Sex Drive and Menopause: 50 Shades of Normal

Desire may decline with estrogen levels
Sex Drive and Menopause: 50 Shades of Normal

Sex and menopause may seem like odd bedfellows. Especially if you’re one of the 15 to 70 percent of menopausal or postmenopausal women with sexual dysfunction, such as low desire or painful intercourse.

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Why do studies report such varying percentages?

Perhaps because when it comes to sex, there are 50 shades of “normal,” according to Judith M. Volkar, MD, an OB/GYN for Cleveland Clinic’s Center for Specialized Women’s Health. There are no standards on how often you should have — or desire — sex. Sexual dysfunction simply refers to any issue that causes distress or interpersonal difficulty in the bedroom. So if you’re not desiring or having sex and you’re not distressed by it, then you’re not dysfunctional.

But if you are distressed, you’re not alone. And there are plenty of things you can do to make your sex life satisfying during menopause and beyond.

Improve function — even without hormone help

As women go through menopause, their estrogen levels drop. Lower levels of estrogen cause a decrease in blood flow to the vagina, which can make it less sensitive to touch and less receptive to physical arousal. Less estrogen also can mean less vaginal lubrication. All of that can make intercourse less desirable, more difficult or downright uncomfortable.

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Fortunately, several things can help women, says Dr. Volkar:

  • Over-the-counter vaginal lubricants can supplement natural lubrication.
  • Vaginal moisturizers are like lubricants, but they stay in the vagina longer and cling to vaginal walls. Use them a couple of times a week (not at the time of intercourse).
  • Vaginal estrogen can help if lubricants and moisturizers are not enough. As a vaginal cream, dissolvable tablet or long-term insert, estrogen can restore vaginal mucosa to the way it was before menopause.
  • An FDA-approved clitoral therapy device works like a gentle vacuum that can increase blood flow to the clitoris. In addition to increasing vaginal lubrication, it can enhance the ability to achieve orgasm.

While some drugs are being tested, currently there is no Viagra®-type drug to treat low libido in women.

Try increasing your receptivity instead of your sex drive

Hormones aren’t the only factor in a woman’s sex life. Emotions play a big role, too. While men can use sex as a stress reliever, women usually prefer to relieve stress before having sex. Tension, fatigue and relationship issues all can affect a woman’s sexual desire.

But here’s an interesting fact: Women don’t necessarily need to desire sex in order to enjoy it. It’s like going to the gym. You may not feel like working out on a particular day. But once you start on the treadmill, you get into it, enjoy it and feel better afterward.

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So, instead of trying to increase your sex drive, try increasing your receptivity — your willingness or ability to enjoy sex once you get into it. You might try:

  • Reading erotic books or articles that make you start thinking about sexual things
  • Watching erotic videos
  • Talking to your partner about things that arouse you
  • Scheduling a romance night — and thinking beforehand about what you’ll do

You’re never too old! Talk to your doctor

If these tips don’t help and you are bothered by your sexual function, see a physician. You are never too old. Even if you haven’t had sex in years, a doctor can guide you in restoring enjoyment.

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