Menopause doesn’t mean you can’t still have fun! Sex never gets old. Unveiling the secrets of “sex on demand” in your 40s – the climax many women don’t know! Answering all the questions women wonder about but are too shy to ask. TUCK TALK interviews Dr. Nataya, Founder of Aomthong Lady Wellness Clinic, a gynecologist specializing in gynecological aesthetics and Lifestyle Medicine. Join us in discovering why sex in menopause is a “fountain of youth,” slowing aging at the DNA level, connecting to hormones, the brain, sleep, and women’s health in a deeper way than you think.
Is it true that women’s bodies deteriorate during menopause?
Dr. Nataya: That’s a misconception. Menopause doesn’t mean we’re “expired” or “out of date.” While it’s true that the body declines and deteriorates, it can be adjusted. Statistically, Thailand is entering a Super Aged Society. The figures for 2025 and 2026 are quite alarming; we’ll have over 20% of our population aging. According to international standards, this is called a Super Aged Society, and we rank third in Asia, after South Korea and Japan. Focusing solely on menopause, we’re seeing it happen much earlier than before, before the age of 40. Previously, the average age for menopause was around 50-55 years old. Going before 40 is considered very early, and the percentage is steadily increasing. Even as young as 30 is experiencing it, but this might be due to underlying conditions like genetics, immune deficiencies, or radiation and chemotherapy, which can cause premature ovarian decline.
What are the cycles that cause many menopausal women to become distant from sex?
Dr. Nataya: There are three main cycles. The first is physical. We might feel like everything is okay because our bodies are changing, but that’s because our physical processes are altering. The second cycle is hormonal. Many people feel that their hormone levels must drop, that they’re gone forever and can’t be restored. But the truth is, our bodies are very smart. Even if our ovaries atrophy, they can still produce reserve hormones. These are produced by the adrenal glands and by fat cells under the skin. The eggshell itself is still useful in producing androgens, or male hormones, throughout our lives. The final cycle, the third one, which causes a decline in sexual satisfaction, is related to the brain’s signals.
Perhaps we receive sensory input. Normally, the brain works in a coordinated manner, involving many different parts. The emotional input (sensory input) goes to the limbic system, which then triggers the hypothalamus (pituitary gland) to release hormones like oxytocin and dopamine. Oxytocin is the “love hormone,” initiating a bond and a desire for further physical contact. However, if we preemptively consider the sensory input, thinking about when we’ll reach climax or feeling anxious, we’re not shutting down the hormones in the prefrontal cortex. Humans are very intelligent; we think constantly. The prefrontal cortex doesn’t allow primal instincts to function without being switched off, so we won’t reach climax if we’re constantly thinking.
Reaching orgasm during menopause is not just about pleasure; it also contributes to good health and a long and healthy life.
Dr. Nataya: It’s called Synergy, the fountain of youth. Hormones aren’t just for males and females. Reaching climax releases a trump card of hormones, a “hormone bomb” of many different types. It adjusts three cycles within our bodies: physical, emotional, and mental. The physical aspect includes self-confidence in one’s body and intimate areas, which we can fine-tune. We can restore and prepare for any deficiencies. Emotional well-being is also partly influenced by hormones. A personalized check-up might be needed to identify deficiencies and provide supplements. There’s the possibility of using bio-identical hormones. Diet also plays a significant role in hormone production. We can differentiate between types of hormones, such as which DHEA or progesterone can be supplemented, depending on the source.
What are the benefits of the hormone DHEA?
Dr. Nataya: DHEA is naturally produced by the adrenal glands. It’s a precursor hormone that can be converted into either female or male sex hormones. It also acts as an anti-aging agent and reduces inflammation in the body. We monitor DHEA levels based on age. If, at a certain age, your DHEA levels are significantly higher than normal (exceeding levels expected for someone your age by more than 10 years), it indicates that your body has been under heavy strain and experiencing inflammation far exceeding your actual age. In such cases, supplementation is necessary, but only under a doctor’s prescription.
And what’s the other one?
Dr. Nataya: We need a trigger first, which is male hormones. Many people don’t know why women need male hormones, but they are very important. Male hormones are the trigger that makes us aroused, makes us want to have sex. Another hormone is Oxytocin, or the love hormone. This is a hormone similar to that of a mother and child, a bond. Between lovers, we also need this hormone.
Where does a woman find happiness?
Dr. Nataya: It’s called the Erotic Zone. We need to explore ourselves. Many people come to me saying they have three children and have never reached a climax in their lives. In medical terms, it’s called anorgasmia—they don’t know what it feels like to experience that climax. It’s actually a combination of causes. Medically, we can help with rehabilitation, focusing on physical aspects, such as checking if there are any problems with the nerve endings, or if they’ve atrophied significantly. But we can revitalize and rekindle those nerves.
Where are the female erotic zones located?
Dr. Nataya: It will be divided into Primary Zones and Secondary Zones. The Primary Zone, which everyone probably knows best through common sense, is the area called the O-Spot. This is the area that receives external sensations, our clitoris, which has a dense cluster of about 8,000 nerve endings. This is basic information that everyone knows about what happens during climax; there will be twitching every 3-5 minutes, and we can reach climax multiple times a day with each arousal. Actually, going through menopause doesn’t cause the O-Spot to disappear; it may just decline, like an internet signal slowing down slightly. It doesn’t disappear completely. If we stimulate it, like taking care of all parts of the body, we don’t want it to decline. We need to constantly stimulate microcirculation, meaning blood supply, collagen, and moisturizer to prevent it from atrophying.
If you’ve never had sex with anyone, never been stimulated?
Dr. Nataya: Anything that isn’t used will atrophy. This happens to all organs, not just the genitals. In fact, it’s natural for humans of all ages and genders to masturbate. They stimulate themselves, whether they’re single, virgins, or married women. It’s a natural thing that many people are hesitant to discuss openly. Gen X and Gen Y tend to be reluctant to talk about it, but Gen Z sees it as a natural, physical phenomenon, a fundamental part of life.
Have you ever had a patient who had never reached a climax come to you for consultation?
Dr. Nataya: There are many possibilities, so we need to do a basic checkup first, including specific physical assessments of the six systems. For the Sensation test, they’ll check if the clitoris is still twitching and its size. For example, we’ll measure the size of the clitoris to see if it’s within the standard range for the general population. Sometimes, sagging tissue can completely cover the clitoris. This doesn’t necessarily affect older people; it can happen at any age. The clitoris is covered by skin, but it’s only partially covered, not thickly. Therefore, it can reduce the sensitivity of the sensors, essentially obscuring them. We’ll measure this, for example, the skin needs to sag a little. Normally, 1.5 cm is enough. If it sags much more, like two or three times as much, the sensors will be completely blocked.
What is the minimum hormone level that women should have to be considered acceptable?
Dr. Nataya: There are many female hormones, and we need to focus on specific ones. For example, the most well-known is estrogen. Think of it like menopause. In your 20s and 30s, the normal estrogen level is around 150-250. If it’s over 300-400, you’ve overdosed. I’ve encountered patients in Japan, age 40, who weren’t using hormones at all. They had a diet high in phytoestrogens, and they ate natto (fermented soybeans) daily. When I checked their estrogen levels, they were 450! That’s called estrogen dominance, which is definitely not good. It leads to tumors and endometriosis. For those conditions, we always need to balance other hormones, such as progesterone. Many people focus solely on estrogen because it reduces the side effects of estrogen that’s too dominant.
What is the minimum age at which this occurs in older people?
Dr. Nataya: If we’re just using it for brain nourishment, around 20 is enough. But if we want to maximize benefits, we need 30-50. I think a dose of no more than 50 is best, because anything lower can lead to osteoporosis and dementia. My mother is over 60 and her level is at 0, so we have to give her the supplement. We give it to her with food and then monitor her for 3 months. We need to do more frequent tests and screen her before using it to be as safe as possible.
What can I eat as a substitute?
Dr. Nataya: Soybeans contain estrogen, but we need to specify which hormone we’re looking for. For example, with DHEA, we need to know how it’s produced. It’s produced from good cholesterol, HDL (High-Density Lipoprotein). If our levels are low, it’s impossible for it to be converted into DHEA in the adrenal glands.
What message would you like to give to women going through menopause who feel that they have lost their happiness in this area?
Dr. Nataya: Actually, I want to say that it’s a happiness we can control. We’ll have to live with the “golden age” for another half of our lives. For example, we want to live to 80 or 90, but we feel we have to accept this for another 40 years. Some people experience it early, as early as 40, and some develop emotional barriers, ceasing to communicate, separating rooms, creating an emotional gap. I want a quality life. We need to adjust first. It doesn’t even have to be about intercourse; just being able to share a room as before, like the senses—sight, taste, smell, sound, touch—as if we never adjusted to these things because we’ve been together for so long, almost half the time. Many couples who have been together for 10 or 20 years start from the daytime, dressing nicely and feeling confident.
We’re confident from midday onwards. The key is to find healthy foods that stimulate climax, like pomegranate seeds, which stimulate nitric oxide release for orgasm. Watermelon also helps. Aromatherapy is also important. As for sound, it’s not about playing music; I suggest changing it to positive conversation. Many people say they’ve been used to it for 10 years, but it takes time because it’s an art of patience. Reaching the climax during menopause is like a charcoal stove, not a gas stove that lights instantly. Once it’s lit, it burns deeply and lasts a long time. I want to emphasize that it should be a part of life, not something unnecessary, and that you don’t need a partner to reach it. Fundamentally, everyone, regardless of age or gender, can reach climax, provided we have the right knowledge and guidance. Masturbation isn’t immoral or forbidden. It’s like some people are afraid to explore themselves because they feel blocked. The mind is the most important factor. Even with physical help, if you block yourself at the prefrontal cortex, believing it’s wrong, you’ll never reach climax.
