There is no reason why you should not be sexually active after menopause.
However, at this time, the vaginal lining becomes drier, thinner, less elastic and is more vulnerable to infection. You may find sexual intercourse uncomfortable or painful, and so lose interest in sex. Loss of sexual desire may also be a symptom of depression or underlying illness.

There may be minor irritations. The skin around the vaginal opening is also dry. With time, it becomes thin and may shrink, causing vaginal discomfort or itching.

Changes around the vagina may cause the passage for urinating (called the urethra) to become inflamed or irritated. This may cause frequent urination, a feeling of wanting to urinate urgently, or pain on urination.

Coughing, laughing, exercising or carrying heavy things may cause urine to leak. This condition is known as incontinence. It can also be caused by the lack of exercise. It is important to know that incontinence is not a normal part of aging, to be masked by using adult diapers. Rather, it is a condition that can be treated.

What to do:
Most women find it useful to lubricate the vagina before sexual intercourse. A water-soluble lubricant is recommended as it helps to reduce the chance of infection. Oestrogen treatment can also effectively reverse the changes seen after menopause.

Personal hygiene is important in reducing infections and other discomforts. Infections are easily treated with antibiotics, but they tend to recur.

To help prevent infection, urinate before and after intercourse, drink a lot of water, avoid keeping a full bladder for long periods, and keep your genital area clean. Douching is not effective in preventing infections.

There is a higher chance of vaginal or urinary tract infection 4 - 5 years after your last menstrual period. If symptoms such as painful or frequent urination occur, consult your doctor.

To prevent incontinence, exercise regularly. You may train your bladder by contracting the muscles that stop urine flow. You can do this at any time and anywhere. However, if infection and incontinence persist, consult your doctor.

With age comes some wrinkling of the skin. However, reduced oestrogen levels worsen it by causing the skin's connective tissue (the layers under the surface) to be less elastic. The skin becomes thinner and drier and there is more frequent bruising and itching. Hair growth also slows down and your hair becomes thinner and less manageable.

What to do:
There is little you can do about wrinkling. However, oestrogen treatment may restore some thickness to the hair and moisture to the skin.