How does menopause affect sex drive?

Dr. Jeanne Morrison, PhD
Family Practitioner

Menopause affects hormone levels, which may affect the sex drive of some women. Because menopause decreases the production of estrogen (which is often associated with levels of sexual desire), women may experience a loss of interest in sex. This decrease in estrogen may also lead to vaginal dryness, as well as hot flashes and night sweats, which can make sex less pleasurable for many women. Other issues that may come up at menopause, including sleep problems, depression, new health issues and medications, and stress, may also affect libido.

Some women experience an increase in their libido after menopause, while others report a decrease in sexual desire and satisfaction. For some women, this decrease in libido is due to physical symptoms that make sexual intercourse uncomfortable.

Loss of estrogen leads to vaginal dryness and a thinning and loss of tone in the vaginal walls. This can lead to painful sexual intercourse or bleeding. Estrogen replenishment by oral medication, possibly by dietary change, and by applying vaginal estrogen and moisturizers can eliminate painful intercourse and restore a more satisfying sex life for most women who experience problems.

Dr. Madeleine M. Castellanos, MD
Psychiatrist (Therapist)

Most of us are aware of the steep drop of estrogen and progesterone that mark the beginning of menopause, the permanent end of a woman's menstrual cycle. In addition to symptoms like hot flashes, sleep disturbances, and mood swings, this decrease can cause delicate vaginal tissues to become thinner and drier, which can make intercourse uncomfortable. Although that can send libido plummeting in some women, others may find that the freedom that comes with knowing they can't get pregnant sends their desire through the roof.

What you may not know is that men can also experience a decline in sex hormones (in this case, testosterone). This so-called male menopause is more subtle than female menopause, but it can carry its own sexual side effects. Although some men are not bothered by low testosterone, many men with lower levels of testosterone find that their libido, too, has gone south. That's because testosterone is truly the hormone that stokes the flames of desire.

As you age, everything takes a little longer, takes a little more effort and is sometimes just little bit more difficult to execute. But people don't extend that same compassion to their sex life. They'll appreciate that it takes a little bit longer to walk a mile, but they expect their sex life—and their sex drive—to be the same as when they were 18 years old. And I look at them and say, "What in your life or your body or in your brain is like it was when you were 18?" I look at it in terms of expectations. You have to moderate your expectations as you age.

Dr. Elizabeth A. Poynor, MD
Gynecologic Oncologist

Anxiety, mood changes, self-image issues and physical issues, such as vaginal dryness, can all affect a woman's sex drive as she goes through menopause. In this video, Elizabeth Poynor, MD, PhD, a gynecologist-oncologist in New York City, explains.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.