single woman, I use toys. I’d say I’m a fan. But I suspect many women have never been there – in fact, I’m pretty sure lots of women, particularly from our mothers’ generation, have never had an orgasm. If you’ve never considered it before, and are still rolling your eyes, please think about it. What have you got to lose, really?

‘The key is discovering what works for you. Some women may find HRT – usually a combination of drugs that top up levels of female sex hormones oestrogen and progesterone – restores their libido…’

You no longer have to go into a sex shop to buy one – they’re available online and are posted in discreet packaging for privacy. They even sell them in Tesco. The science has evolved – we now know, for example, that certain vibrations are the most effective for stimulating pleasure. There are even vibrators approved as medical devices, which are proven to treat an array of menopause-related sexual dysfunctions.

I’ve recently partnered with a British-based company, MysteryVibe, whose products are licensed as medical devices by the US regulator, the Food and Drugs Administration (FDA). The company recently launched billboards in New York with the brilliant strap­line: ‘Orgasm now comes with a medical prescription.’

We still don’t know precisely why it works – so much of women’s sexual pleasure remains a scientific mystery. But MysteryVibe’s medical director, urological surgeon Professor Prokar Dasgupta, says: ‘We think vibrators improve the signalling between the body and the brain, and that the vibrations also may tone up the muscles of the vaginal wall.

‘The vibration also seems to encourage the glands to secrete vaginal fluid – again, we don’t know why, but it does.’

If none of this has convinced you yet, perhaps this will: one day, says Prof Dasgupta, vibrators could be dished out by the NHS. Orgasms on prescription would be just what the doctor ordered.