Ever find yourself saying, "Not tonight dear, I just don’t have the (sex) drive"? If this rings a bell, know that you're not the only one. Almost 25% of females ages 40-65 say they struggle with low sex drive.*
One frustrating symptom of menopause is what the medical community calls hypoactive sexual desire disorder (HSDD). You and I call it low sex drive, low libido, or just not feeling in the mood. Want to understand why you may be feeling this way and what you can do about it? Read on.
What’s the connection between menopause and sex drive?
The main hormones involved in menopause-related decreased sex drive are estrogen, progesterone, and testosterone. These hormones are important for your sexual health. They keep your vagina lubricated and contribute to you feeling interested in sex.
Hormonal balance
As these hormone levels drop, sexual desire can too. Those hormones are doing double-duty. They influence both your sensory perception and the blood flow to your pelvic area. Both drive motivation for sex.
Specifically, a decrease in estrogen causes the vaginal tissue to thin, dry out, and become inflamed. This is part of a larger set of symptoms called genitourinary syndrome of menopause (GSM). It can cause pain during sex, and you may not feel like having sex.
Testosterone also plays a role in sexual desire. You produce small amounts of testosterone in your ovaries, and those levels may decrease during menopause. This decline can contribute to a lower sex drive and reduced response to sexual activity.
Decreased orgasmic function
Hormone-related vaginal symptoms and less blood flow to the pelvic area can affect orgasms. Both the intensity of your orgasms or whether you're able to have one can be affected. When sex doesn't quite hit the spot like it used to, it can add to the challenges in maintaining interest and desire.
Hot flashes and night sweats
Menopause symptoms, like hot flashes and night sweats, can disturb your sleep by causing you to wake up throughout the night. This can make it hard for you to fall back to sleep. Lack of quality sleep can cause fatigue, moodiness, and irritability. These negative feelings can also affect interest in sex.
Sometimes a lower sex drive can be because of physical symptoms. But there are also emotional reasons that can affect it. Let's dive into some key factors that might impact your sex drive during this phase of life.
Mood changes
As we know, estrogen levels go down during menopause. This can cause lower levels of chemicals in the brain called serotonin and dopamine. As a result, changes in these brain chemical levels can contribute to mood swings, anxiety, and depression. These emotional changes may lead to less interest in sex and feeling less than your best.
Relationship dynamics
It's normal for sexual desire to ebb and flow over the years in a relationship. Common factors that can affect relationships and sex include:
- Stress.
- Trouble talking.
- Health issues.
- Mental health challenges.
- Ideas about what a “healthy” sex life should be.
Add to any of these the potential negative effects of a lower menopause sex drive, and it can make these issues feel even worse.
Open and honest communication, as well as redefining what “sex” means in your relationship, are key components to understanding and perhaps even increasing desire. Sex looks and feels different for everyone. The most important thing is to be on the same page as your partner.
Body image concerns
Menopause can lead to weight gain, specifically a change in where fat on your body is located. Lower estrogen levels, along with the decline in muscle mass, forces fat to accumulate more in the abdominal area, leading to the infamous "menopause belly".
As estrogen levels decrease, other body parts can be affected. You may notice more age spots, thinning hair, and new wrinkles. Your skin may become dry and saggy. For some, these changes can impact self-esteem and body image, which can then affect your confidence and interest in sex.
How to increase sex drive after menopause
It's true that a decreased sex drive during menopause is common, but that doesn't mean you have to accept it. There are strategies and treatments that can help you reignite the spark and get back in the mood.
Menopause hormone therapy
Hormone therapy, or menopause hormone therapy (MHT), is one option to consider. Specifically, localized estrogen therapy which comes in the form of a vaginal ring, cream, or a tablet, can be used to alleviate some of the physical symptoms of menopause related to low sex drive. It does so by improving vaginal tone and elasticity, increasing vaginal blood flow, and enhancing lubrication.
Some people prefer this type of hormone therapy because it works only in the vaginal region and has fewer possible side effects. It's important to talk about the potential risks and benefits of MHT with a healthcare provider before starting treatment.
Lubricants
Over-the-counter vaginal lubricants can provide relief from vaginal dryness and discomfort during sex. There are several types of lubricants on the market, including water-based, silicone, oil, and hybrid. Each has its pros and cons, and everyone has their own preferences.
Do your research before you choose what lube, if any, to use. Typically, these products can make having sex feel more comfortable and enjoyable.
Counseling and therapy
For emotional and relationship-related issues, counseling or therapy can be helpful. A sex therapist can help you work through emotional or mental roadblocks that may be causing sexual issues in your relationship. A sex therapist is a licensed provider who has specialized training in sexual health. In addition, individual or couples therapy with a trained therapist can be helpful.
Finding the right therapist can provide a safe space for you and your partner to discuss your concerns, improve communication, and strengthen your emotional connection.
Sexual health education
Awareness and education are key. Make sure you and your partner understand some of the challenges around sexual health and decreased sex drive during menopause. This can help you manage these issues together.
Decreased sex drive during menopause is a complicated issue and involves physical, emotional, and partner relationship issues. It's important for you to know that you're not alone in feeling this way and there are things you can do to help.
Talking to healthcare professionals, therapists, and partners can help you regain control over your sexual health. With the right resources and mindset, you can continue to enjoy a fulfilling and satisfying sex life.
*Data from Attitudes & Usage study conducted in August 2021 with 4,578 female participants ages 40-65. Funded by Kenvue.
