As men and women age, sexual desire typically declines, but women are two to three times more likely to experience sexual decline than men. When the hormone levels of estrogen in women and testosterone in men drop, sexual pleasure and intimacy become challenging due to a decline in sexual function. After menopause, the physical changes that occur in the vagina, such as less elasticity, lubrication, tissue atrophy and reduced acidity, may make sex more difficult. A lack of desire for sex might also be due to the variety of menopausal symptoms we experience—hot flashes, night sweats, mood swings, irregular bleeding, sleep problems and insomnia.
However, sexual desire is also influenced by non-hormonal factors, such as the level of satisfaction in the relationship with your partner. The most important way to help your libido is to stay sexually active. Women can help maintain vaginal health through regular sexual activity, which promotes blood flow to the genital area. You can continue to enjoy sex from perimenopause through postmenopause, although you may need to explore treatments to navigate any sexual discomfort.
Hormone therapy can help treat some of the sexual symptoms that may come with menopause—especially the vaginal dryness or atrophy. Here are some of the options available:
- Oral hormone therapy
- Estrogen patch
- Hormonal creams, gels and lubricants
- Vaginal estrogen therapy in ring or tablet form
In 2013, the FDA approved the drug ospemifene for postmenopausal women experiencing discomfort or pain during sexual intercourse. This pill, taken once a day, can help make vaginal tissue thicker and less fragile. Side effects and risks of this drug, including stroke, should be discussed with your OB/GYN or healthcare professional.
Other methods to treat sexual discomfort due to menopause include:
- Physical therapy for pelvic discomfort
- Kegal exercises
- Vaginal dilators
- Yoga
- Over-the-counter water-soluble vaginal lubricants (Astroglide, Silk-E, Moist Again)
- Over-the-counter vaginal moisturizers (Replens, K-Y long-lasting vaginal moisturizer)
Be sure to talk with your OB/GYN or healthcare provider about the many treatment options available to keep sex a priority in your life. For a comprehensive list of detailed treatments for sexual problems, click here
