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Diseases & Conditions

Sex&Menopause

How does menopause affect your sex drive?

The loss of estrogen following menopause can lead to changes in a woman’s sexual functioning. Menopausal women may notice that they are not as easily aroused, and may be less sensitive to touching and stroking, which can result in decreased interest in sex. Further, the emotional changes that often accompany menopause can add to a woman’s loss of interest in sex and/or inability to become aroused.

In addition, lower levels of estrogen can cause a decrease in blood supply to the vagina. This decreased blood flow can affect vaginal lubrication, causing the vagina to be thin, pale, and dry. The lower one-third of the vagina can shrink, leading to painful sexual intercourse.

A lower estrogen level is not the only culprit behind a decreased libido; there are numerous other factors that may influence a woman's interest in sexual activity during menopause and after. These include:

  • Bladder control problems
  • Sleep disturbances
  • Depression or anxiety
  • Stress
  • Medications
  • Health concerns
  • Relationship issues with a partner

Do all menopausal women experience a decrease in sexual desire?

No. In fact, some post-menopausal women report an increase in sexual satisfaction. This may be due to decreased anxiety associated with a fear of pregnancy. In addition, many post-menopausal women often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

What can I do to treat vaginal dryness?

Vaginal dryness can be treated with water-soluble lubricants such as Astroglide® or K-Y Jelly®. Do not use non-water soluble lubricants such as Vaseline® because they can weaken latex (the material used to make condoms). Condoms should continue to be used to avoid pregnancy until your doctor verifies you are not producing any more eggs and also to prevent contracting sexually transmitted infections. Local vaginal estrogen may be used to improve the integrity of the vaginal tissue. This comes in different forms including cream, pills, and vaginal rings.

How can I improve my sex drive?

Currently, there are not any good drugs to treat sexual problems in women. Estrogen replacement may work, but research has yielded conflicting results regarding its effectiveness. Estrogen can, however, make intercourse less painful by treating vaginal dryness.

Doctors are also studying whether a combination of estrogen and testosterone may be helpful in increasing sex drive in women.

Although sexual problems can be difficult to discuss, talk to your doctor; there are options to consider, such as counseling. Your doctor may refer you and your partner to a health professional who specializes in sexual dysfunction. The therapist may advise sexual counseling on an individual basis, with your partner, or in a support group. This type of counseling can be very successful, even when it is done on a short-term basis.

What can I do to increase intimacy with my partner?

If your sex drive isn’t what it once was but you don’t think you need counseling, you should still take time for intimacy with your partner. Being intimate does not require having intercourse--love and affection can be expressed in many ways. Enjoy your time together--you can take long romantic walks, have candlelit dinners, or give each other back rubs.

To improve your physical intimacy, you may want to try the following approaches:

  • Educate yourself about your anatomy, sexual function, and the normal changes associated with aging, as well as sexual behaviors and responses. This may help you overcome your anxieties about sexual function and performance.
  • Enhance stimulation through the use of erotic materials (videos or books), masturbation, and changes to sexual routines.
  • Use distraction techniques to increase relaxation and eliminate anxiety. These can include erotic or non-erotic fantasies; exercises with intercourse; and music, videos, or television.
  • Practice non-coital behaviors (physically stimulating activity that does not include intercourse), such as sensual massage. These activities can be used to promote comfort and increase communication between you and your partner.
  • Minimize any pain you may be experiencing by using sexual positions that allow you to control the depth of penetration. You may also want to take a warm bath before intercourse to help you relax, and use vaginal lubricants to help reduce pain caused by friction.

Do I still have to worry about sexually transmitted infections?

Yes. Just as you must use protection if you do not want to become pregnant during perimenopause, you must also take measures to protect yourself against sexually transmitted infections (STIs) during menopause and postmenopause. It’s important to remember that your risk of contracting STIs is a possibility at any point in your life during which you are sexually active, and this risk does not go down with age or with changes in your reproductive system.

Left untreated, some STIs can lead to serious illnesses, while others, like AIDS, cannot be cured and may be deadly.

How can I protect myself from STIs?

Here are some basic steps that you can take to help protect yourself from STIs:

  • Consider that not having sex is the only sure way to prevent STIs.
  • Use a latex condom every time you have sex. (If you use a lubricant, make sure it is water-based, not Vaseline.)
  • Limit your number of sexual partners. The more partners you have, the more likely you are to catch an STI.
  • Practice monogamy. This means having sex with only one person. That person must also have sex with only you to reduce your risk.
  • Choose your sex partners with care. Don’t have sex with someone whom you suspect may have an STI.
  • Get checked for STIs. Don’t risk giving the infection to someone else.
  • If you have more than one sex partner, always use a condom.
  • Don’t use alcohol or drugs before you have sex. You may be less likely to practice safe sex if you are drunk or high.
  • Know the signs and symptoms of STIs. Look for them in yourself and your sex partners.
  • Learn about STIs. The more you know about STIs, the better you can protect yourself.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 5/13/10...#10083