The Real Causes of Low Sex Drive and Arousal During Menopause
By: Sara Coughlin
It’s important to acknowledge that your relationship with sex may change as you go through menopause — it might feel different or you may struggle to feel aroused as often as you used to. While these changes can be frustrating, they don’t have to become your new normal.
Why Menopause — and Midlife in General — Can Affect How You Experience Sex
The matter of decreased sex drive and arousal during menopause is complicated. It’s highly unlikely that a single reason — for example, whether your partner is making an effort to excite you — is to blame. Rather, a whole host of physical, emotional, and sociological forces can play a role, says Stephanie Faubion, MD, MBA, medical director of The North American Menopause Society and medical director of the Mayo Clinic’s Center for Women’s Health.
From a purely physical standpoint, the hormonal fluctuations associated with menopause can cause vaginal dryness, which can make sex more painful. Naturally, if you find sex uncomfortable or painful, you’ll probably be less interested in it, Dr. Faubion says. She adds that other bodily changes that happen around this time, while not direct results of menopause, can contribute to a decrease in sex drive as well. Weight gain and other signs of aging, for example, can lead to confidence and body image issues in some women, which then fuels a decrease in sexual desire.
Dr. Faubion explains that, as we age, desire may come second, only after one experiences arousal. In other words, you may find that you feel more interested in sex only after physically engaging with your partner — and that’s perfectly normal.
Beyond that, menopausal women may see their sex lives evolve due to changes in their relationships (say, if their children move out of the house or they go through a divorce) or to outdated, negative socio-cultural messaging around sex and aging women. “Their attentions are directed to a lot of different places at this point in their lives,” Dr. Faubion says. “There’s a lot of complexity to what is menopause-related and what is life stage-related.”
Either way, sexual function and desire can fall as a result.
What You Can Do to Alleviate Menopause’s Impact on Your Sex Life
If vaginal dryness or painful sex during menopause is to blame for your decrease in arousal, talk to your doctor. They’ll be able to discuss your options in terms of both over-the-counter treatments and prescription therapies. And, Dr. Faubion says, the sooner you see them, the better: “Unlike hot flashes and night sweats, which do tend to get better with time, vaginal dryness does not get better with time, and typically can get worse. So, waiting it out is not the right way to go.”
In addition to your regular doctor, seeing a sex therapist, either by yourself or with your partner, can help improve issues around communication, your perception of aging, and your understanding of how sex can evolve with age, Dr. Faubion says. Ideally, seeing both kinds of professionals will allow you to address any physical issues that prevent you from enjoying sex, while challenging foundational and emotional notions that may be undermining your sex drive.
Finally, don’t forget that there’s a difference between arousal and desire. Where the former describes how you physically feel when you want to have sex, the latter refers to your emotional state when you are, quite literally, “in the mood.” Dr. Faubion explains that, as we age, desire may come second, only after one experiences arousal. In other words, you may find that you feel more interested in sex only after physically engaging with your partner — and that’s perfectly normal.
If you start to notice changes in your sex drive upon entering menopause, don’t panic — and don’t blame the first thing that comes to mind. Instead, consider all the possible factors, then get in touch with your health care providers to devise a solution that works for you.
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Sara Coughlin is a writer living in Brooklyn, NY. She's covered health, wellness, and lifestyle trends for such publications as Refinery29, InStyle, SELF, Livestrong, and Food52.