By Marie Morice
Last week I was invited to deliver a lecture at the London School of Hygiene & Tropical Medicine on a topic that is slowly gaining attention in public health: the intersection between menopause, sexual wellbeing and pleasure.
For decades, menopause has largely been framed in medical terms as a hormonal transition associated with symptoms such as hot flushes, sleep disturbances and mood changes. While these symptoms are very real and affect many women, the dominant narrative has often focused on what is “lost” during this life stage rather than what continues to matter for wellbeing — including sexuality and pleasure.
Yet sexuality does not disappear at menopause. Research consistently shows that many women remain sexually active and interested in intimacy well into midlife and beyond. However, sexual wellbeing is still rarely addressed in conversations about menopause within healthcare systems.
This is where pleasure-based approaches to sexual health become particularly important.
Organisations such as The Pleasure Project have long argued that sexual health interventions are more effective when they acknowledge pleasure rather than ignoring it. By recognising pleasure as a legitimate part of sexual health, programmes and policies can become more realistic, inclusive and empowering.As an advisory member of The Pleasure Project, I see firsthand how integrating pleasure into sexual health conversations can transform the way people relate to their bodies and their sexuality.
In my own work as a sexologist and founder of The Pleasure Atelier®, I explore how pleasure-based approaches can support women in reconnecting with their bodies and sexual wellbeing — particularly during life transitions such as menopause.
During the lecture, we explored how cultural narratives have historically shaped our understanding of female sexuality. For much of modern medical history, women’s pleasure was poorly understood or ignored altogether. Even today, many people are unaware of basic anatomical facts about the clitoris and its central role in sexual pleasure.
These gaps in knowledge contribute to what researchers have called the pleasure gap — the persistent disparity in orgasm frequency between men and women in heterosexual encounters. This gap is not primarily biological, but reflects differences in education, expectations and cultural scripts.
But what does this have to do with menopause?
Recent research conducted by the Kinsey Institute and Womanizer explored an intriguing question: could masturbation play a role in relieving certain menopause symptoms?
In a large survey of women aged 40 to 65, researchers found that 57 percent of participants reported that masturbation improved at least one menopause symptom. The most commonly reported improvements included sleep, anxiety, irritability and mood.
These findings are biologically plausible. Orgasm triggers the release of endorphins and oxytocin, reduces stress and increases blood flow to genital tissues — all processes that could plausibly influence symptoms associated with the menopause transition.
However, the most interesting insight from the study may not be the reported benefits themselves, but the gap between research and clinical practice.
While many women reported improvements, only a minority used masturbation intentionally as a symptom-management strategy. Even more strikingly, very few participants reported ever discussing masturbation with a healthcare professional.
This highlights a broader issue in sexual health: pleasure is still largely absent from healthcare conversations.
Integrating pleasure into sexual health does not mean prescribing specific behaviours. Rather, it means recognising that sexuality remains an important dimension of wellbeing throughout the life course.
Healthcare professionals should feel equipped to discuss sexual wellbeing openly and without stigma — including during life transitions such as menopause.
For organisations such as The Pleasure Project, this shift is essential. Sexual pleasure has long been marginalised within global health conversations, yet it plays a fundamental role in people’s lives, relationships and wellbeing.
Menopause reminds us that sexuality evolves across the life course. Instead of framing it solely as a period of decline, we have an opportunity to rethink how pleasure, intimacy and sexual wellbeing fit into this stage of life.
If sexual health is truly part of overall health, then pleasure must be part of the conversation.
Marie Morice is a sexologist, speaker, and founder of The Pleasure Atelier®, a global platform dedicated to closing the pleasure gap and embedding sexual wellbeing into women’s health. With over 25 years of experience in sustainability and gender equity, her work now focuses on helping women reconnect with their bodies, desires, and confidence — because pleasure is the new wellness.
