All women should be having orgasms in midlife and beyond, and here’s how to do it… by a top professor who reveals the incredible health benefits

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

But it could change your life and improve your health. It is this: masturbation is medicine. And women, but especially those who are postmenopausal, should consider using sex toys, in my opinion.

You might be shocked. Or maybe if you think you’ve heard it all already, you even roll your eyes. Not this bullshit again. But this isn’t about doing gymnastics in the bedroom. It’s about our overall health because orgasms are good for us.

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

Most recently, I interviewed dozens of women over 50 for a book I’m writing about how to rediscover your mojo later in life. What I found is that while many are still sexually active – alone or with a partner – some haven’t had an orgasm in a very long time. They don’t masturbate or have sex.

“Perhaps it’s easier to put a lid on it and laugh when they come across vibrators on the shelves in Boots and dismiss it as a young person’s game…”

A large study shows that, for some women, this happens because they lost their partner through death or divorce. Others say their own poor health, or that of their partner, is a barrier to a healthy sex life. But for too many women, having an orgasm simply isn’t a priority anymore, and hasn’t been for years.

Outside of my research, I’ve had conversations with friends who shrug their shoulders and admit that they “don’t care about any of that,” as they put it.

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

Only two women have contacted us – normally her mailbag is bulging. One said that at 56, she loved her orgasms and hoped to continue them into old age. The other, aged 79, admitted to using a sex toy in the past two years, since her husband’s death.

I’m delighted for both of them. But I suspect they are not typical. So why haven’t more women written? It is unlikely that everyone has no interest in sex: in the last census, from 2021, only 28,000 people (0.046% of the adult population of England and Wales) described themselves as asexual.

I suspect that for many women, getting rid of their periods means they enter what I describe as the stage in their lives where they no longer feel obligated to please anyone other than themselves. Giving up 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 at Boots and dismiss it as youthful play.

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

But it will take a little more work to rediscover it. Perimenopause, the state of hormonal flux that most women go through before their periods finally stop and menopause begins, throws a spanner in the works, both physically and emotionally.

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

“Perhaps it’s easier to put a lid on it and laugh 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 problems for decades. They are not new or unusual problems and you should not be embarrassed to speak to a GP if you are suffering.”

For some women, declining levels of the sex hormone estrogen 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 wider incontinence problems.

Without regular penetration, the vagina itself can contract. Doctors have been aware of these problems for decades – they are not new or unusual problems and you should not be embarrassed to speak to a GP if you are suffering.

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

I remember my mother – who was single for many years and died aged 90 – returning from a GP visit with vaginal dilators. “He says I have to put these things in my vagina because it’s too tight,” she told me.

And it’s even less openly talked about what can happen to your clitoris, a muscular organ that might look like a bean from the outside but extends to the top of the vagina.

It contains thousands of nerve endings, and for some women, clitoral stimulation is the only route to orgasm. But as women age, blood flow to the nerve endings around the clitoris decreases, meaning they may become less sensitive and less receptive to touch. It may even recede – called clitoral atrophy – in a small minority of women.

So it’s no surprise that many women turn their backs on sexual pleasure during this time and then forget about it.

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

If there is penetration into the vagina, this can also help prevent it from narrowing. There are also psychological benefits. An orgasm reduces stress and stimulates the release of the hormone oxytocin and the neurotransmitters serotonin and dopamine, all of which enhance feelings of well-being.

They can help you sleep at night because an orgasm floods the brain with melatonin, which is why you feel pleasantly sleepy afterward. Longer term, research even suggests that orgasms may lower blood pressure, protect against cardiovascular disease, and help relieve headaches.

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

The key is to find out what works for you. Some women may find that HRT – usually a combination of medicines that supplement the levels of the female sex hormones estrogen and progesterone – restores their libido. Official guidelines also state that if this doesn’t work, testosterone can be used to support a declining libido.

But I suggest you see how you feel once menopause is over. It can feel like a fog has lifted, a moment of hallelujah.

Often, your libido can resurface naturally without needing to take medication. And some women reported that testosterone made them feel like horny teenagers. Is this what you want?

What I would suggest starting is lubrication, if dryness is a problem. Some products such as Sylk and Yes are available on prescription from the NHS. You can also ask your GP about vaginal estrogen, which should ease any vaginal problems. But sex toys can also help awaken your body to pleasure.

As a single woman, I use toys. I would say I’m a fan. But I suspect many women have never been there – in fact, I’m pretty sure many women, especially those of our mothers’ generation, have never had an orgasm. If you’ve never thought about it before and you’re still rolling your eyes, think about it. What do you have to lose, really?

“The key is to find out what works for you. Some women may find that HRT – usually a combination of drugs that supplement the levels of the female sex hormones estrogen and progesterone – restores their libido…”

You no longer need to go to a sex shop to buy one: they are available online and are displayed in discreet packaging for added privacy. They even sell them in Tesco. Science has evolved: we now know, for example, that certain vibrations are the most effective in stimulating pleasure. There are even vibrators approved as medical devices, proven to treat a range of sexual dysfunctions related to menopause.

I recently partnered with a UK company, MysteryVibe, whose products are authorized as medical devices by the US regulator, the Food and Drugs Administration (FDA). The company recently launched billboards in New York with the brilliant slogan: “Orgasm now comes with a doctor’s prescription.”

We still don’t know precisely why it works – much of women’s sexual pleasure remains a scientific mystery. But MysteryVibe’s medical director, urological surgeon Professor Prokar Dasgupta, says: “We believe that vibrators improve signaling between the body and the brain, and that…