On October 22, 2026, La Vanguardia published an interview about sexual pleasure in menopause with pelvic-floor physiotherapists Laia Blanco Ratto and Stéphanie Kauffmann and physiotherapist and psychologist Inés Ramírez García. The RAPbarcelona cofounders and directors discussed their book Placer en la menopausia and argued that satisfying intimacy need not depend on penetration.
The interview challenges resignation rather than clinical standards
The assumption under examination is that sexual discomfort should simply be accepted with age, or that intercourse is the main measure of a satisfying sex life. The interviewees challenge both ideas. They also question a hormone-only explanation for pain that leaves muscle tension and emotional factors outside the conversation.
This does not replace an established medical approach. In Cleveland Clinic’s Ob/Gyn Time discussion, OB/GYN Jacqueline Zuponcic already describes sexual function as shaped by biological, psychological and social factors. The interview brings that broader perspective into a public conversation about menopause and pleasure.
Both sources offer expert clinical perspectives rather than population research. The La Vanguardia interview accompanies a book and provides no prevalence estimates, trial results or comparative treatment data. It is not a new consensus guideline, so its observations should be read as the specialists’ experience rather than a universal account of menopause.
Comfort and personal preference belong at the centre of care
- Pain and desire deserve separate attention. The interviewees say pain during penetration and reduced desire are concerns they often hear in practice. Those concerns can appear in the same conversation without being treated as one problem with one solution. A useful assessment makes room for what hurts and what has changed in desire, rather than assuming that either experience fully explains the other. For readers trying to describe their experience, separating desire from dryness and pain offers a clearer starting point than placing every change under a single label.
- Tissue changes are part of the picture. The specialists identify reduced lubrication and changes in vulvovaginal tissue elasticity as possible contributors to discomfort around menopause. Their account places physical comfort within the discussion of sexual wellbeing rather than treating pain as something a woman should tolerate. The practical point is to describe the discomfort during a professional assessment instead of deciding in advance that menopause explains it completely. This keeps the conversation focused on the person’s experience while leaving room for the other contributors the interview describes, including muscle tension and pelvic mobility.
- Sleep and fatigue provide useful context for desire. The interview connects exhaustion, insomnia and irritability during perimenopause with possible reductions in spontaneous desire. That makes the wider experience of daily life relevant to a sexual-health conversation, not a distraction from it. When lower desire coincides with poor sleep or fatigue, those details are worth bringing into an assessment rather than presenting libido as an isolated concern. The goal is a fuller account of what is happening, without turning an exhausted woman’s lack of spontaneous interest into an automatic demand for treatment.
- There is no single required level of sexual interest. In the Cleveland Clinic discussion, Zuponcic places weight on whether a person is bothered by changes or affected in quality of life. That approach leaves room for differences in preference instead of measuring everyone against the same expectation of frequency or desire. A change that feels upsetting deserves space in the conversation, while a level of interest that feels acceptable does not automatically need correction. The relevant question is how the woman experiences her sexual life, rather than whether it resembles someone else’s idea of normal.
- Penetration is an option rather than a test of success. The La Vanguardia interviewees argue that satisfying sexual experiences do not have to depend on intercourse. This is particularly relevant when penetration is painful or unwanted, because it allows comfort and preference to shape the discussion of intimacy. Their position leaves room for women who value penetration and for those who want other forms of closeness. It is not an instruction to abandon something enjoyable, but a rejection of the idea that one activity must determine whether a sexual experience counts as satisfying.
- Pleasure also belongs in ordinary life. The specialists describe pleasure broadly enough to include sleeping well and living without pain or urinary leakage limiting everyday activities. This moves the discussion beyond whether a particular sexual activity is possible and towards the quality of life a woman wants. It also gives comfort outside sexual situations a legitimate place in a consultation about intimate wellbeing. Read this way, their message is not that every daily difficulty is sexual, but that a conversation about pleasure need not exclude the physical concerns that matter beyond the bedroom.
- Urinary changes and pelvic heaviness deserve attention. The interview discusses urinary leakage, urinary discomfort and prolapse alongside a feeling of pelvic heaviness or pressure. The specialists caution against accepting these experiences as an inevitable consequence of getting older. Persistent symptoms are therefore a reason for a conversation with a qualified healthcare professional, rather than something to leave out because the appointment began with a question about sex. Describing whether urinary or pelvic symptoms occur alongside sexual pain gives the professional a fuller account without requiring the woman to identify the cause herself.
- Lubricants and vaginal moisturisers have different roles. In the interview’s description, lubricants reduce friction during sexual activity while vaginal moisturisers contribute to routine tissue care. Cleveland Clinic clinicians also discuss these products as common initial approaches to dryness. The distinction matters when discussing options because a product intended for friction during activity is not being described as the same thing as ongoing tissue care. Suitability belongs in a conversation with a healthcare professional, with the woman’s particular discomfort clearly described rather than relying on a general promise about improving sex after menopause.
- Local hormonal treatment is one possible part of care. The interview lists clinician-indicated local hormonal treatment among the options for pain, alongside lubricants and moisturisers. The specialists also describe muscle tension, pelvic mobility and emotional factors as possible contributors that a hormone-only approach may leave unaddressed. For a reader, the useful next step is a broader discussion of the problem rather than choosing a treatment from a list. A personal care decision can then be connected to the symptoms and assessment instead of an assumption that every painful experience around menopause has the same hormonal explanation.
- Pelvic-floor care does not always mean strengthening. The interviewees say that learning to relax muscles and rebuilding confidence in the body can be relevant in some cases. Their account challenges the idea that every pelvic-floor concern should lead straight to exercises intended to make muscles stronger. The practical implication is to discuss the role of pelvic-floor assessment with a qualified professional rather than treating strengthening as the default response to pain or urinary symptoms. For readers thinking about comfort after painful experiences, the emphasis remains on assessment and personal preference rather than a universal exercise plan.
- A dedicated appointment can make room for the full conversation. Cleveland Clinic clinicians note that a visit set aside for sexual-health concerns may allow more time to discuss them. The practical details supported by these sources include describing what hurts and when it happens, together with any urinary discomfort or pelvic symptoms. Sleep and fatigue are also relevant context when they coincide with changes in desire. Refemina’s guide to putting sexual symptoms into words offers a related starting point for a conversation that reflects the woman’s concerns rather than reducing them to a request for one treatment.
Future care should follow the person rather than a sexual benchmark
The interview’s practical contribution is a case for individual assessment and broader definitions of pleasure, with comfort and personal preference shaping care rather than penetration serving as the default goal.
How Refemina helps
The woman and her clinician lead decisions about sexual comfort; Refemina brings research-led explanations to the questions surrounding those decisions. Its coverage connects intimacy with the wider experience of midlife, helping readers distinguish credible evidence from sensational claims without treating every change in desire as a problem that needs fixing.
Explore Resources
Sources
- Taking Charge of Your Sexual Health - Cleveland Clinic
- Todavía se asocia el envejecimiento con la idea de que una mujer ya no necesita disfrutar de una vida sexual”: cómo recuperar el placer en la menopausia
