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The North American Menopause Society says that most women experience menopause between the ages of 45 and 55, with 51 being the average. Based on this data, many will go through perimenopause in their 40s. “On average, perimenopause, which means ‘around menopause,’ lasts for four years before the complete transition into menopause, though it can be longer,” says Candice Vaden, WHNP.

Perimenopause occurs when your estrogen levels slowly and sporadically decrease — imagine a chart with many spikes that downtrend over time. As a result, life-changing symptoms such as irregular menstrual cycles, vaginal dryness, and hot flashes can occur and change your vagina.

Though menopause may be looming, some women give birth during this decade, too. Essentially, your 40s can be marked by fertility and the end of fertility.


“Decreases in estrogen lead to decreased blood supply to the vagina and vulva, less collagen in the vulvar tissue, and changes in vaginal pH, to name a few,” says Vaden. “A woman may notice that her pubic hair is thinning, her vulva and vagina have become drier, and that her labia [appear looser] due to less fat content.” She emphasizes that these perimenopausal symptoms are very individualized — some women barely notice them while others experience them in a more pronounced manner.

Vaden says that along with previous vaginal deliveries, body weight can also impact pelvic floor strength. “Pregnancy and vaginal delivery place great strain on the pelvic floor, while increased abdominal weight also puts pressure on it.”

Coupled with decreasing estrogen levels, any of these factors can result in less pelvic floor tone, which may show up as unintentional urine leakage or vaginal prolapse. Vaden recommends keeping up with Kegel exercises and staying healthy to maintain pelvic floor strength. “Exercises like Pilates and barre, which focus on core and pelvic strength, are also great options,” she adds.

Similar to your 30s, if you do become pregnant in your 40s, Vaden adds that the vagina may take longer to heal after a vaginal delivery than before.


Here’s where two common perimenopause symptoms may affect your sex life: a decrease in vaginal lubrication, particularly during sexual arousal, and general vaginal dryness. Beyond using a lubricant to address dryness, Vaden suggests allowing plenty of time for foreplay and clitoral stimulation prior to intercourse. If vaginal dryness persists, she adds that doctors can prescribe a low-dose topical estrogen cream.

Physically, your body may not be the same as it was when you were in your 20s. In other words, it’s totally normal for sex to be accompanied by a few joint cracks. “Women in their 40s may find that aging joints and muscles are not cooperating for certain positions,” says Vaden. “I suggest people try new positions that are easier on joints and muscles, like spooning.”


Hormonal symptoms, combined with others like hot flashes, mood changes, and sleep disturbances, can negatively impact your eagerness for physical intimacy. After all, the last thing we want to do is cuddle after waking up drenched from night sweats. But don’t worry, there are natural remedies to help with these symptoms.

But our favorite piece of advice from Vaden? “If you don’t use it, you lose it!” she says. Often, we think we need to be in our prime to have sex — but it can be the other way around. Having sex brings out our healthiest self. “As women age and estrogen levels decrease, the vagina can become less elastic, shorter, and more narrow, which in turn makes intercourse uncomfortable. This is why continuing sexual activity can help prevent changes in the size and shape of [the] vagina.”

The skin of the vulva is also likely starting to thin during this time, so watch out for harsh scrubs and be cautious with waxing, which can damage the skin. “Declining hormone levels also change the pH of the vagina, so the amount of healthy vaginal flora decreases,” says Vaden. “This sets women up to be more prone to vaginal infections and vulvar skin infections, which a probiotic supplement for vaginal health can help offset.”

Labdoor, an independent company that tests, grades, and ranks supplements based on label accuracy, product purity, efficacy, and more, reports that Culturelle Digestive Health Probiotic is the best probiotic supplement in terms of quality.

Vagina in your 40s

  • Strength: Ramp up on exercises for core muscles.

  • Sex: Try new positions in the bedroom.

  • Self: Take a probiotic for your vagina’s health.

    Source :

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