Menopause Health Center

Sex and Menopause

How Does Menopause Affect Sex Drive?

The loss of estrogen and testosterone following menopause can lead to changes in a woman's sexual drive and functioning. Menopausal and postmenopausal women may notice that they are not as easily aroused, and may be less sensitive to touching and stroking -- which can result in decreased interest in sex.

In addition, lower levels of estrogen can cause a decrease in blood supply to the vagina. This decreased blood flow can affect vaginal lubrication, causing the vagina to be too dry for comfortable intercourse.

A lower estrogen level is not the only culprit behind a decreased libido; there are numerous other factors that may influence a woman's interest in sexual activity during menopause and after. These include:

• Bladder control problems
• Sleep disturbances
• Depression or anxiety
• Stress
• Medications
• Health concerns

Does Menopause Lower Sex Drive in all Women?

No. In fact, some postmenopausal women report an increase in sex drive. This may be due to decreased anxiety associated with a fear of pregnancy. In addition, many postmenopausal women often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

What Can I Do to Treat Vaginal Dryness During Menopause?

During and after menopause, vaginal dryness can be treated with water-soluble lubricants such as Astroglide or K-Y Jelly. 

Do not use non-water soluble lubricants such as Vaseline, because they can weaken latex (the material used to make condoms, which should continue to be used until your doctor verifies you are no longer ovulating and to prevent contracting sexually transmitted diseases). Non-water soluble lubricants can also provide a medium for bacterial growth, particularly in a person whose immune system has been weakened by chemotherapy. 

Vaginal moisturizers like Replens and Luvena can also be used on a more regular basis to maintain moisture in the vagina. You can also talk to your doctor about vaginal estrogen therapy. 

A oral drug taken once a day, Osphena, makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex. The FDA warns that Osphena can thicken the endometrium (the lining of the uterus) and raise the risk of stroke and blood clots.   

How Can I Improve My Sex Drive During and After Menopause?

Estrogen replacement may work, but research has yielded conflicting results regarding its effectiveness. Estrogen can, however, make intercourse less painful by treating vaginal dryness.

Doctors are also studying whether a combination of estrogen and male hormones called androgens may be helpful in increasing sex drive in women.

Although sexual problems can be difficult to discuss, talk to your doctor; there are options to consider, such as counseling. Your doctor may refer you and your partner to a health professional who specializes in sexual dysfunction. The therapist may advise sexual counseling on an individual basis, with your partner or in a support group. This type of counseling can be very successful, even when it is done on a short-term basis.