Menopause affects both your physical and mental health, which can lead to a reduced sex drive (libido). Here we’ll explore how the different symptoms of menopause can change your sex life and what you can do to improve your sex drive.
Menopause leads to a drop in your hormone levels, specifically oestrogen, progesterone and testosterone. This causes changes in your vaginal and vulval area, specifically causing atrophic vaginitis ie thinning, drying and inflammation of the walls of your vagina. This can make sex painful.
Sex can also become painful due to urinary tract infections, which can become more common during menopause as the microbiome of your vagina (bacteria that naturally live in your vagina) changes in response to reduced oestrogen levels.
Low mood and depression, which are common during menopause, can also reduce your sex drive.
While low mood and depression can occur due to direct effects of menopause on your brain chemistry, they can also happen as a result of physical changes that make you feel less confident in your body or less like yourself.
The mental and physical changes that happen during menopause can put a strain on your personal relationships. You may feel that your partner doesn’t understand what you’re going through and this can consequently have an impact on your sex life.
If you’re concerned about your sex life and/or reduced sex drive due to menopause, it’s important to think about what factors are contributing to this. Speaking to your GP can help you work through this.
If your reduced sex drive is mainly due to physical changes, treatments such as hormone replacement therapy (HRT) and vaginal preparations (including lubricants and moisturisers) can make a significant difference.
Sex toys and vibrators can be helpful too for vaginal symptoms, such as pain and tightness, as they stimulate blood flow — this helps soften ligaments, which makes sex less painful. It is also important to avoid using soaps on your vaginal and vulval area as they have a drying and irritant effect; just use water.
If your reduced sex drive is mainly due to psychological and/or relationship factors, you may benefit from talking therapies such as cognitive behavioural therapy (CBT), couples counselling and psychosexual counselling.
Your doctor may also discuss testosterone supplements with you; while testosterone levels decline gradually with age, this can become more apparent during menopause and can lower your sex drive.
In addition to these specific therapies and treatments, taking steps to follow a healthy lifestyle, such as exercising regularly, following a healthy balanced diet, getting enough sleep and avoiding drinking too much alcohol can help through improving your mood, confidence and the way you see yourself.
In most cases, there is not one single treatment that can solve reduced sex drive. However, a rounded approach to therapies and treatment can address the problem.
Dr Wendy Molefi is a GP and Menopause Specialist at Spire Harpenden Hospital, where she leads a Menopause Clinic. She holds Advanced Menopause Specialist accreditation from the British Menopause Society and a Master's degree in Mindfulness-Based Cognitive Therapy (MBCT) from the University of Oxford. Dr Molefi has a special interest in the psychological impact of menopause on women’s quality of life and brings a holistic and preventive approach to her clinical practice and menopause service. She is also the owner and founder of the private menopause clinic, Vital Wellness Clinic.
If you're concerned about symptoms you're experiencing or require further information on the subject, talk to a GP or see an expert consultant at your local Spire hospital.