How Sex Changes During Menopause (and What to Do About It)

By: Dr. Alyssa Dweck

Your sex life can change in a number of ways as you approach and experience menopause. Some of these changes — like vaginal dryness and pain during intercourse— may be directly tied to the hormone fluctuations that happen during menopause. But there may be other factors affecting your sex life as well.

In this video, Bonafide Medical Advisor Dr. Alyssa Dweck talks about how sex can change during menopause and lays out potential causes and treatments.

Video Transcription

It should really come as no surprise that your sexual life during perimenopause and menopause may not be the same as it was in your twenties. This can be really dramatic and disconcerting for some women. It’s really important to bring this up to your healthcare provider during your routine exam, or during a problem-focused visit. By the same token, your healthcare provider should elicit this information in a direct but open-ended way, so that they can assist if needed.

First, women tend to complain about a lowered sexual drive, vaginal dryness and discomfort, and even orgasm concerns, like weakening or absence during the perimenopausal and menopausal times.

Who better to address this than your gynecologist?

How Sex Changes During Menopause

The first thing to recognize is that libido is complicated for women. It’s just not a simple light switch that goes on and off, but rather has a lot of different variables. For example, if your relationship is strained or there’s discord going on in your marriage, this is going to affect your libido, and is probably best helped with a mental health provider or counselor. 

Second, if you have chronic medical issues or are taking medications that might interfere with your drive, these things need to be addressed as well.

Third, if you’re suffering with vaginal dryness and subsequent pain as a result of low estrogen levels during menopause, it behooves you to use a vaginal moisturizer. I’m a huge fan of Revaree® from Bonafide®. This is a hyaluronic acid suppository, a super moisturizer used twice a week in the vagina to help with moisture, and it is not hormonal. Lubricants may also be quite helpful, especially during intimacy.

If you suffer from a busy mind, where you just have so many tasks to perform and so many responsibilities that it’s causing undue stress, you’ll need to manage this: whether it’s with exercise, altering the diet, or meditation or mindfulness to help de-stress and bring you more into the present.

Finally, orgasm issues do plague many menopausal women, where they become weaker or they become nonexistent. Part of this is due to hormonal change, and part of it is due to managing discomfort. We’ve already spoken about moisturizers, which I think are quite helpful, but from time to time you must consider the blood flow being enhanced in the genital area to assist with an ideal, more pleasurable sexual experience. For this, I often recommend Ristela®, which is an antioxidant and amino acid combination that helps to enhance blood flow to the genitals to enhance satisfaction.*

I hope all of these are of help to you. Thanks!