As you go through menopause, you might notice that your libido, or sex drive, is changing. Some women may experience an increase in libido, while others experience a decrease. Not all women go through this libido decrease, though it is very common. In most cases, a lower libido during menopause is due to decreased hormone levels.
These decreased hormone levels can lead to vaginal dryness and tightness, which can cause pain during sex. Menopause symptoms can also make you less interested in sex. These symptoms include:
If you’re experiencing a loss of libido, you can try to increase your sex drive with lifestyle changes or sex aids, such as lubricants. If at-home remedies don’t help, your doctor can help you find the right treatment.
Menopause can negatively affect libido in several ways. During menopause, your testosterone and estrogen levels both decrease, which may make it more difficult for you to get aroused.
A decrease in estrogen can also lead to vaginal dryness. Lower levels of estrogen lead to a drop in blood supply in the vagina, which can then negatively affect vaginal lubrication. It can also lead to thinning of the vaginal wall, known as vaginal atrophy. Vaginal dryness and atrophy often lead to discomfort during sex.
Other physical changes during menopause might also affect your libido. For example, many women gain weight during menopause, and discomfort with your new body can decrease your desire for sex. Hot flashes and night sweats are also common symptoms. These symptoms can leave you feeling too tired for sex. Other symptoms include mood symptoms, such as depression and irritability, which can turn you off from sex.
If you’re going through menopause and noticing changes in your libido, your doctor can help determine the underlying cause of those changes. That can help them suggest treatments, including:
- home remedies
- over-the-counter (OTC) medications
- prescription medications
Depending on why your sex drive has decreased, your doctor might refer you to another professional for help. For example, they might recommend a sex therapist if there’s no physical cause for your decreased libido, or marital counseling if you and your partner want help improving your relationship.
Tips for talking with your doctor
Talking about sex with your doctor might make you uncomfortable, but remember that it’s their job to take care of all aspects of your health and well-being without judgment. If you’re uncomfortable with this topic, here are some tips to help:
- Bring notes. Be specific about what your concerns are. It will help your doctor if you have notes on your symptoms, including what makes them better or worse, and how you feel when they occur.
- Write down questions to bring with you to your appointment. Once you’re in the exam room, it might be hard to remember everything you wanted to ask. Writing down questions beforehand will help make sure you get all the information you need and help guide the conversation.
- Know what your doctor might ask. While every situation is different, understanding what your doctor might ask can help calm your nerves. They will probably ask how long your symptoms have been going on, how much pain or distress they cause you, what treatments you’ve tried, and if your interest in sex has changed.
- Tell the nurse. You’ll usually see a nurse before the doctor. If you tell the nurse that you want to talk to the doctor about sexual issues, the nurse can let the doctor know. Then they can bring it up with you, which may be more comfortable than bringing it up yourself.
There are many ways to treat libido changes due to menopause.
Hormone replacement therapy (HRT)
One way is to treat the underlying hormone changes with hormone therapy (HRT). Estrogen pills can help reduce vaginal dryness and vaginal atrophy by replacing the hormones your body is no longer making. There are potential serious risks of estrogen therapy, including blood clots, heart attacks, and breast cancer. If you only have vaginal symptoms, an estrogen cream or vaginal ring might be a better choice for you.
There is also some evidence that moderate doses of testosterone can help women going through menopause increase their libido. Testosterone therapy also has potential negative side effects, including a risk for higher cholesterol and increased hair growth and acne.
A lubricant such as K-Y Jelly or Astroglide can ease vaginal dryness and help make sex more comfortable. That may help increase your libido if pain or discomfort during intercourse is affecting your libido.
Exercise not only helps combat weight gain, but can also improve your mood. That’s because exercise releases endorphins, which can reduce stress and trigger positive emotions.
If you’re new to exercise or haven’t exercised in a while, start slow and work toward exercising for at least 30 minutes a day. At first, that may mean exercising for 10 minutes a day until you build up your endurance.
You may also want to consider trying an activity that you’ve always been interested in but haven’t tried before. The point is to do something that you enjoy so that exercise doesn’t feel like work.
Communicate with your partner
Loss of libido during menopause is often due to physical symptoms, but feeling more connected to your partner might also help you get in the mood for sex. Keep lines of communication open and be honest about your relationship and what you’re going through, both physically and mentally.
Focus on intimacy
Sex is not the only way to feel close to your partner. Kissing, caressing, and other nonsexual acts of intimacy can actually help boost your sex drive by creating a bond between you and your partner.
Kegel exercises can help tighten your pelvic muscles and enhance sensations during sex. To perform this exercise, you’ll first need to locate the correct muscles. The easiest way to do this is to stop peeing midstream. The muscles you activate are your pelvic floor muscles.
To do Kegels:
- Contract your pelvic floor muscles and hold the contraction for five seconds. Then slowly release for five seconds.
- Work up to repeating this move 10 times, 3 times a day.
Therapy, both alone and with your partner, can help you manage some of the mood symptoms of menopause and understand how to manage a decreased libido.
A loss of libido during menopause is generally due to decreased hormone levels. During and after menopause, hormone production falls to very low levels. This means that some symptoms, such as vaginal dryness, probably won’t improve without treatment. Other symptoms that lead to loss of libido, such as night sweats, do eventually go away for most women. There are treatments that can help most causes of a decreased sex drive during menopause.