Sex, Libido, and Menopause

Menopause does not mean the end of your sex life. We’re here with advice on how to maintain sex drive and keep passion alive

Here at KCM, we’re constantly trying to help our readers demystify the transition to menopause, so you feel well informed and prepared for the life change that every woman will eventually experience. We’ve talked about hot flashes, we’ve talked about treatment options, and today we’re going to cover one of the most important topics of all: sex drive. Entering menopause does NOT mean your sex life has to stop or even slow down, but it might mean that you have to make a few adjustments. That’s why, with the help of our friends at Kindra, a female-led company that makes estrogen-free menopause essentials, we shared some of your sex questions with women’s health expert Dr. Suzanne Gilberg-Lenz. She explains that with the right tools and communication skills, conquering this topic doesn’t have to be scary, and that it’s completely possible to maintain or even increase intimacy during this natural journey in womanhood.

KCM Reader: I’ve had a major decrease in libido since entering menopause…will it ever go back to “normal”?

Dr. Suzanne: Libido does decrease with age, but it won’t go away altogether as long as you work at it. Here’s the complicated thing about libido— it is not just a hormonal on-off switch. Some women seem to think “if I go on hormones my libido will come back,” but it’s not that simple. Libido is a combination of sensation, anticipation, neurotransmitter and hormone-driven elements like dopamine, plus sexual interests, novelty, mystery, surprise, and more. It’s psychological and it’s emotional. Is this really an intimacy issue? Is it that you’re stressed? Is it that you’re bored? Is it that you’re annoyed? Then of course there is your physical sexual response, which shifts as tissue changes during the menopausal transition, so you potentially have less blood flow to the area. Sensation may change with changes to the tissue, which may make sex less pleasurable and more painful. This is where maintaining your overall health is crucial— first by feeling good in your body, and then by using specific products. These could be vaginally applied hormone replacement therapy, or something like Kindra’s Daily Vaginal Lotion, which can help replenish moisture and reduce discomfort without the hormones. 

The thing is, your libido changes over the course of your lifetime. You need to work to maintain it by continuing to grow, evolve, explore, and be curious, whether it’s with yourself or a partner. 

When women are young, they’re constantly being objectified, and that can be horrible. But as we get older, all of a sudden you may feel less noticeable— our culture has told you to fade  away, and that you are not a commodity anymore. And as much as maybe you don’t want to be a commodity, there’s also a sense of grief around losing that attention. It’s, it’s really intense.

Speaking from my own experience, I got breast cancer at 47 and I got divorced at around 48, so I was peri-menopausal and newly dating. I can tell you firsthand that your libido is still there, if you know how to look for it. Ask any woman of a certain age who isn’t interested in sex, and then all of a sudden finds herself single. For women who have been with the same partner for years, I recommend reading Esther Perel— she talks a lot about mystery and anticipation and novelty, and how in a long-term relationship you have to work at that. 

Do you have any tips to increase sex drive naturally?

There are supplements that have some okay data that seem to indicate they may increase libido naturally. There’s some decent data on the use of matcha, or green tea, which can be found in Kindra’s Energy Boosting Dietary Supplement. [KCM also recommends Kindra’s Core Supplement, whose hero ingredient duo, Ashwagandha and Pycnogenol, may help to improve vaginal dryness and libido after 12 weeks of use.]

That said, I think the most important thing for a woman’s libido is that she feels comfortable in her own skin. So really pay attention to yourself, and take care of your body. Work on accepting and loving yourself. Beyond that, foreplay can really help, especially touching, whether it’s by yourself or with another human. Try a sensual massage, or just cuddling. These can be really helpful.

Is it normal for sex to hurt during menopause? I’ve heard painful sex is just something that’s “all in my head,” and that I just need to relax. Is that true?

Absolutely not! And this is super-duper fixable. A lot of women think “oh, painful sex it just part of being a woman.” That is both very untrue, and very unfair! During menopause, as estrogen levels drop, we have a decrease in blood flow and decrease in collagen production, which means a decrease in elasticity. So vaginal tissue becomes more delicate, and more sensitive— and not in a good way. Women may experience dryness, irritation, and tearing, which causes pain. I’ve heard people tell me that it feels like shards of glass are in there. That’s awful, and that is not going to help you feel relaxed and sexy. 

This is not in your head— these issues are caused by real changes to your physical being. Moisture is super important, and again Kindra’s Daily Vaginal Lotion is fantastic for that. [The vast majority of women who used this lotion reported feeling hydrated, soothed, comfortable, and naturally lubricated after just one day of use, and reported an improvement in the feeling of pain during sex after 14 days of use]. It’s not specifically a lube just for sex— think about it more like a daily moisturizer that will mitigate irritation and rebuild the moisture barrier over time.  And then for some women, localized vaginal hormones really can be fantastic. So if you’re unsure, or if you’re hearing otherwise, I suggest you find a specialist who knows about menopause. 

For sex, you’ve got to get a good lube. Not all lubricants are created equal! Just because something is advertised as “natural,” it doesn’t make it better. The reality is, for sex, you need something that’s non-absorbable, so silicone-based lubes are better for sex as you age. 

I worry that my partner is unhappy because I’ve lost interest in sex. How can we stay intimate as a couple if I’m no longer feeling sexual? 

It sounds to me like this person’s problem is a lack of communication. Maybe you’ve been with your partner for a while, and now things feel stale. If you want to try something new and fun, like sexting, that can increase anticipation, which then releases dopamine and increases sexual response. If you are excited and interested in trying something new, it’ll perk you both up. Maybe try greeting your partner at the door in lingerie!

That said, you don’t have to do anything that makes you feel uncomfortable. Maybe doing something super out of the box sexually feels strange, and that is totally ok. One of the things that I encourage people to try is to let go of the idea of “result-oriented” sex. Intimacy doesn’t have to end in orgasm. Maybe just try laying naked together and explore each other, just touching. Maybe you won’t have an orgasm, maybe you will. Try to stop focusing so much on what you think your partner wants, especially if it’s something you aren’t interested in doing anymore. Try focusing on being curious, and especially being curious with your own body. If exploring your own body is something you’ve never done before, now is the time to try it. Figure out what type of touch feels good to you now. I would bring curiosity and play into it, and maybe just make that the goal. 

Does male libido decrease with age?

There is some data indicating that there’s a “manopause.” I don’t know much about it and I’m certainly not an expert, but I believe there is a decline in libido as men age. Older men may suffer from erectile dysfunction. If this is something your partner is experiencing and he refuses to deal with it, he needs to go see his doctor because it may be an early indicator of serious heart disease. A lot of times men will say they don’t want to deal with this type of issue because they’re embarrassed, but it’s actually a really important part of overall male health. 

If my partner now needs to use lube or lotion during sex, does it mean she’s not turned on?

Absolutely not! If your partner is saying to you “can we use some lotion or lube,” do it, because it sounds like she wants to have sex! You should never take someone else’s bodily changes personally. With major hormonal changes, sometimes the brain and the body just don’t interact how you expect them to. This is a thing that can happen in perimenopause and menopause, or in younger women too, because they’re on birth control pills, or maybe there’s another hormonal issue altogether. A woman can absolutely feel aroused but not have a physical response. 

The other thing this person could do, which sounds so obvious, is just ask this woman how she’s feeling. It can be so hard to be vulnerable. Your partner might feel terrified because they’re exposed, quite possibly literally naked, and are afraid of being rejected. But taking that chance and asking anyway— that’s what vulnerability is. 

Intimacy builds when you are willing to just be honest, and be yourself. If your partner asks you  “Hey, what’s going on in your body, what’s going on in our sex life, I’m not taking this personally, this isn’t about my wants or needs, I want to make you feel good,” you’re probably going to want to jump their bones. 

Does the intensity of orgasms decrease during and after menopause? Why? Is there anything that can be done about that? 

That’s really individualized. For some women it does. It can be the result of tissue changes and blood flow changes. Some of it can be altered by all the things we’ve talked about, like intimacy and trust, but I would also suggest changing things up a little bit. What made you orgasm ten years ago might not work now, but something different that didn’t work for you then my work now. So you’ve just got to try new things. Understand your own anatomy. I’ve found that women of a younger generation are much more aware of their own bodies. Maybe it’s because they grew up with the internet, but they seem to have a very different take on body positivity, self-pleasure, and a general understanding of sex. 

I know women my age who maybe come from a more conservative background may just be unfamiliar with their own bodies. It’s important to understand your own vagina, and what is going to make you feel good. It’s important to know that different parts of that tissue may be more aroused or more sensitive at different times of your cycle, and different times of your life. Looking in a mirror and getting a visual of your own anatomy can be so helpful. Often it’s just a matter of exploring, and making sure you’re really attending to your own vaginal health.

Written and reported by Emily Pinto