Your libido is also known as your ‘sex drive.’ It can vary from woman to woman and can be influenced by various factors.
There are many causes of a lowered libido. A significant factor is the decline of the sex hormones estrogen and testosterone during menopause. Decreased levels of these hormones can hamper desire and arousal, leading to physical changes that may make you less interested in or uncomfortable during sex.
Mental and physical health challenges, such as mood changes, anxiety, body image concerns, and changes in your personal, social, and professional life, can also contribute to a lower sex drive.
Decreasing estrogen levels lead to changes in the body that may make sex less enjoyable. Two common change includes vaginal dryness and vaginal atrophy, the thinning, drying, and inflammation of the vaginal walls, which can cause pain during sex.
Hormone-driven shifts elsewhere in the body can also reduce your sex drive and overall desire for sex. Lowered testosterone levels in the brain contribute to the loss of spontaneous sexual desire. Fluctuations in weight may lead to body image issues. Hot flashes and night sweats may make sex seem unappealing. Insomnia or sleep issues may leave you feeling too tired to be interested in sex. Mental health issues, like anxiety and depression, can also decrease desire.
Talk to your provider about your symptoms, and they will discuss treatment options, both holistic remedies and potential prescriptions, based on what you are experiencing.
Menopausal Hormone Therapy: Also known as hormone replacement therapy, helps you reduce vaginal dryness and atrophy that may cause discomfort during sex. Testosterone therapy, although not FDA-approved for use in women, also improves sex drive and is supported by several medical societies, including the North American Menopause Society.
Dehydroepiandrosterone (DHEA): This hormone is prescribed as an FDA-approved vaginal suppository to treat painful sex caused by vaginal atrophy.
Ospemifene: This oral pill is FDA-approved to treat vaginal dryness and painful sex caused by vaginal atrophy.
Medications for mental health: Your provider can help you identify whether your lowered sex drive is due to mental health issues and recommend a tailored treatment plan.
Vaginal moisturizers and personal lubricants: If you are experiencing painful sex due to vaginal dryness or atrophy, a non-hormonal vaginal moisturizer or either silicone or water-based lubricant can help make sex more comfortable.
Set the mood: During perimenopause and after menopause, many women may not experience spontaneous desire, but they can still feel responsive desire. With some upfront effort, you may be able to get in the mood even if you were not feeling it from the start. Setting the mood can include listening to, reading, viewing erotic material or getting started with a sex toy before your partner joins in.
Kegel exercises: The pelvic floor, which is made of the muscles encircling the vagina, uterus, and bladder, can weaken during menopause. When done correctly and consistently over several months, Kegel exercises can increase the strength and tone of the pelvic floor muscles, leading to more intense orgasms.
Exercise and yoga: Physical activity can help boost your sex drive because it triggers the release of endorphins—improving overall mood, health, and self-confidence.
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Research published in the journal Menopause in 2021 linked poor sleep among menopausal women with a higher likelihood of sexual dysfunction.
A review article published in the journal PLOS Medicine in 2021 linked menopausal hormone therapy (MHT) with improved sexual function across ten trials.