Sex and Menopause

How Does Menopause Affect Sex Drive?

The loss of estrogen and testosterone following menopause can lead to changes in a woman's body and sexual drive. Menopausal and postmenopausal women may notice that they're not as easily aroused, and they may be less sensitive to touching and stroking. That can lead to less interest in sex.

Also, lower levels of estrogen can cause a drop in blood supply to the vagina. That can affect vaginal lubrication, causing the vagina to be too dry for comfortable sex -- but there's help for that.

Other factors may influence a woman's level of interest in sex during menopause and after. These include:

• Bladder control problems
• Sleep disturbances
• Depression or anxiety
• Stress
• Medications
• Health concerns

Does Menopause Lower Sex Drive in all Women?

No. Some postmenopausal women say they've got an improved sex drive. That may be due to less anxiety linked to a fear of pregnancy. Also, many postmenopausal women often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

What Can I Do to Treat Vaginal Dryness During Menopause?

During and after menopause, vaginal dryness can be treated with water-soluble lubricants such as Astroglide or K-Y Jelly.

Do not use non-water-soluble lubricants such as Vaseline, because they can weaken latex, the material used to make condoms. You or your partner should keep using condoms until your doctor confirms you're no longer ovulating -- and to prevent getting an STD. Non-water-soluble lubricants can also provide a medium for bacterial growth, particularly in a person whose immune system has been weakened by chemotherapy.

Vaginal moisturizers like glycerin-min oil-polycarbophil (Replens) and Luvena can also be used on a more regular basis to maintain moisture in the vagina. You can also talk to your doctor about vaginal estrogen therapy.

An oral drug taken once a day, ospemifeme (Osphena), makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex. The FDA warns that Osphena can thicken the endometrium (the lining of the uterus) and raise the risk of stroke and blood clots.

How Can I Improve My Sex Drive During and After Menopause?

Estrogen replacement may work, but more research is needed. Estrogen can make sex less painful by treating vaginal dryness, though.

Doctors are also studying whether a combo of estrogen and male hormones called androgens may help boost sex drive in women.

Although sexual problems can be hard to discuss, talk to your doctor. There are options to consider, such as counseling. Your doctor may refer you and your partner to a health professional who specializes in sexual dysfunction. The therapist may advise sexual counseling on an individual basis, with your partner, or in a support group. This type of counseling can be very successful, even when it's done on a short-term basis.

A sexual aid called Eros is available by prescription to treat women with disorders of sexual arousal. The device consists of a small suction cup, which is placed over the clitoris before sex, and a small, battery-operated vacuum pump. The gentle suction provided by the vacuum pump draws blood into the clitoris, increasing pressure on the clitoral nerve. This device increases lubrication, sensation, and even the number of orgasms in many women who have used it.

How Can I Improve Intimacy With My Partner?

During menopause, if your sex drive has dropped but you don't think you need counseling, you should still take time for intimacy. You can still show your partner love and affection without having sex. Enjoy your time together: take walks, eat dinner by candlelight, or give each other back rubs.

To improve your physical intimacy, try these tips:

• Consider experimenting with erotic videos or books, masturbation, and changes to sexual routines.
• Use distraction techniques to boost relaxation and ease anxiety. These can include erotic or non-erotic fantasies, exercises with sex, and music, videos, or television.
• Have fun with foreplay, such as sensual massage or oral sex. These activities can make you feel more comfortable and improve communication between you and your partner.
• Minimize any pain you might have by using sexual positions that allow you to control the depth of penetration. You may also want to take a warm bath before sex to help you relax, and use vaginal lubricants to help ease pain caused by friction.
• Tell your partner what's comfortable and what's not.

Do I Still Have to Worry About Sexually Transmitted Diseases?

Yes. Menopause and postmenopause don't protect you against STDs. You can get an STD at any point in your life during which you're sexually active. This risk doesn't go down with age or with changes in your reproductive system.

Left untreated, some STDs can lead to serious illnesses, while others, like HIV, cannot be cured and may be fatal.

How Can I Protect Myself From STDs?

Take some basic steps to help protect yourself from STDs:

• Not having sex is the only sure way to prevent STDs.
• Use a latex condom every time you have sex.
• Limit your number of sexual partners. The more partners you have, the more likely you are to catch an STD.
• Practice monogamy. This means having sex with only one person. That person must also have sex with only you to lower your risk.
• Choose your sex partners with care. Don't have sex with someone who you suspect might have an STD.
• Get checked for STDs. Don't risk giving the infection to someone else.
• Ask a potential sex partner to be checked for STDs. Symptoms of STDs may not be visible or even cause any symptoms for your partner.
• If you have more than one sex partner, always use a condom.
• Don't use alcohol or drugs before you have sex. You may be less likely to practice safe sex if you're drunk or high.
• Know the symptoms of STDs.

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