In classic Cialis ads, middle-aged women are depicted smooching on windswept beaches, gazing seductively from bathtubs and otherwise looking ready for steamy sex the moment their husband pops a pill.

It's an unrealistic depiction of sexual desire for some postmenopausal women who, with half of their lives still ahead of them, may experience decreased libido, difficulty becoming aroused and pain during intercourse. After going through menopause, women may also experience difficulty orgasming, said Claudia Six, Ph.D., a clinical sexologist in the San Francisco Bay area.

"It's one of those secret side effects of menopause they don't tell you," she said.

"During menopause, women have more distress over the changes in their sex lives than any other time in their lives," added Caroline Colin, M.D., an obstetrics and gynecology specialist in Santa Monica, California.

While life after menopause might not be exactly like a spicy erectile dysfunction ad, it doesn't have to be a desolate sexual wasteland, either. Good sex—and good orgasms—is possible after menopause, but you may have to adjust your approach and expectations.