As you go through menopause, you might notice your libido, or sexual desire, changes. Some people may experience a libido increase or decrease. These changes may be temporary or long lasting, but you can do several things to help.

Menopause is a gradual process. It generally takes about 7 years from beginning to end but may last up to 14 years.

The time leading up to menopause is called perimenopause. This is when your hormone levels change, and your periods become more irregular. Perimenopause usually begins in your 40s.

Menopause occurs when at least 12 months pass since your last menstrual period. During this time, your body stops producing the hormones that cause menstruation.

People in the United States may experience natural menopause at around 51 years old. The time after menopause is known as postmenopause. Your decreased hormone levels usually stabilize to their new norm.

Your ovaries begin producing fewer sex hormones during perimenopause. Your estrogen levels change unpredictably, and your progesterone levels steadily decline.

Your adrenal glands and ovaries continue producing testosterone during this time. However, it’s important to understand that these levels also decrease. The decreasing levels are a natural result of aging and unrelated to menopause.

These hormonal changes can contribute to various mental, physical, and emotional changes that affect:

  • libido, which is your baseline desire for sexual activity
  • arousal, which is your body’s physical response to sexual stimuli
  • pleasure, which is your measure of enjoyment or satisfaction


For many people, perimenopause and menopause result in a lower libido. A 2019 research review found that sexual function may noticeably decline 20 months before your last menstrual period.

But for others, decreased estrogen and progesterone levels can make the effects of testosterone more apparent. This can have the opposite effect, leading to an increased libido.


Hormonal changes can affect more than your libido — they can also have a visible effect on your genitals.

Sexual arousal typically involves:

  • increased blood flow to your genitals
  • an enlarged or erect clitoris or penis
  • vaginal canal wetness
  • ejaculate from a penis’ tip

Hormone changes can interfere with this process. Lower estrogen levels, for example, can cause reduced blood flow to your genitals. The reduced blood flow can negatively affect your ability to become aroused.

It can also hinder your body’s ability to produce natural lubrication. Vulvovaginal tissue may become thinner, less elastic, and ultimately more fragile.


If you don’t enjoy having sex, you may not want to do it again. The same can occur for sex or masturbation that causes pain or discomfort.

Vaginal dryness and tightness can cause burning, itching, and irritation that may intensify with manual stimulation or penetration. You may be more likely to get accidental cuts and tears, increasing the risk of infection.

You may have less interest in sexual activity due to other symptoms or bodily changes.

Perimenopause and menopause can cause:

Some symptoms may make you feel too tired for sex:

Some symptoms may turn you off from sex entirely:

Other underlying conditions may worsen genital symptoms:

Still, some people find that they feel more confident and in control of their sexuality during this life stage.

You may find a newfound appreciation for certain activities or more freedom to explore once pregnancy is no longer possible.

It’s important to honor your feelings and move forward in a way that’s comfortable for you. Try to be open and honest with your partner about what you’re going through physically and mentally.

It may be nerve-wracking to start the conversation, but talking about it generally becomes easier with time. You may find that these conversations make you feel closer and more connected, strengthening your relationship.

Here are some ways to bring it up:

  • “I’ve been researching how menopause can affect libido, and I think it’s important for us to have an open conversation about it. Can we talk about how you’re feeling and how we can support each other through this phase?”
  • “Lately, I’ve been experiencing pain during sex, and I believe it’s connected to menopause. It’s been difficult for me, and I want to be honest with you about it. Let’s talk about how we can adapt our intimacy to ensure it’s pleasurable and pain-free for both of us.”
  • “I’ve been feeling tired more than usual lately, and it’s affecting my desire for intimacy. I want to talk about how we can adjust our routines and expectations to accommodate these changes so that we can still prioritize our relationship and intimacy despite the fatigue.”

Your sex life may change during this transition period, but that doesn’t mean it’s over.

You have the power to shape your sex life into whatever you want it to be — whether that looks like taking a step back from physical intimacy, exploring a solo pleasure practice, or reconnecting with a partner.

Here are a few things you can try out at home.

Temperature control

Keep the room cool with a fan or air conditioning, and have extra blankets nearby in case one partner gets cold.

Avoid heavy blankets or comforters that may trap heat and worsen hot flashes. Instead, opt for lightweight bed linens made out of breathable materials.

Investing in a moisture-wicking mattress protector or cooling mattress topper can help regulate body temperature during sleep.

Vaginal lubricant

You can apply lubricants just before or during sexual activity. They provide short-term relief from vaginal dryness and related pain.

Water-based lubes are generally safe to use with condoms and sex toys. They have a slippery texture that closely mimics vaginal wetness.

Silicone-based lubes last longer than water-based lubes, so you won’t have to reapply as often. They’re safe to use with condoms but are incompatible with silicone sex toys.

Although oil-based lubes provide excellent lubrication, they’re incompatible with latex condoms. The oil will break down the latex, increasing the risk of sexually transmitted infections and unintended pregnancy.

Vaginal moisturizer

If you have dryness and don’t already use a vaginal moisturizer, this is your cue to add one to your routine.

Vaginal moisturizers aren’t for sexual activity. You can apply them anytime, and manufacturers design them for consistent, long-term symptom management.

Pelvic floor exercises

Strengthening your pelvic floor muscles can help with bladder and bowel control.

Kegels are a popular type of pelvic floor exercise. You may benefit from Kegels if you have a weak or hypotonic pelvic floor, but it’s important to consult with a doctor to get the OK first.

Lower body exercises like squats, lunges, and certain yoga postures may offer a more straightforward approach to at-home pelvic floor training.

Broaching the topic of sex with your doctor might feel awkward at first, but it’s important to remember that they’re there to address all aspects of your health and well-being without judgment.

You might find it helpful to:

  • Bring notes: Get specific about your concerns. List your symptoms, including what seems to make them better or worse.
  • Prepare questions: It’s easy to forget things in the exam room. Drafting a list of questions in advance can help you guide the conversation more effectively and ensure you can address all your concerns.
  • Anticipate their questions: Understanding what your healthcare professional might ask can help soothe your nerves. Be prepared to discuss when symptoms began, their severity, and anything you tried to find relief.

Your doctor can also discuss the potential benefits and risks of using hormone therapy during perimenopause or menopause.

They may prescribe low dose estrogen to help manage vaginal and urinary symptoms. It’s available as a tablet, ring, gel, or cream that you insert into your vaginal canal.

Your healthcare professional may recommend systemic hormone therapy if you have full-body symptoms.

Your hormone levels begin changing as you approach menopause. It generally takes several years for your hormone levels to stabilize and your menstrual periods to stop.

Although some symptoms may fade, most require medical treatment to maintain your quality of life. Make an appointment with a doctor if your symptoms cause distress or interfere with your daily activities.

Tess Catlett is a sex and relationships editor at Healthline, covering all things sticky, scary, and sweet. Find her unpacking her inherited trauma and crying over Harry Styles on Twitter.