Low Sex Drive? Here's a Menopause Makeover

Medically Reviewed by Traci C. Johnson, MD on May 19, 2016
3 min read

You can feel just as sexy after menopause as you did in the decades before. You can have great sex, too. If your sex drive slows, think of it as a speed bump, not a stop sign. Here's a roadmap.

Low sex drive may be the No. 1 sex complaint among midlife women. Though not all women feel it, it's normal if you do.

Don't be shy about sex talk now. Start with a frank doctor visit.

"The causes of low desire in women can be very complex," says Mary Rosser, MD, PhD, an OB/GYN at Montefiore Medical Center in New York. One or more of these issues could be to blame:

  • Age. Out of sync with him? Women are two to three times more likely than men to see desire dip with age. You can feel the effects of menopause 10 years or more before your periods end.
  • Hormone effects. Falling estrogen around the time of menopause drags down desire. Hot flashes, night sweats, and vaginal dryness can also crash sleep, mood -- and romance. If chemotherapy or having your ovaries removed thrusts you into menopause, you may have a harder time. It can cause more intense symptoms than the slower process of natural menopause.
  • Partner problems. Marriage trouble may have put your sex drive in park -- not hormones.
  • Other health troubles. Being depressed can be a leading sex-killer. Others include anxiety, bladder control trouble, chronic illness, and medications.
  • Life stress. "I can’t tell you how many women I see are just too busy with work and home life to be sexy human beings," Rosser says.

It would be nice if you could pop a Viagra, like men, to pump up your sex drive. But male desire centers on blood flow. In women, it's more complex. What can help:

  • Lubricate. Thinning vaginal tissue causes painful sex and can lead to urinary tract infections. Both can make you avoid sex. Products like KY Jelly and Astroglide add moisture. Shy about buying? Order them online. Or ask your doctor about a medication that makes sex less painful.
  • Try hormones. Your doctor can prescribe estrogen (in a cream, ring, or tablet) to apply in your vagina. This thickens the tissue and helps make sex feel better. If you also have symptoms like hot flashes, an estrogen patch or pills can ease them and may boost desire.
  • Try changing medicines. Some drugs for blood pressure and depression can nuke your sex drive. Ask your doctor about taking a break from a problem drug or switching to one with less sexual side effects.

You may need a mental makeover. Tweaking your approach to sex can make a big difference:

  • Put your pleasure first. If you focus on yourself during sex, you can set the right tempo for you. One study found that older women who were least likely to take the lead about when and how to have sex had the most unhappy partners.
  • Make time for each other. Your instinct may be to avoid romance when you don't feel in the mood. Yet date nights and mini-trips can say "this is key to me" and help reset desire.
  • Bring back foreplay. Your clitoris takes longer to respond with age. Give ample time to cuddle, kiss, or stroke. Just start fooling around, without climax as the goal.
  • Stoke sex organ No. 1, your brain. New things turn us on. Try changing places, positions, toys, and roles. Having more sex makes you want more sex.

Things that happen out of your bed can affect what goes on in it. Try these tips:

  • Talk. Make sure your partner gets that your chill isn't due to how you feel about him, if it's not. He might be confused and feel rejected. Discuss how to make sex better. "Talk about what helps, what you like," says Elizabeth G. Stewart, MD, a gynecologist and author of The V Book.
  • Look in your mirror. Maybe it's your self-image that needs a boost. Lose weight if you need to, or take a fitness class -- steps like these can help you see the great things about your body. Feeling sexy is rooted in feeling good.
  • Reach out. Are you bummed by a new empty nest or feeling "old"? Are you and your partner stuck? Talking to a counselor can shed light on how to power forward.

Show Sources


American Society for Reproductive Medicine: "Current Perspectives on Testosterone Therapy for Women."

Cleveland Clinic: "Sex and Menopause."

National Women's Health Network: "Strategies for Staying Sexual After Menopause."

North American Menopause Society: "Causes of Sexual Problems," "Decreased Desire," "Decreased Response and Pleasure," "Keeping Sex Fresh and Special," "Sexual Problems at Midlife."

Leveque, H. The Canadian Journal of Human Sexuality, Dec. 22, 2012.

Mary Rosser, MD, PhD, obstetrician-gynecologist, Montefiore Medical Center, New York.

Elizabeth G. Stewart, MD, gynecologist, associate professor, Harvard Medical School, Boston, Mass.; author, The V Book: A Doctor's Guide to Complete Vulvovaginal Health.

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