Should Self-Pleasure Be Part Of Menopause Treatment?

Menopause care is full of advice. Women are told which lifestyle habits to adjust, which foods to avoid, and which supplements or medications to consider. But because menopause remains under-researched, symptom management is often deeply personal. What works for one person may do nothing for another.

One thing that guidance almost never includes? Sexual pleasure.

New research suggests self-pleasure may be a meaningful, low-risk way to manage some of the most disruptive symptoms of menopause and perimenopause, particularly those related to mood, sleep, and stress.

A recent study by researchers at the Kinsey Institute, published in Menopause, surveyed more than 1,000 women ages 45 to 60. Participants ranked masturbation as one of the most effective strategies for improving menopausal symptoms, with many reporting benefits that rivaled or exceeded hormone replacement therapy in perceived effectiveness. Both perimenopausal and menopausal women reported improvements in mood, sleep quality, and pain relief. Many also said masturbation reduced vaginal dryness, a symptom that can make partnered sex uncomfortable or painful and is often under-treated.

Allison, 53, who is post-menopausal, says orgasms help ease both mental stress and persistent malaise. “It's very much a ‘release’ from both these hangups. I feel a lot better, even though that could just be the dopamine talking,” she says. “But if I'm having trouble sleeping or am very tense due to stress or over-stimulation, it seems to relax everything.”

Why Pleasure Can Help

Physiologically, these findings make a lot of sense, says Dr. Sarah de la Torre, board-certified ob-gyn at menopause companies JoyLux and Respin.

“During menopause, we’re losing estrogen, and progesterone also declines, which leads to sleep disruptions, anxiety, and mood changes,” she says. “When you masturbate, you get uterine contractions and a release of dopamine and serotonin to the brain. It’s a mood elevator. The person feels more relaxed, and they may be better able to go to sleep.”

Yet masturbation remains one of the least discussed topics in menopause care. Only seven percent of study participants said they had ever talked about self-pleasure with a healthcare provider. Many reported they would masturbate more often if they knew it could help manage symptoms, especially if a clinician explicitly recommended it.

Still, framing self-pleasure as a “treatment” is complicated.

The Complications of Self-Pleasure During Menopause

For many women, menopause symptoms are debilitating. Joint pain, fatigue, brain fog, anxiety, and dramatic shifts in energy and libido can make self-intimacy feel like another demand rather than a relief.

Low libido, resulting from declining estrogen levels, can make sexual pleasure feel like a hurdle. You’re supposed to want it, but you don’t have the bandwidth. One woman on Reddit described masturbation recommendations as adding just another chore to a never-ending to-do list of exercise, supplements, and daily household duties. “I feel this in my soul! I'm already grumpy and tired!” another Redditor responded.

Allison acknowledges the benefits of self-pleasure but says orgasms became much harder to achieve after menopause, even with toys. “We aren't really aware how much of our behavior is tied to hormones and our bodies' intent on reproduction,” she says. “Now it has to be directly intentional. It’s more like scratching an occasional itch rather than a compulsion.”

Still, experts say masturbation can sometimes help address the very symptoms contributing to low desire. “You’re increasing blood flow to the vagina and uterus,” says de la Torre. Improved circulation can temporarily ease dryness and discomfort, making pleasure more accessible over time.

Masturbation can also remove many of the pressures tied to sex, including pain, performance expectations, or mismatched desire. And for many women, it’s simply more reliable. “The evidence is very strong that women are more likely to orgasm during masturbation than with partnered sex,” says Cynthia Graham, a senior scientist at the Kinsey Institute and co-author of the study who focuses on sexual wellbeing in older adults.

Untangling Menopause from Asexuality

As desire shifts, menopause is often mistakenly framed as the end of sexuality. “That’s just not what we found,” Graham says. Research shows that while sexual frequency may decline with age, sexual satisfaction often stays the same or even improves, particularly as women feel more confident communicating what they want.

Still, cultural and generational messaging often attaches guilt or shame to self-pleasure. “People think it’s somehow not okay to take care of yourself in that manner,” de la Torre says. “But when women understand the physiologic changes involved—how pleasure affects blood flow, hormones, and mood—it can take some of the taboo out of the conversation.”

Graham notes that during her years in sex therapy, she spoke with many women who reached midlife without ever experiencing orgasm, often not because of physical limitations but because they were never encouraged to explore pleasure on their own.

And de la Torre sees this in her practice as well. “I’m in my fifties, and a lot of women in my generation and older still don’t know their bodies that well,” she says. “I’m still encouraging women in this transition period to understand what works for them.” Masturbation, she adds, can be one practical way to do that, whether using hands or sex toys.

That said, low desire or asexuality doesn’t necessarily need fixing. “There’s no harm in trying self-pleasure,” de la Torre says. “But it’s equally valid if someone doesn’t want to or has tried and seen no changes.”

Where Self-Pleasure Fits in the HRT Era

The study arrives at a moment of reckoning for menopause care. Medical organizations are in the midst of a long-overdue course correction, walking back decades of overly cautious guidance around hormone replacement therapy. In the early 2000s, findings from the Women’s Health Initiative (WHI) were widely interpreted to suggest that hormone replacement therapy significantly increased the risk of breast cancer, heart disease, and stroke. HRT was rarely prescribed, even for women with severe symptoms. Years later, researchers acknowledged that those conclusions were overgeneralized and inaccurate.

Today, HRT is recognized as safe and effective for many women when appropriately prescribed. Still, some women bristle at the idea that masturbation could be framed as an alternative to medical care. On online forums, several described the suggestion as dismissive. (One Reddit user described it as a “slap in the face.”) For many women, pleasure strategies alone don’t address the underlying hormonal shifts driving many of the horrible symptoms, like bladder problems, hot flashes, and cognitive issues.

Hormones are often essential, even just as they pertain to libido. For some women, masturbation alone isn’t enough to increase their sex drive. One woman describes not seeing measurable improvements in libido until she began vaginal estrogen, which enabled her to climax for the first time in years.

Graham is careful to clarify that the study does not argue for masturbation instead of hormone therapy. “Sometimes combining some kind of medical treatment—maybe a drug treatment—with some kind of psychological approach is more helpful than one or the other alone,” she says.

And de la Torre agrees. Not all women find relief through HRT, and some cannot use it due to health conditions or contraindications. For them, non-medical strategies become especially important.

The Future of Menopause Care

Self-pleasure is one of the most accessible, low-risk strategies for easing certain menopause symptoms. Yet the taboo around discussing sex has kept many women from ever considering it.

“We know from research that doctors often don’t raise sexual topics with patients,” Graham says. “But I don’t think it’s impossible—and maybe I’m optimistic—that doctors and OBGYN health professionals can encourage women to think about this.”

Allison hopes future research will help reframe sex toys as legitimate health tools. She’d like to see vibrators classified as medical devices that could be covered by insurance, particularly given their potential benefits for sexual and pelvic floor function. For now, they remain unregulated by the FDA, keeping them outside formal medical guidance. This gap reflects how slowly sexual health tools are taken seriously, but continued research into sexual health could hopefully, eventually bring these tools into more serious medical consideration.

Self-pleasure isn’t a replacement for medication. But for some women, it may be a valuable addition. Menopause care doesn’t have to begin and end with prescriptions. Perhaps we are moving towards a medical system that can acknowledge pleasure as a legitimate health strategy and empower women to decide how, when, and whether to use it.