Perimenopause & Menopause Sexual Health
Perimenopause and menopause can affect comfort, desire, lubrication, pelvic floor function, bladder symptoms, and sexual confidence. These changes are common, treatable, and not something you simply have to “push through.” We offer sex therapy and pelvic floor physiotherapy support, and when needed, we coordinate with your physician, gynecologist, nurse practitioner, or menopause provider for medical treatment options.
Menopause-related genital and urinary symptoms are often called Genitourinary Syndrome of Menopause, or GSM, and may include vaginal/vulvar dryness, burning, irritation, pain with sex, urinary urgency, frequency, recurrent UTIs, or changes in arousal and orgasm. Canadian and North American guidelines recognize lubricants, moisturizers, pelvic floor physiotherapy, vaginal estrogen, vaginal DHEA/prasterone, ospemifene, and hormone therapy as possible options depending on symptoms and medical history.
Treatment Options
Pelvic Floor Physiotherapy
Pelvic floor assessment for muscle tension, weakness, coordination, and pain patterns
Treatment for pain with penetration, pelvic floor overactivity, vulvar pain, and vaginal tightness
Manual therapy, relaxation training, down-training, breathing, and nervous-system calming strategies
Guidance with dilators, pelvic wands, stretching, and graded return to penetration
Support for urinary urgency, frequency, leakage, and bladder sensitivity
Scar tissue support after childbirth, surgery, tearing, or pelvic procedures
Home exercises tailored to your symptoms, goals, and comfort level
Pelvic floor physiotherapy may help when painful sex is related to high-tone pelvic floor muscles, vulvar pain, dyspareunia, vaginismus, or chronic pelvic pain.
Sex Therapy
Support for low desire, desire mismatch, avoidance, fear, or shutdown around sex
Rebuilding sexual confidence after pain, hormonal changes, childbirth, surgery, or trauma
Communication tools for couples navigating painful sex or changing intimacy
Reducing the pain–fear–tension cycle
Pleasure-focused exercises that do not pressure penetration
Body image, aging, identity, and relationship support
Helping partners understand what is happening without blame or shame
Menopause-related sexual pain and pelvic symptoms are treatable. Our approach combines pelvic floor physiotherapy, sex therapy, education, and coordinated medical referral when needed, so you can make informed choices and feel more comfortable in your body again.