Why does a woman's sex drive decrease after menopause?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

Menopause, or the change in life ending your fertility, produces a variety of changes that can lower your sexual energy. During menopause, your estrogen level drops. The decreased estrogen can cause sadness, fatigue and other emotional problems that dampen your sex drive. Physical changes, including breast sensitivity and vaginal dryness, make it even more challenging to maintain your sexual energy.

Each woman experiences the changes in sexuality that occur with menopause differently. While many women become less interested in sex after menopause, others find they enjoy intimacy more because they no longer have to use birth control. If menopause-related physical changes, such as vaginal dryness or thinning, are making sex uncomfortable and less pleasurable, your doctor can suggest treatments that will help.

Dr. Bonnie Lynn Wright, PhD
Geriatrics Nursing Specialist

There are some sexual changes you may need to learn to manage:

  • Reduced sexual desire and prolonged response time due to hormone level changes
  • Tissue dryness that may increase discomfort during intercourse
  • Symptoms such as hot flashes that may occur at the most inconvenient times
  • Grieving for the loss of womanhood or your self-image as a fertile woman

Generally, whatever your sex life was like before menopause should return when your symptoms are over or managed. Life may change but it still goes on.

Menopause does not mean your sex life is over. A survey found that most people between the ages of 57 and 85 consider intimacy a vital part of their life. Still, midlife changes can pose new challenges. Menopause is the end of menstrual periods. Physical changes can also hamper the urge to get frisky. Lower levels of estrogen can cause vaginal walls to become dry, thin, and fragile, and sex may become less comfortable. Known as genitourinary syndrome of menopause, the condition affects around half of women. The good news is, postmenopausal women said factors such as stress or relationship issues had a bigger impact on their sex lives than biological changes, such as decreased hormone levels.

Sexual changes during menopause can lead to problems for many women. Before you throw up your hands in despair (or throw out your lacy lingerie), here are some ideas worth considering:

1. Physical therapy for pelvic discomfort.

2. Kegel exercises.

3. Regular sexual activity, which promotes vaginal health and blood flow. To make it easier, you may want to consider:

  • vaginal dilators
  • over-the-counter vaginal lubricants (for temporary relief of dryness before and during sex)
  • over-the-counter vaginal moisturizers (for longer-term relief from dryness)
  • low-dose vaginal estrogen therapy in cream, ring or vaginal tablet form (reverses underlying atrophy and dryness)
  • higher-dose hormone therapy throughout the body via pills, patches and other preparations (reverses underlying atrophy and dryness, but generally reserved for women with bothersome hot flashes)

4. Laser therapy. A non-hormonal therapy, the MonaLisa Touch uses a fractional carbon dioxide (CO2) laser to help restore vaginal health in postmenopausal women. It works by delivering controlled energy to the vaginal tissue to make more collagen (which is an essential ingredient in vaginal cell health).

5. Ospemifene (Osphena). This drug was approved by the Food and Drug Administration in 2013 for postmenopausal women who experience pain or discomfort during sexual intercourse. The once-a-day pill, which works by acting like estrogen in some parts of the body, helps make vaginal tissue thicker and less fragile.

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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.