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Lower Sex Drive

Perimenopausal and postmenopausal women are experiencing so many physical and emotional changes that it's no wonder issues can sometimes develop in a woman's sex life as well. Declining estrogen levels may cause women to develop physical problems like vaginal dryness and/or pain during intercourse. Some women also notice a change in their sexual desire.

What factors play a role in changing sexual function?

Many components contribute to sexual function and desire. Some have more to do with a woman's attitude than with hormonal changes and aging:

  • Usually, women who enjoy having sex continue to feel this way as they age.
  • As women get older, it is normal to experience a gradual decline in sexual interest.
  • A woman's self-image is a crucial factor in feeling good about her sexuality.
  • As a woman ages, she may have experienced illnesses or medical procedures that could affect her sex life.
  • Although urinary incontinence is a common and often curable condition, it may make women avoid sexual encounters.
  • Women having night sweats often have a diminished desire for sex.
  • Women who are feeling depressed, anxious or stressed-out may have diminished sexual desire.
  • Many drugs used for medical conditions, such as high blood pressure and depression, have a negative effect on sexual interest.
  • Hysterectomy can change how a woman experiences sex and/or orgasm.
  • Vaginal dryness can make sexual intercourse painful.

Can changes be treated?

Sometimes lifestyle changes can be useful in making sex more enjoyable. Some factors to consider:

  • Talking with your partner.
  • Making more time in your schedule for sex.
  • Spending more time on foreplay.
  • Trying different ways of achieving sexual pleasure:
    • Gently touching your partner.
    • Sensual massage.
    • Relaxing baths.

Treatment for vaginal dryness

About 10 percent to 15 percent of women will have vaginal dryness. Lubricants such as KY Jelly® or Astroglide® can help if the dryness is not too bad. REPLENS® can increase generalized moisture in the vagina and has also been shown to help. Estrogen products are also available by prescription to treat vaginal dryness and can work. However, women who may be at particular risk for breast cancer or endometrial cancer may wabt to use topical estrogen-containing products for severe symptoms. Talk to your doctor about these medications and whether they are a good choice for you.

Treatment for decreased sexual desire

There are some medical treatments, including androgen replacement therapy and testosterone, which may be used. However, there is not enough information about the safety of using testosterone, and recent studies show that it increases breast cancer risk.

Related Articles

Menstrual Changes

Fertility Changes

Hot Flashes

Mood Swings

Urinary Problems

Insomnia and Perimenopausal Women

Heart Palpitations in Menopause

External Sources

The North American Menopause Society

Menopause Guidebook: Helping Women Make Informed Healthcare Decisions Through Perimenopause and Beyond, (2001)

The Hormone Foundation

Menopause: Managing Your Body's Changes The American College of Obstetrics and Gynecology

Basson R. Female sexual response: the role of drugs in the management of sexual dysfunction. Obstetrics & Gynecology. September 2001

This article was reviewed and updated June 2007.

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