Menopause and low libido
While sexual desire is known to ebb and flow during different life stages, menopause is often a time when you may notice a loss of libido. Sexual desire changes as you age and that is okay and normal. If your libido is lower than before and that doesn’t bother you, it doesn’t mean that there is something wrong with you.
There are many ways to have intimacy and maintain relationships that don’t necessarily involve sex. If your low libido in menopause is causing problems or distress – don’t worry – satisfying sex is possible.
LOW LIBIDO DEFINITION
When we discuss sexual desire or libido, we are talking about your interest or motivation to seek out and engage in sexual activities. Everyone’s level of desire is different – some might be satisfied having sex once every few months or years and for others, it might be once every few weeks or days.
Perhaps you are having no sex at all, and you feel totally satisfied and fulfilled – totally okay! There is no normal or right amount of sex to be having and low libido in menopause is only a problem if you think it is.
Discover your personalized treatment options
HOW LIKELY IS LOW LIBIDO IN MENOPAUSE?
- Difficulties with libido are some of the most prevalent sexual issues worldwide, particularly during menopause. While some find their desire for sex increases, most report the opposite. Studies have found that over 50% of those who are middle-aged reported having low libido.
Read more about the stages of menopause.
How can you improve low libido during menopause?
While hormones are not always to blame, they can play a big role. Reduced estrogen levels can affect nerves that provide feeling to the clitoris and vagina, making them less sensitive. The same hormonal changes can cause vaginal dryness, tightness, and increasingly delicate vaginal tissues, all of which can make sex uncomfortable and seem unappealing at best.
However, hormones aren’t the whole story. If you aren’t sure what turns you on, it may contribute to your distress about low libido or loss of libido during menopause.
Know your desire type and reframe the way you think about it
The first step to improving libido is to understand that there is more than one form of sexual desire. You have likely heard of spontaneous desire, which is that sudden and immediate desire for sex that often arises out of the blue. However, the most common form in women is responsive desire or when cues and triggers, such as a make-out session or back rub, cause your desire to grow. It is all about getting yourself into that headspace for sex.
Be open to getting in the mood
Sometimes you might feel neutral about having sex or would like to feel sexual but aren’t quite there yet. Consider being open to the possibility of responsive desire building. This does not mean forcing yourself to have sex or having sex out of obligation but rather staying open to getting in the mood and consciously creating opportunities for intimacy – perhaps with a cuddle or a massage. If you end up wanting to have sex, then great, but if not, you don’t have to.
Understand your brakes and accelerators
When you are experiencing low libido, you may often think that you need to step on the gas – more erotica, sex toys, a more attractive partner, etc. What you need to do is reduce the speed bumps that prevent the building of desire like stress, fatigue, and disconnection. Try Emily Nagoski’s Sexual Temperament Questionnaire to help you understand what impacts both you and your partner.
Improve foreplay
When it comes to good sex, foreplay is key to building anticipation and creating intimacy. Kissing and cuddling are important but foreplay could also include things like scheduling sex, sending a sexy text, or wearing underwear that makes you feel sexy.
Improve communication
Communication is essential to cultivating your libido and sexual satisfaction. If you are experiencing a decreased interest in sex, let your partner know.
Try sensate focus
Sensate focus is an effective sex therapy technique that helps people overcome libido problems by focusing primarily on sensations and not focusing on orgasm as the goal.
Mindfulness practice
Mindfulness is highly effective in improving low libido. The practice involves increasing sexual awareness – how you are feeling and responding in the moment. It has been found to improve libido by boosting mood, increasing self-compassion, and reducing distraction. Some great apps for mindful sex are Ferly, Coral and Blueheart.
Managing medications
Some drugs, such as certain antidepressants, can negatively impact your libido. If you are taking any, it’s best to discuss this with your healthcare provider to see if you can find alternatives.
Self-esteem/body image work
Many report that the physical changes that can accompany aging and menopause leave them feeling a lower sense of self-esteem and confidence about their bodies, particularly when it comes to sex. Read more about low confidence and menopause.
Sex therapy
Sex therapy is a great way of uncovering the psychological, emotional, or practical dynamics that are negatively impacting your desire and addressing them. Find out more about what sex therapists do and how to find one.
Can hormone therapy (HT) help with loss of libido during menopause?
HT can help with low libido for some, as well as hot flashes, sweats, sleep issues, and mood changes. There is some evidence that transdermal HT is more likely than oral HT to improve your libido. Talk to your healthcare provider as HT is not suitable for everyone. Read more about the HT risks and benefits.
Read more about the HRT risks and benefits.
LOSS OF LIBIDO AND MENOPAUSE FAQs
There are several reasons why your libido might change during this life stage, and this varies greatly from person to person.
The decreased levels of hormones associated with menopause may lead to painful or uncomfortable sex, which can negatively impact your desire for sex and relationships.
Reduced estrogen levels reduce the blood flow and affect the nerves that supply the genital area, meaning that you may become less sensitive and may find it more difficult to orgasm. You might also be experiencing other symptoms of menopause such as night sweats and hot flashes, which could impact sleep and interest in sex. If you are taking medications such as antidepressants, this may also contribute to your loss of libido.
Going through bodily changes can be challenging and many experience a sense of loss for the body they once had. Difficulties with self-esteem and body image are not uncommon and may leave you feeling less attractive and interested in sex. You could also be experiencing other symptoms of menopause such as anxiety, irritability, or feeling down, none of which are exactly aphrodisiacs.
While we recommend seeing a sex therapist or a healthcare provider if you are concerned, you can certainly work on self-identifying what might be negatively affecting your libido. Ask yourself:
- Are you suffering from stress, fatigue, or lack of sleep?
- Do you suffer from mental health concerns such as depression or anxiety?
- Do you think it could be hormonal/menopausal symptoms?
- Could it be from other sexual issues such as pain or difficulties with orgasm?
- Could it be that your beliefs about sex and sexuality are affecting your desire?
- Have you been getting enough physical exercise and eating a healthy diet?
- Do you feel secure and happy in your relationship?
- Have you experienced sexual trauma?
If your partner is trying to make it seem as though your libido isn’t ‘high enough’, that doesn’t necessarily mean anything’s wrong with you or your libido. A low libido is only a problem if you see it as one. Your partner might be making assumptions based on their own libido, or maybe your libido has changed over time but it’s a change that you’re ok with.
Read more about the conversations needed for intimacy during menopause.
Yes. While this might feel scary or make you anxious, by voicing what the issue is you can both begin to work together to find ways to cultivate desire.
If you are persistently experiencing a low libido that bothers you, this is not something to ignore. Consider speaking with a healthcare provider or sex therapist.
You should always see a healthcare provider if sex is painful, if you have any bleeding after sex or at unexpected times if you have any sores on your genital area which aren’t healing, or any other new or worrying symptoms. The same applies if you are struggling with your mental health – please reach out for help.
- Australasian Menopause Society, Sexual difficulties in the menopause
- Australasian Menopause Society, Will menopause affect my sex life?
- Blueheart, What’s the Relationship Between Menopause and Decreased Libido?
- Harvard Health Publishing, Yes, you can have better sex in midlife and in the years beyond (2021)
- Healthline, Menopause libido
- Leventhal JL. Management of Libido Problems in Menopause. Perm J. 2000 Summer;4(3):29–34. PMCID: PMC6220606.
The North American Menopause Society: Decreased Desire - Taylor HS, Tal A, et al. Effects of Oral vs Transdermal Estrogen Therapy on Sexual Function in Early Postmenopause: Ancillary Study of the Kronos Early Estrogen Prevention Study (KEEPS).
- AU. JAMA Intern Med. 2017;177(10):1471.
