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How You Can Improve Sex During Menopause

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The onset of menopause can induce fear and anxiety in any woman, after all, the symptoms of menopause are not only associated with a high level of discomfort—they can significantly influence a woman’s quality of life. Among the most common symptoms—though rarely uttered aloud—are low sex drive and sexual dysfunction.

As menopause occurs, the ovaries stop producing estrogen and progesterone. These hormones, along with wavering levels of testosterone, are linked to a woman’s sexual function. The diminishing production of these hormones leaves many menopausal women to experience unfavorable changes to their sexual desire and even their ability to engage in sexual activities comfortably.

Menopausal hormone changes, particularly those related to estrogen, have a direct impact on a woman’s genitals. Estrogen is responsible for the fleshiness of the vaginal lining, the tissue elasticity around the vagina and moisture production in the cervix secreted to the vaginal canal. As estrogen diminishes, the vagina loses elasticity. As a result, a woman’s skin around the vagina and vulva can become thinner and drier. Coupled with lack of lubrication during sexual arousal, this can lead to painful or uncomfortable intercourse.

Estrogen isn’t the only hormone causing unwelcome changes. Low progesterone can hinder sleep and lead to mood swings. Decreases in testosterone also occur, more often as a result of normal aging than menopause. However, testosterone—though commonly associated with the male sex drive—plays a role in sexual sensation and desire for women too. Low levels of testosterone can be a central factor contributing to a woman’s low sex drive.

Sexual dysfunction does not affect every woman experiencing menopause, but it is common. A 2012 study compared the occurrence of sexual dysfunction before and during menopause in 174 participants. Researchers found that 38 percent of the women experienced sexual dysfunction before menopause, however 72.4 percent experienced it during menopause. These results suggest that although women may be affected by sexual dysfunction during their productive years, the condition may be intensified or initiated with the onset of menopause.

Although hormonal imbalance is largely to blame for low sexual desire, the general symptoms of menopause may also play a role in decreased sex drive. Irregular periods, hot flashes, night sweats, sleep problems, mood changes and weight gain are some of the other symptoms that may affect menopausal women—factors that could tank anyone’s sex drive. Some women may discover that their metabolism slows down, their hair thins or their skin loses its softness—even their breasts may lose fullness.

Despite the unpredictable onslaught of menopausal symptoms, women can find relief.

Hormonal fluctuation is an inevitable part of the aging process. However, all women can promote balance with a healthy lifestyle—eating right, exercising regularly and monitoring their hormone levels throughout their lifespan. These habits ensure that when imbalance does occur, the issue is addressed before women experience distress or irreversible damage.

Advancements in hormone therapy are helping women around the world reclaim control of their health and restore their quality of life, including improving sexual function.

In recent years, bioidentical hormone replacement therapy (BHRT) has become a popular treatment option for millions of people suffering from various types of hormonal imbalance. Among women, BHRT has been selected as an effective treatment option for reducing or eliminating the side effects of menopause. In March 2013, seven major medical organizations supported hormone therapy by endorsing it as the best form of treatment for menopausal symptoms in the Global Consensus Statement on Menopausal Hormone Therapy. The medical organizations included The North American Menopause Society, The International Menopause Society, The American Society for Reproductive Medicine, as well as others.

What makes BHRT different from traditional hormone therapy?

Both traditional and bioidentical hormones are created in a lab. Yet bioidentical hormones are derived from plants, such as soy or yams, and structured to be bioidentical to the hormones produced in a woman’s body. This distinction allows bioidentical hormones to fit hormone receptors within the body perfectly—just as the hormones naturally produced by the body would—making them an ideal substitute and equally effective at initiating and maintaining normal body functions.

Bioidentical hormone therapy treatment achieves hormonal balance specific to each woman’s unique needs. Some women may find balance is achieved with a bit more testosterone, while others will need to simply downplay estrogen. A physician specializing in hormone therapy can assess the needs specific to each woman and help her manage her levels of progesterone, estrogen and testosterone to promote optimal function.

As with any treatment option, the choice for bioidentical hormone therapy is personal. Each woman should work with a physician who specializes in hormones and hormone therapy and have her medical history assessed, along with her symptoms and lifestyle. Patients who have had breast or endometrial cancer, stroke or blood clots, will need to seek alternative solutions for sexual dysfunction. While estrogen is a common recommendation, it is not the only option when it comes to treating menopause and its symptoms.

Hormonal balance takes time, but with adherence to an expert-administered, comprehensive treatment plan most women will find relief from the harrowing symptoms of menopause, including low sex drive, vaginal dryness and pain during sex.

In addition to HRT, women can take some steps on their own to improve uncomfortable symptoms of menopause. Here are some things women can do right now to help find relief:

  • Give yourself ample time for arousal during sex
  • Practice Kegel exercises
  • Avoid products such as bubble bath and douches that can cause vaginal irritation
  • Review your medications as some medications can lessen your sex drive
  • And finally, just “do it.” Having sex more often increases blood flow to the vagina and improves overall function.


Beigi, Marjan, and Fariba Fahami. "A Comparative Study on Sexual Dysfunctions before and after Menopause." Iranian Journal of Nursing and Midwifery Research. Medknow Publications & Media Pvt Ltd. Web. 20 May 2015. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696979

"Body Logic MD®." Bioidentical Hormones For Women. Web. 14 May 2015. https://www.bodylogicmd.com/for-women/bioidentical-hormones

"Decreased Desire."Sexual Side Effects of Menopause. Web. 19 May 2015. http://www.menopause.org/for-women/sexual-health-menopause-online/sexual-problems-at-midlife/decreased-desire

Kingsberg, Ph.D., Sheryl. "How Does Menopause Affect Sexuality, And Is There Anything I Can Do To Improve Sex After Menopause?" ABC News. ABC News Network, 2 Apr. 2009. Web. 19 May 2015. http://abcnews.go.com/Health/WellnessResource/story?id=7183078

McCoy, MS, Krisha. "Maintaining a Healthy Sex Life in Menopause." EverydayHealth.com. Web. 19 May 2015. http://www.everydayhealth.com/menopause/sex-and-menopause.aspx

"Menopause." Symptoms. Web. 14 May 2015. http://www.mayoclinic.org/diseases-conditions/menopause/basics/symptoms/con-20019726

"Menopause and Sex: Decreased Hormones May Impact Sex Drive." MedicineNet. Web. 14 May 2015. http://www.medicinenet.com/menopause_and_sex/article.htm

Ovarian overproduction of androgens. MedlinePlus. Web. 20 May 2015. http://www.nlm.nih.gov/medlineplus/ency/article/001165.htm

Global Consensus Statement on Menopausal Hormone Thearpy. Climateric. International Menopause Society. Web. 1 June 2015. http://www.menopause.org/docs/default-source/2013/ims-ht-ps-2013.pdf

Reviewed May 20, 2015
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.