Prioritise pleasure: Why masturbation is a self-care must in surgical menopause
After surgical menopause, conversations about sexual health often focus on what’s been lost: desire, comfort, spontaneity, confidence. What’s discussed far less is what can actively support genital and pelvic health, regardless of whether you’re partnered, having sex, or feeling sexual at all.
Masturbation is one of those supports.
This isn’t about performance, fantasy, or pressure to feel desire. It’s about circulation, tissue health, nerve signalling, and pelvic function. In other words, masturbation after surgery can be a form of self-care and maintenance, not just a sexual act.
The physiological role of arousal
Sexual arousal triggers increased blood flow to the vulva, vagina, clitoris, and pelvic tissues. That blood flow delivers oxygen and nutrients, supports tissue elasticity, and helps maintain nerve sensitivity.
After ovary removal, reduced oestrogen means tissues can become thinner, drier, and less resilient over time. Reduced blood flow accelerates that process. Without regular stimulation, tissues may become less responsive, more fragile, and more prone to discomfort.
Masturbation gently encourages circulation without the pressure or complexity of partnered sex.
Supporting vulval and vaginal tissue health
Regular genital stimulation helps maintain:
blood flow to vulval and vaginal tissues
elasticity and suppleness
nerve responsiveness and sensation
natural lubrication response
This is particularly relevant for women experiencing vaginal atrophy or early GSM symptoms. Masturbation does not replace treatments like vaginal moisturisers or local oestrogen, but it can work alongside them, helping tissues respond more effectively.
Importantly, stimulation does not need to involve penetration. External touch alone can support blood flow and nerve signalling.
The clitoris and nerve health
The clitoris is a highly vascular, nerve-dense structure. Reduced stimulation over time can contribute to reduced sensitivity and responsiveness, especially when hormone levels are low.
Masturbation helps keep neural pathways active. This can preserve sensation and make future intimacy — partnered or solo — more comfortable and pleasurable.
Loss of sensation is not inevitable, but inactivity can contribute to it.
Pelvic floor function and awareness
Pelvic floor muscles are influenced by arousal and orgasm. Gentle stimulation can increase awareness of pelvic sensations and encourage natural muscle engagement and release.
For some women, especially those who’ve experienced pain, guarding, or pelvic floor tension after surgery, masturbation can help reconnect mind and body in a non-threatening way. It allows exploration without pressure, helping muscles relax rather than brace.
This can complement pelvic health physiotherapy and support long-term pelvic comfort.
When desire is low or absent
Many women worry that masturbation “should” involve desire. After surgical menopause, desire may be absent for long periods, or may never return in the same way.
That does not make masturbation pointless.
Think of it as physiological care rather than sexual motivation. You don’t need to feel turned on to support circulation or tissue health. Curiosity, neutrality, or even mild detachment are all valid starting points.
Pleasure may or may not emerge. Both outcomes are fine.
Reducing fear and rebuilding trust
After pain, dryness, or difficult sexual experiences, fear often becomes associated with genital touch. Masturbation can help rebuild trust gradually, on your terms, without needing to perform or meet anyone else’s expectations.
You control pace, pressure, and duration. You can stop at any point. That sense of agency is powerful, particularly after surgery where bodily control may have felt compromised.
Practical considerations
Comfort matters. Using a vaginal moisturiser regularly, and a lubricant during stimulation if needed, can make touch more comfortable and protective. Gentle touch is enough — more pressure is not better.
Some women find vibrators helpful for increasing blood flow with minimal effort. Others prefer manual touch. There’s no right approach.
If stimulation causes pain, burning, or distress, that’s a signal to pause and seek support. Masturbation should feel supportive, not something to push through.
A quiet but important form of care
Masturbation after surgical menopause is rarely talked about, yet it plays a meaningful role in maintaining genital and pelvic health. It supports tissues, nerves, circulation, and confidence — whether or not partnered sex is part of your life.
This is not about obligation. It’s about choice, information, and giving yourself permission to care for your body in ways that are often overlooked.
SURGE Suggestions
Think of masturbation as tissue and nerve care, not performance
External stimulation alone can support blood flow and sensation
Use vaginal moisturisers regularly and lubricant if needed
Go gently and follow comfort, not expectation
Don’t wait for desire — curiosity is enough
Stop if touch is painful and seek support
Remember: this is about health, agency, and self-connection
