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    A Woman's Guide to Reviving Sex Drive

    By Paula Spencer Scott
    WebMD Feature

    Know that old song "Where Did Our Love Go"? Many women in their 40s, 50s, and 60s are asking, "Where did our sex go?"

    Loss of desire is common in the years before and after menopause. Desire problems peak around ages 35 to 64.

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    Why? It’s a time of life with a lot going on! Changing hormones can cause spontaneous desire --or craving sex out of the blue -- to plummet.

    “To blame it all on hormones is unfair, though,” says Stephanie Faubion, MD, director of the Mayo Clinic’s Women’s Health Clinic.

    What’s called receptive desire -- being turned on when your partner makes the first move -- keeps going. At least, it can if related issues in your body, mind, or relationship -- usually some mix -- don’t get in the way, Faubion says.

    The fix for sex drive issues: Tease out the complex causes and address them. 

    Sex-drive zapper: Pain, dryness and other hormonal issues

    Before menopause, your libido peaked just before and after you ovulated. But when your periods stop, those revved-up days in your cycle vanish. Less estrogen also means less blood flow to the vagina and more dryness. So when you do have sex, it hurts -- and who craves more of it when it feels like that?

    What helps:Start by removing pain. Try over-the-counter water- or silicone-based lubricants to reduce friction. Also, ask the doctor about vaginal moisturizers or low-dose vaginal estrogen in a cream, suppository, or ring. Hormone therapy (HT) doesn't seem to kindle desire for most women. But it can ease hot flashes, night sweats, and other symptoms that leave you feeling not-so-sexy. Regular sex can help promote blood flow and reduce dryness, too.

    The drug ospemifene is used to treat severe vaginal pain due to menopause, but it can cause hot flashes. The medication flibanserin is approved for premenopausal women who have hypoactive sexual desire disorder (loss of libido) with no other things affecting desire. “That’s a very small group of women,” says Faubion, who also wrote The Menopause Solution.

    Sex-drive zapper: Stress

    At midlife, many women are deep into a marriage, a job, raising teens, and caregiving. Any of these can amp up stress, and the tension puts sex drive in park. Avoiding sex because you're not feeling it can, in turn, make you get along less well. “Your relationship is key -- if you don’t like your partner, you won’t feel sexy,” Faubion says.

    What helps: Make plans for dates and lovemaking, even if you never had to do this before. Downplay the focus on sex and focus on just making time to be together, along with foreplay, massage, and oral. Consider getting short-term couples counseling when your sex life or relationship in general hits a rough patch.

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