Does menopause affect your sex drive?
If you’re not in the mood, you’re not alone. Low libido is more common than you think in menopausal women - but there are steps you can take to get back in the groove.
Everyone’s sex life is going to have lulls. Stress, exhaustion, relationship issues, and a million other things can put “having sex” towards the bottom of your to do list. But if you’re going through the menopause transition, it can fall off the list completely. Here, learn what’s going on, how to know if your loss of libido is an issue, and what you can do to get yourself back in action.
What is libido?
Libido refers to your sexual interest or desire. It’s not just mental; it’s driven by hormones like oestrogen and testosterone, which increase sexual desire, while progesterone may suppress it. This hormonal balance shifts dramatically during menopause.
How common is low libido during menopause?
Very common. A systematic review of more than 80,000 women found that up to 75% experienced some form of sexual dysfunction during menopause. “Sexual difficulties can range from a lack of interest in sex to trouble having an orgasm,” explains Dr. Aimee Eyvazzadeh, M.D., an OB/GYN and reproductive endocrinologist.
What causes it?
Menopause triggers a drop in oestrogen, progesterone, and androgens. And these hormonal shifts “kick off” changes that have a ripple effect on your body and mind, says Dr. Stephanie Faubion, M.D., the director for the Centre for Women's Health at the Mayo Clinic, medical director for The Menopause Society, and member of the WeightWatchers Scientific Advisory Board.
Reduced blood flow: Lower oestrogen decreases blood flow to the clitoris and vaginal area, reducing sensitivity and arousal.
Vaginal dryness: Less oestrogen means less natural lubrication, which can make sex uncomfortable or painful.
Low energy: Hormonal changes can disrupt sleep and increase fatigue, especially with night sweats and insomnia.
Mood changes: Menopause can lead to anxiety, depression, and body image issues, all of which can reduce sexual desire.
Symptoms of low libido
The exact way a lower libido presents itself can vary from person to person, but symptoms generally include:
having less or no interest in sex
not having sexual thoughts or fantasies
being depressed or concerned about a lack of sexual activity
What can help?
Fortunately, there are several effective treatments and strategies:
1. Lifestyle changes
Balanced nutrition, regular exercise, stress management, and good sleep are essential. Even small habits can help. Eating enough protein and drinking enough water can increase your energy, which may make you more motivated and excited in the bedroom. Going on evening walks can improve your mood, increase blood flow in the body (including your sex organs).
Learn more about menopause nutrition
2. Hormone replacement therapy (HRT)
Hormone replacement therapy (HRT), also known as menopause hormone therapy (MHT), may relieve menopausal symptoms, including low libido, by replacing oestrogen/or progesterone. Faubion notes that low-dose vaginal estrogen (the creams, tablets, rings, and inserts applied directly into the vagina) is most likely to improve low libido by improving dryness and comfort.
3. Lubricants and moisturisers
Over-the-counter lubricants offer immediate relief during sex, while vaginal moisturisers help maintain tissue health long-term. Both can make sex more comfortable and enjoyable.
4. Other medications
Non-hormonal options like buspirone or bupropion may help boost libido, especially if mood is a factor. Be cautious with supplements like maca or ginseng - they’re unproven and may interact with other meds.
5. Pelvic floor exercises
Strengthening pelvic floor muscles with exercises like Kegels can enhance blood flow, increase sensation, and improve overall sexual satisfaction. One study found that after 12 weeks, many postmenopausal women report better arousal and orgasm.
6. Therapy and counseling
Sex drive is influenced by emotional and relational factors. Therapy can help address self-esteem issues, relationship dynamics, or underlying mental health challenges.
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