Menopause and sex - fact sheet

Sexuality is an important part of our human experience, but hormonal changes at menopause can sometimes lead to reduced libido (sexual desire) and pain during sex. While this is common, it can be frustrating and may affect your relationships.

Can menopause affect your sex life?

Life stage and relationships

Not all sexual problems are due to menopause. At this stage of your life, you may have added pressures that affect your sex life. For example, children moving out of home, caring for elderly parents or relationship issues.

You may also feel differently about your body and may not want to be intimate with your partner as often as you used to. If your partner does not understand what you are going through, this can also affect how you feel about sex.

Vaginal symptoms

Lower oestrogen levels can change the tissues of your vulva and vagina. Your vaginal skin gets thinner, and your vagina becomes drier, less lubricated and less elastic. This may cause vaginal irritation and pain during sex.

Menopausal symptoms

Menopausal symptoms, such as hot flushes, night sweats, low energy levels, poor sleep and low mood can also affect your sexual desire.

Lower sexual desire

Changing hormone levels can have an impact on your sexual desire, make it harder to have an orgasm or make sexual experiences feel less pleasurable.

Management options

Vulvovaginal atrophy

Vulvovaginal atrophy is the thinning of tissues in the genital area due to lowered oestrogen levels. This can affect your vagina, vulva, urethra, base of your bladder and pelvic floor muscles.

Vulvovaginal symptoms can be treated with:

• vaginal oestrogen (in the form of a cream, pessary or tablet)
• menopausal hormone therapy (MHT)
• vaginal moisturisers.

You can also relieve vaginal dryness and pain during sex by using vaginal lubricants or oils.

Your doctor can recommend the most suitable treatment for you.

Sleep

Improving your sleep may help improve your sex life.

You can:

• keep cool at night (e.g. wear lightweight fabrics, use layers on your bed instead of heavy doonas, use a fan or air conditioner)
• improve your sleep habits (e.g. go to bed at the same time each night, avoid napping, develop a bedtime routine)
• adopt a healthy lifestyle (e.g. exercise most days, eat healthy foods and avoid caffeine, alcohol and nicotine before bed).

Hot flushes and night sweats

There are lots of ways to deal with hot flushes and night sweats.

For example:

• use MHT
• avoid your triggers (e.g. spicy foods, hot drinks, alcohol, caffeine, nicotine)
• reduce stress
• keep cool (e.g. dress in layers, use a fan or air conditioner, drink cold drinks).

Mood and emotions

Looking after your emotional health is important and may help you feel better about sex. You can:

• look after your physical health (e.g. exercise, eat well, rest)
• work through your emotions (e.g. talk to a friend or counsellor)
• try different mindfulness and relaxation techniques
• use strategies such as cognitive behavioural therapy (CBT), with help from a trained practitioner.

Counselling

If you have relationship problems, you can try talking to your partner about what you’re going through and ask for their support. You could also seek help from a psychologist who specialises in couples counselling, or a sex therapist.

Sexual desire

If you are concerned about having little to no sexual desire, it’s important to discuss this with your doctor.

Testosterone therapy

Some women become very distressed about their loss of sexual desire. This condition is called hypoactive sexual desire disorder (HSDD). For women with HSDD, testosterone therapy may be appropriate. Testosterone is available as a cream in Australia. It’s important to use this treatment under the close supervision of your doctor.

Pelvic floor physiotherapy

Pelvic floor muscles can become tight during the menopause transition, which may increase pain during sex. The muscles can also lose tone, which might cause aching, incontinence or prolapse (i.e. the bladder, uterus or bowel protrudes into the vagina). A pelvic floor physiotherapist can teach you pelvic floor muscle awareness, relaxation and massage techniques to help reduce any pain.

When to see your doctor

Talk to your doctor if symptoms affect your daily life.

For example

• menopausal symptoms are affecting your sex life
• you are experiencing strong emotions, anxiety or depression
• you have vaginal symptoms such as vaginal irritation or painful sex
• you are distressed about your loss of libido.

For further information visit https://www.jeanhailes.org.au/health-a-z/menopause