Sex Drive in Perimenopause: Does Menopause Affect Your Libido?

Do you wake up wondering if you’ll like your spouse today or feel the total ick? Or maybe you’re in the (luckier?) category where you just cannot get enough. Either way, you’re not alone.

Let’s talk about sex, baby.

Oh yes, we are going there. And for good reason! So, so, so many women experience a change in libido during perimenopause and beyond. According to a Johns Hopkins study, more than a third of perimenopausal women experience sexual difficulties, from lack of interest in sex to difficulty reaching orgasm.

Luckily, there are ways to manage these mood shifts and desire swings. And your partner won’t secretly wonder whether you’ll wake up as Dr. Jekkyl or Mr. Hyde each day.

How Does Menopause Affect Your Sex Drive?

Perimenopause is a roller coaster. With hormonal changes and physical changes wreaking havoc on your mood and body at every turn.

Add to this the usual stress of life in your 40s and 50s. You may be raising kids or teens. You might have a demanding job. You could also be caring for aging parents.

It can be tough to find interest or time for an intimate encounter. It is even harder to nurture a physical relationship.

Kara Pettinger, clinical sex therapist, LMSW, explains how perimenopause impacts your sex drive:

https://youtube.com/shorts/vCk7ck88by8?feature=share

Let’s dig a little deeper.

Hormone Changes

Of course, estrogen is a primary factor in libido (your baseline desire for sex). Your body experiences a significant decline in estrogen production, often leading to a lower sex drive in perimenopause.

Estrogen is also vital to maintaining lubrication, elasticity, and blood flow to your pelvic region. These are critical to sexual function. They impact your body’s ability to become aroused and find pleasure in sex.

Testosterone levels plays a role, too. Females produce less of the hormone than males, but testosterone production also declines over time, at a slower rate than estrogen. Relatively speaking, this can initially produce a sexual boost, if you will, for some women (lucky them), but it may not be permanent.

• Sometimes testosterone therapy is used to help women improve libido (hypoactive sexual desire disorder). However, it is not approved for general use in women by the FDA at this time. Talk with your doctor about libido issues.

Physical Changes

Your body changes a lot, externally and internally, during the perimenopause transition. Once again, estrogen has a starring role.

As estrogen levels decline, your body gets drier – from dry skin and hair changes, to vaginal dryness, nearly every system in your body changes. This means, you may experience pain or discomfort during sex because vaginal tissues aren’t as well-lubricated.

Lower estrogen also impacts blood flow to your pelvic organs, and makes female arousal difficult.

Then there are peri symptoms like hot flashes, fatigue, joint pain, or a change in body image or shape (looking at you, menopause belly), that simply make you feel less than desirable. It is hard, maybe even impossible, to feel sexy when all you really want to do is put on stretchy pants or sleep.

Psychological Changes

We live in a hyper-connected, go-go-go era. You have a full-time job, two kids in club sports and one in competitive dance, aging parents who need more assistance by the month. Not to mention the stress of life (politics, social media, climate change, etc.).

Oh, and you have a spousal relationship to nurture.

That’s only an example, but odds are you relate to at least some of these pressures. It is stressful, to say the least. It’s no wonder, mental health – especially stress, anxiety, and depression – can take a nosedive in the perimenopausal years.

These psychological changes can also lower your sex drive.

Relationship Issues

So your spouse folded the towels (the wrong way!), sending you seething. Or didn’t rinse the toothpaste out of the sink after brushing and all you can think about is how disgusting they are. (“I can never sleep with this animal again!”) Yay, hormonal roller coaster.

Once again, you can thank drops in estrogen for the swings from loving to loathing and back. Always unpredictably… for you and your partner.

But a lack of desire isn’t only tied to low estrogen.

Relationships are a ton of work, based on communication and connection. If you and your partner aren’t communicating well verbally, it shouldn’t be surprising if the, uh, nonverbal also struggles.

This is particularly true if you’re already feeling vulnerable about your body or not in a good mental space.

Check out this clip for more on why communication with your partner is so essential to your sex drive:

Yes, that’s an intimidating list.

So, Does This Mean Your Sex Life Is Over After Menopause?

Definitely not. Let’s just bust that myth immediately.

Even though you’re no longer in the baby-making stage of life, it doesn’t mean sex matters less. Sex is an important part of a physical relationship, and just because your body is changing, it doesn’t mean you can’t have the fulfilling sex life that is right for you.

There are many benefits to sex after menopause.

• Many women find it more freeing to have sex after they’ve reached menopause (once you’ve hit 12 months without a period you are officially postmenopausal). Can a woman get pregnant after menopause? Nope! The potential stress of pregnancy is no longer an issue.
• Other women report feeling more comfortable in their own skin and in asking for what they want. Confidence is sexy.
• Sex also promotes stress relief, and thanks to the flood of “feel good hormones” like endorphins, oxytocin, etc., increase relaxation and improve sleep.
• Sex helps strengthen the bond between partners. It often goes hand-in-hand with improved communication and emotional intimacy.
• A cross-sectional study by the National Institute of Health shows women who maintain an active sex life during perimenopause experience fewer/less intense perimenopause symptoms.

HOWEVER, remember you CAN get pregnant during perimenopause. Your body is still going through the menstrual cycle, even if it is wonky.

Yet, perimenopause occurs during some of the busiest and most stressful stages of life. Finding a few moments for some sexy time is hard, and if the sex is painful or lackluster, why bother?

Ways to Improve Sex Drive In Menopause

You deserve good sex. The benefits are impossible to ignore.

Our sex drive is impacted by so many things, from mood to stress to sleep levels and connection with your partner, and there are many options to help bring that sexy back.

Let’s get tactical:

Hormone Therapy and Estrogen Cream

Hormone therapy (HT), also called hormone replacement therapy (HRT), can be life-changing. Talk with your doctor about the benefits and risks, and if you’re a candidate for HT.

You can also try a topical estrogen cream. This can be applied to the vulva and surrounding vaginal tissue to help improve elasticity and lubrication and ultimately, make sex feel better. Talk with your doctor about a prescription.

Vaginal Lubrication

It’s a classic for a reason. Try applying an over-the-counter lubricant before or during sexual activity. Water-based lubes are generally safest, can be used with sex toys and condoms.

You can also try a vaginal moisturizer. They aren’t designed for sex – think of it more like a lotion to hydrate your lady parts. They can be applied any time.

Lifestyle Changes

Four big lifestyle factors: a nutritious diet, regular exercise, rest, and stress reduction can create a chain reaction effect on your overall health, including your sex life. Obviously, some of these are easier said than done, but they’re worth the effort.

Communication

Though it can feel awkward at first, talk with your partner. Keeping communication open, explaining how you feel and what you need in regards to sex is as important as any other topic.

It may be worth exploring relationship counseling, specifically to help improve communication with your partner. As we explored above, good communication in a loving/trusting relationship can lead to an even better sex life.

Try Something New

Consider incorporating sex toys or new positions. This can be a fun way to explore new things with a partner (or on your own)! Maybe you send a flirty text or add a mysterious appointment to the calendar to get your mind into the mood for what you hope to make happen later.

Menopause and a low sex drive do not have to go hand in hand. Now, go have some fun!

How Menovation Can Help

Check out the Menovation app and become empowered during perimenopause and beyond. It features exercises, nutrition plans, and education for improved well-being, reduced symptoms, and inspiring self-care for confidence and vitality. Then tell a friend – we are trying to keep the lines of communication about peri(menopause) open, right?

Did you know that entering menopause takes several years? There are so many factors to consider! Take our Stage of Menopause Quiz to find out what stage you are in!

As always, talk to a doctor or mental health professional about your experience. Don’t hesitate to contact a professional if you need extra support. If you have severe symptoms, want to learn about hormone therapy, or have other health issues, reach out for help.