Has your doctor ever asked you how often you use your ­vibrator? Or if you even have a vibrator?

If the answer is “Certainly not!” you’re not alone. Almost no doctors ask women about vibrators—or orgasms—at all. Most women won’t bring up or even think about this topic on their own. Yet for many women whose sex lives decline after menopause, as often is the case, the use of a vibrator is a safe and effective way to restore the joyful (and healthful) sex that they miss. It’s good for relationships, too.

Gynecologist Lauren Streicher, MD, often recommends vibrators as a health device. She is on a mission to get women to talk about sexuality, including the inability to have an orgasm, with their doctors. We ­talked with her about what that could ­accomplish…

Why should women talk about sexual problems, including a lack of ­orgasms, with their doctors? 

Because sexual pleasure is important for most women’s physical and emotional health and, if a woman has a partner, for her romantic relationship. Vibrators can help—and doctors should feel comfortable recommending them. More than half of American women ages 18 to 60 have used them at some point in their lives, but that means nearly half never have.

That is a missed opportunity because vibrators can help many women, both before and after menopause, with desire, arousal, lubrication and, yes, orgasm.

Is not being able to have an orgasm really a health condition? 

It is if it’s negatively affecting a woman’s life. Many women enjoy sex without orgasms, and in fact, most women don’t have orgasms during intercourse and they still consider it a pleasurable experience.

But when a woman—or a man, for that matter—has an orgasm, it not only feels good, it also can be profoundly relaxing for him/her. Often, it decreases stress and helps a woman sleep better.

Plus, levels of the hormone prolactin go up after orgasm—and that’s true for both men and women—which increases bonding with your partner. Men also really like their partners to be orgasmic and to enjoy themselves, and it can strengthen a relationship.

Many women, particularly as they get older, are distressed that they can no longer achieve orgasms. Some are not able to have an orgasm at all, while others find that their orgasms are not as strong as they once were and/or take a very long time to happen. Most women I see with these issues used to have orgasms just fine, and then something changed.

The medical term for this is “female orgasmic dysfunction.” Often, it’s related to menopause. That said, if a woman doesn’t have orgasms but it doesn’t bother her, she does not have a dysfunction.

How does menopause affect sexual pleasure and orgasms?

There are several ways. One is a decline in libido that is related to the decline in estrogen that starts around perimenopause and continues for the many years that follow. That estrogen drop also reduces genital blood flow—and the ability to have an orgasm is tied to good blood flow.

It’s similar to erectile dysfunction in men. Also, medical conditions such as cardiovascular disease, diabetes or pelvic surgery can reduce blood flow. For a woman, good blood flow to the clitoris allows the tissue to become engorged, aroused and stimulated and keeps nerve endings healthy and ­responsive.

How exactly does a vibrator address all that? 

Most women need direct clitoral stimulation to have an orgasm. For younger women, manual or oral stimulation, or even just the contact during intercourse, can be sufficient. But as women age, they may need something to increase the intensity of the sensation. Even women who are not able to have an orgasm with other kinds of stimulation very often can have them with vibrators.

The clitoris actually has receptors that specifically respond to vibration. That vibrating stimulation also increases blood flow, which in turn increases ­lubrication. If it is a dildo-type vibrator, regular use also can help maintain elasticity of vaginal tissues.

If it doesn’t seem like a comfortable topic, how can a woman bring up to her partner the idea of using a ­vibrator? 

She might say something like, “I love when we have sex, but I think it would be fun to try something different, and I hear that using a vibrator can make sex more pleasurable.” She might mention that she read a health article—such as this one—reporting that vibrators can help women her age and that many women use them.

Aren’t many men put off by the idea of their partners using vibrators because it implies that the men aren’t “enough”? 

That’s sometimes true, but not as often as you might think. In one national survey, published in Journal of Sex & Marital Therapy, 70% of men said that vibrators are not intimidating. In fact, a man can take the lead on this and say to his female partner, “I’ve heard it’s much more pleasurable for many women with a vibrator, and I’d love for you to have that kind of pleasure, so I bought you one.” How any particular couple handles this topic is very individual—in some, the woman takes the lead, in some the man, and some couples like to shop for vibrators together.

Of course, vibrators also can enhance same-sex relationships. Nor does anyone’s sexuality have to stop when the person’s not having sex with a partner. By discovering more about your own body and how to sexually satisfy yourself, you’ll facilitate your ability to achieve orgasm in an intimate relationship, too.

Can older women who have never had orgasms start having them?

Absolutely. A typical woman who has never had an orgasm—and who is likely to be quite reticent about all these matters that we’ve been discussing—just needs “permission” from a health professional to use a vibrator…and in some cases, a little help finding her clitoris. And then, she usually is just fine.

Do you hereby give all our readers permission?

I do!

The Doctor’s Guide to Sexual Aids

One type of vibrator that I recommend is a small, external bullet-style clitoral vibrator that you can hold on the right spot—either on your own or while you’re having intercourse with your partner. There also are couples’ vibrators that are U-shaped. They slide in the vagina so that the man can put his penis in at the same time as the woman is getting direct clitoral stimulation.

Many women also benefit greatly from lubricants after menopause. For intercourse, I recommend silicone-based lubricants—they’re very slippery and won’t damage vaginal tissue. Water-based lubricants are good, too, and are the best choice if you are using a vibrator or other sex toy, because silicone lubricants do not mix with silicone toys.

If you are using a water-based lubricant, however, be sure to choose one that has low osmolality—a measure of dissolved particles. Many popular lubricants have high osmolality, but that can dry out tissue (the opposite of what you are trying to accomplish!) and increase the chance of irritation and infection. Recommended: Water-based low-­osmolality lubes include Pulse H2Oh!, Good Clean Love, Sylk, System JO and Slippery Stuff. When using a vibrator, use a water-based lube only—silicone-based lubes can damage the silicone used in many vibrators.

Steer clear of lubes with chemicals in them for flavor or warming—these can damage delicate vaginal tissue. But warming your lube is a really nice option. Pulse is a lubricant-warming dispenser sold with low-osmolality water- or silicone-based lubricant pods.

Many women are nervous about shopping for vibrators. Tip: Look for women-friendly erotic shops near where you live. There’s also a big selection of products available online, of course. That can be overwhelming, but if you shop for my recommendations above, it should be less daunting. I don’t have any financial connections to any of these companies.

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