Menopause and Sex

Menopause and Sex

Experts say there's no physiological reason for a drop in sex drive. Find out why -- and learn how to reclaim your sexiest self.

News flash. Remember the umpteen stories you've read about how women's sex drive goes into reverse once she enters her perimenopause years (typically, at some point in her 40s)—until it comes to a screeching halt? Not true, experts say. In fact, for some women, libido goes into overdrive, and lucky is the man who has a partner like this—​if, that is, he's up to it. "There is nothing about the menopausal transition per se that lowers sex drive," says Christiane Northrup, ob-gyn and author of The Wisdom of Menopause. "Depending on where the relationship is, it can suddenly wane or not change at all."

While there are hormonal fluctuations at menopause, they don't directly impact a woman's libido. "Progesterone, which has a calming effect, begins to drop first," Northrup says. It's progesterone that lets you psychologically shove it all under the rug—the frustrations, the feelings of being overworked and overwhelmed, being pulled in every direction. "But at around age 45 your hormones have changed and your soul is waking up and saying, what about me?" Northrup says. "Your needs come to the fore and women want fulfillment, they want sex to be different." That is, different in the sense that it's more satisfying.

"Menopausal women who don't figure out how to get their needs met drop into oblivion sexually," says Gina Ogden, PhD, LMFT, sex therapist, researcher, and author of The Return of Desire. "They're the ones who end up with low libido and not interested, and getting fat and grumpy. Women who do figure out another way, they go into orbit in some interesting ways."

Another factor that affects a woman's libido is what's going on in her head. "Women have been taught that the end of physical fertility is also the end of their desirability," Northrup says. "This mindset is the problem, not what the body is doing. Women have as much erotic erectile tissue as men, but it's all inside."

Northrup and Ogden agree that there's also something of a spiritual awakening taking place around the time of menopause. "We gain wisdom and perspective, so that while progesterone is dropping and we aren't self-soothing automatically, we're seeing more and wanting more, and understanding that it's now or never," Ogden says.

Instead of "shriveling up," after menopause a woman is at a point in her life when she can, if she lets herself, bloom in a way as never before. It starts with how she feels about herself. "Research has shown that the biggest predictor of good sex over the long term is self-esteem," Ogden says.

Here are a few ways to recharge your sexuality during this exciting (in every sense of the word) and liberating time of your life:

  • Become familiar with your body and what gives you pleasure. "Most women have had a less than satisfying sex life over the span of their lives," Northrup says. "From 18 to 65, women have not learned what they need sexually, they don't know their own anatomy," she says. "You need to become the new partner for yourself, to put yourself first."
  • Discover your hidden erogenous zones. "A woman has sensory receptor sites for erotic stimulation all over her body," Northrup says. "She needs 10 nonsexual touches a day to want sexual intimacy." It could be a long hug, your partner spontaneously coming up behind you and running his fingers through your hair, just taking your hand, or sending an alluring text in the middle of the day saying something like he's thinking of you and how pretty you are. "Discovering what these things are and communicating them to your partner will set you up for a night of great sex," Northrup says. The bottom line? Women crave attention more than anything, so learn how to ask for it.
  • Sometimes activity has to precede desire. "This is news to a lot of women," Ogden says. "Start having sex and then the desire comes. It's managing your change. It's creating a new normal."
  • Get some sleep. "Many women arrive at perimenopause exhausted," Northrup says. "They won't have a sex drive until they've replenished their batteries."
  • Be playful and inventive. Try sex toys or reading erotica to get your juices flowing. The 50 Shades of Grey trilogy is enormously popular with women because it allows them to experiment sexually through the lives of the characters. Some women are taking the lessons home. One New York City hardware store owner notes that a certain type of rope—the kind that loosens easily—has become an unexpected bestseller in his store.
  • Get a lubricant for dryness. "There are lubricants used just for intercourse," says Margery Gass, MD, executive director of the North American Menopause Society. "Vaginal moisturizers like Replens, Luvena, Me Again, and others like it can provide longer-lasting moisture." These creams do the same thing that they'd do for the rest of your skin: reduce dryness. "If you've tried a moisturizer and a lubricant and you still have dryness, a vaginal estrogen at a very low dose can often remedy the problem," Gass says. "It's an efficient way to use it since a very tiny amount is absorbed into the body. If a woman has had breast cancer, that's another issue. Talk to your doctor to see if it's right for you."
  • Don't be too rigorous when you wash. "You can use soap on your hair and groin area, but not the inner area of your vagina," Gass says. "Chemicals can be irritating and lead to more dryness."

Medically reviewed in November 2018.

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