Menopause and sexuality

Sexual issues and menopause

In the years around menopause, you may experience changes in your sexual life. Some women say they enjoy sex more after they don't have to worry about getting pregnant. Other women find that they think about sex less often or don't enjoy it as much.
Changes in sexuality at this time of life have several possible causes, including:

Decreased hormones can make vaginal tissues drier and thinner, which can make sex uncomfortable.
Decreased hormones may reduce sex drive.
Night sweats can disturb a woman's sleep and make her too tired for sex.
Emotional changes can make a woman feel too stressed for sex.

Keep in mind that being less interested in sex as you get older is not a medical condition that needs treatment. But if you are upset about sexual changes, you can get help. Don't be shy about talking with your doctor or nurse. They certainly have talked with many women about these issues before.

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Lifestyle changes

Some simple steps may help with sexual issues you face at this time:

Get treated for any medical problems. Your overall health can affect your sexual health. For example, you need healthy arteries to supply blood to your vagina.
Try to exercise. Physical activity can increase your energy, lift your mood, and improve your body image — all of which can help with sexual interest.
Don't smoke. Cigarette smoking can reduce both the blood flow to the vagina and the effects of estrogen, which are important to sexual health.
Avoid drugs and alcohol. They can slow down how your body responds.
Try to have sex more often. Sex can increase blood flow to your vagina and help keep tissues healthy.
Allow time to become aroused during sex. Moisture from being aroused protects tissues. Also, avoid sex if you have any vaginal irritation.
Practice pelvic floor exercises. These can increase blood flow to the vagina and strengthen the muscles involved in orgasm. Learn more about pelvic floor exercises in our Urinary incontinence fact sheet.
Avoid products that irritate your vagina. Bubble bath and strong soaps might cause irritation. Don't douche. If you're experiencing vaginal dryness, allergy and cold medicines may add to the problem.

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Treatment options

Discuss your symptoms and personal health issues with your doctor to decide whether one or more treatment options are right for you.
If vaginal dryness is an issue:

Using an over-the-counter, water-based vaginal lubricant like K-Y Jelly or Astroglide when you have sex can lessen discomfort.
An over-the-counter vaginal moisturizer like Replens can help put moisture back in vaginal tissues. You may need to use it every few days.
Prescription medicines that are put into a woman's vagina may increase moisture and sensation. These include estrogen creams, tablets, or rings. If you have severe vaginal dryness, the most effective treatment may be menopausal hormone therapy.

If sexual interest is an issue:

Treating vaginal dryness may help. Talking with your partner or making lifestyle changes also may help. Learn about lifestyle changes on the Natural/alternative treatments and lifestyle changes page.
You may wonder about Viagra. This medication has helped men with erection problems, but it has not proven effective in increasing women's sexual interest.
Some women try products like pills or creams that contain the male hormone testosterone or similar products. The U.S. Food and Drug Administration (FDA) has not approved these products for treating reduced female sex drive because there is not enough research proving them safe and effective.
The FDA has approved menopausal hormone therapy (MHT) for symptoms like hot flashes, but research has not proven that MHT increases sex drive.

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Talking with your partner

Talking with your partner about your sexual changes can be very helpful. Some possible topics to discuss include:

What feels good and what doesn't
Times that you may feel more relaxed
Which positions are more comfortable
Whether you need more time to get aroused than you used to
Concerns you have about the way your appearance may be changing
Ways to enjoy physical connection other than intercourse, like massage

Talking with your partner can strengthen your sexual relationship and your overall connection. If you need help, consider meeting with a therapist or sex counselor for individual or couples therapy.

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More information on menopause and sexuality

Explore other publications and websites

Dealing With Sexual Problems (Copyright © American Cancer Society) — This resource addresses a number of different sexual issues ranging from reaching orgasm to preventing pain during intercourse. These suggestions can create a more comfortable setting for you and your partner.
http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/SexualSideEffectsinWomen/SexandWomenwithCancer/sex-and-women-with-cancer-dealing-with-sexual-problems
Fast Facts for Your Health: Sex & Intimacy After Menopause (Copyright © National Women's Health Resource Center) — Your sex life does not have to end with menopause. This fact sheet discusses the changes you may experience as you go through menopause, how you can optimize your sex life, and related topics you may want to discuss with your doctor.
http://www.healthywomen.org/content/publication/fast-facts-your-health-sex-intimacy-after-menopause
Fixes for a Stalled Sex Life (Copyright © The North American Menopause Society) — This resource offers some tips that may lead to a healthier sex life.
http://www.menopause.org/menopauseflashes0912sexlife.aspx
Sex and Menopause (Copyright © Cleveland Clinic) — This online publication discusses concerns such as vaginal dryness and what you can do to stay intimate with your partner while going through menopause.
http://my.clevelandclinic.org/disorders/Menopause/hic_Sex_and_Menopause.aspx