Menopause & Sex : Problems, Causes & Solutions

Menopause and sexual problems

For women experiencing perimenopause and menopause, there are often many dramatic changes happening at the same time.  Some of the well-known symptoms include hot flashes, irritability, weight gain, and insomnia.  However, there are very real and important sexual changes that often go undiscussed.  This silence can lead to many long-lasting and unnecessary issues for women and their relationships and was one of the main reasons I created Rosy

While the age of menopause can vary greatly, the average age is 51.  The technical definition of menopause is the lack of a period for 12 months.  Perimenopause may start several years before you actually stop having a cycle, and can have many of the same effects.  When our hormones start swinging widely and then eventually fall dramatically, it affects how we feel about ourselves, how we interact with our partners, how we look and feel, and how our bodies function and react sexually.  However, these are not changes that have to define us.  Women who are 40, 50, 60, 70, 80, even 90 deserve full and fulfilling sexual lives.  Here are some general ideas to help you navigate these changes successfully: 

It Takes Two

In our late 40s and 50s, our male partners may start to experience sexual dysfunction, such as erectile dysfunction, premature ejaculation or diminished erection. These issues are extremely common, affecting up to 50% of men in their 50s!  It’s important that your partner knows they can find help through a urologist, websites like Hims and Roman, or a sex therapist.

Coming and Going 

Other life stressors that may come your way during these times (as if we didn’t have enough!) are children leaving the home and/or the complicated and tiring issues that come with aging parents. These major life changes can be difficult because they take a toll on our sense of identity and independence. It is important to recognize that these changes outside your sex life could actually be affecting your sexual function. Confronting these changes head-on through open communication, clear boundaries, and therapy (if needed) can be extremely beneficial to you and your sexual relationship. 

Physical Changes 

The hormonal changes of menopause can have real and intense effects on our bodies, and our sexual function.  It’s common to experience depression, agitation, anxiety and insomnia.  These symptoms don’t feel good at all, and often result in a decreased interest in sex. Some other common sexual problems that arise during menopause include decreased sexual desire, vaginal dryness, and trouble with arousal and orgasm.

Sexual desire is multifaceted and complex.  It involves how we feel about ourselves, how we feel about our partner, and how we are feeling IN our own bodies.  This may feel overwhelming, but there are some quick fixes that you can try to get started.  Exercise has long been recommended to reduce hot flashes, but did you know that 20 minutes of cardiovascular exercise can improve sexual desire as well?  Also, there is an over the counter supplement, L- arginine, that has been shown in several studies to increase desire.  If bothersome low desire persists, make an appointment with your physician to discuss some other medical options that are available as well.

Ways to improve sex drive after menopause

As estrogen declines, the tissues of the vulva and vagina get thinner and less lubricated during arousal and sex.  This is EXTREMELY common and usually very easy to handle.  First, it’s important to try a vaginal moisturizer for general comfort and or a lubricant for sex.  These can help dramatically, and will give most women the relief and pleasure they are looking for.  Some women may also need vaginal hormones or other treatments, and it’s important to discuss with your provider if you are not finding the relief you need and deserve!  

If you are experiencing trouble with arousal or orgasm, consider adding a vibrator into your sexual routine.  Sometimes the nerves that supply the clitoris can become a little less sensitive with age, and a vibrator can help to bring that pleasure back.  If change in orgasm or arousal is sudden or severe, please see a medical provider experienced in sex medicine.  There are many causes of these issues as we age, and there are effective interventions for help.  

The effects of menopause are often understated by women and society in general.  Menopause changes more than just our bodies, but our relationships and sexual function as well.   Positive thinking, consistent exercise and a healthy diet can aide in a smoother transition.  It is important to know that sexual problems are common, but can be easily solved.  Communication with partners and providers is key to success.  You deserve a healthy sex life for many more decades, and, with this knowledge, menopause will not take that away!

Photo: Dean Mitchell


About the author
Lyndsey Harper, MD is the Founder and CEO of Rosy, an app for women with decreased sexual desire. Dr. Harper created Rosy out of frustration when she couldn’t find a modern and accessible resource to help her many patients with this problem.

Filed under: Vaginal Health