Most physical changes take place after menopause and are the result of decreased estrogen levels. These changes can be altered if a woman is taking hormone therapy.

• It may take longer for a woman to become sexually excited.
• A woman's skin may feel more sensitive and irritable, making caressing and skin-to-skin contact less pleasurable.
• The walls of the vagina become thinner and drier and are more easily irritated during sexual intercourse.
• Orgasms may be somewhat shorter than they used to be, and the contractions experienced during orgasm can be uncomfortable.

Not all women experience these problems. Those who do can experiment to find ways to enjoy sex despite these physical changes.