Do sex drive and intimacy change with menopause?

While sex can be an enjoyable activity for most of our lives, during menopause (the time when your ovaries stop producing eggs and your period stops completely), it can feel itchy, prickly, and uncomfortable. So, you might be put off by even the thought of being sexual with anyone (including yourself). Other physical symptoms of menopause like hot flushes and headaches on top of a generally low mood and lack of energy can really make it seem like sex will not be the same again. But there are ways around this! Let's explore how you can rediscover your libido around the menopausal years.

During perimenopause (the time leading up to menopause), our bodies go through a series of hormonal changes. Eventually, our ovaries stop producing oestrogen, which is the hormone responsible for regulating ovulation. As a result, our menstrual cycle eventually stops completely and that’s when we officially reach menopause.

These changes can lead to symptoms like hot flushes, irregular bleeding, changes to your discharge, and reduced libido (sex drive). There is also generally less blood flow in your intimate area, which can make it harder to orgasm ^[3]. That’s why, for some women+, it might feel like intimacy does not come as naturally as it did before, and this is completely normal (blame our hormones!).

While this causes us to experience sexuality and our bodies differently, it doesn't mean that the days of great sex are over. There are plenty of things you can do to have a pleasurable and healthy sex life around menopause.

As oestrogen levels fall during menopause, vaginal tissues start thinning and becoming drier, which can lead to penetrative sex becoming uncomfortable or even painful for some of us. But that doesn’t mean sex is off the table!

Using lubricant (oil or water-based) or a vaginal moisturiser can reduce dryness, itchiness, or burning during penetrative sex. Also, frequent vaginal stimulation (with or without a partner) can help us maintain healthy vaginal tissue after menopause. ^[2] And keep in mind you can always go with oral sex and other forms of play instead of penetration... there are plenty of options to explore!

Sometimes, though, it’s not just menopausal symptoms getting in the way. If we’ve had painful sex in the past, this could bring up feelings of anxiety and fear during new encounters. This anxiety can tighten the muscles in the vagina and make penetrative sex difficult. Remember that sex should be enjoyable for everyone involved and it’s okay to take a pause or even stop completely whenever something doesn’t feel right.

If you're experiencing anxiety or stress around sex, it's important to talk to your sexual partners about it. Open communication and honesty will help them understand what you are going through so that you can figure out a way forward together. And if that idea of sex is really getting you down, it might be a good idea to reach out to a mental health professional or sexologist. They may have the tools you need to process and cope with the feelings that are getting in the way of your sex life. Remember, everything has a solution!

Despite the possible complications, yes, it's totally possible to enjoy sex after menopause. 

Although we often hear of and talk about sex on a physical level, it really all starts in our brains. Feeling at ease, safe, and comfortable can be huge turn-ons. This means we can enjoy sex at any stage of our lives. Particularly after menopause, it may help you relax during sex to know that unwanted pregnancy is extremely unlikely. It’s also possible that around this time you will have less career or family responsibilities and pressures, allowing for the time and space to focus on your own enjoyment.

Keep in mind that sex means different things for different people, it’s not just about penetration. Especially if your vagina becomes less sensitive to touch, there are lots of options out there for external stimulation and many other body parts beyond your V-Zone (that’s everything to do with our vagina, vulva and the V-shaped front of our body that you can see) that may give you pleasure. This is a fantastic time to explore yourself and to connect with a partner!

And if you're planning to engage in sexual activity with others, remember you can still catch sexually transmitted infections (STIs) before, during and after menopause, so practising safe sex can save you a few trips to the doctor.

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The first step is always focusing on yourself. If you feel like menopause has affected your attitude towards sex and pleasure, you may want to take some time to rediscover your body. Explore what feels good and what doesn't — this might have changed in the past few years, and that’s completely okay.

It could be as simple as buying yourself underwear that makes you feel fabulous, practising a little self-care, or trying a workout class you've been putting off. Feeling comfortable and empowered in your body can boost your confidence, increase your desire, and make you feel good overall.

It's also important to connect and communicate with your partner about intimacy post-menopause. Consider doing this earlier rather than later (when you reach that phase) — the more time you have to prepare and adjust, the better! Let them know what works for you and what doesn't when it comes to sex (and your relationship in general). Although this can be an awkward conversation, it's totally worth it — your wants and needs are always valid. And it’s completely human for them to change throughout life.

Plus, intimacy doesn't always (or ever) have to be just about sex. When menopause approaches, it’s a great time to open up the conversation to redefine what it means for you. It could just be holding hands or cuddling in bed — whatever you both are comfortable with. 

So why not try going on a date or scheduling some quality time with your partner to ease the tension before speaking about intimate topics? And if you can’t find the right words or are struggling to recognise what you want, it’s absolutely fine to ask for help. A sex and intimacy expert can help you, whether it’s on your own or as a couple.

There are a few things you can try to boost your libido around this new phase in life:

• Use a vaginal moisturiser to keep you comfortable throughout the day.
• Use a vaginal lubricant (like water or oil-based lubricant) to help your V-Zone get ready for penetrative sex.
• Try masturbating to figure out what feels good. This can also boost your body confidence, self-esteem, and body image.
• Give pelvic floor exercises a go — these are exercises that help strengthen the muscles around your vagina and bladder and can help penetrative sex feel better.
• Set a date and time for sex and pop it in your calendar. It may sound unsexy but scheduling it can help you prepare and get in the mood.
• Consider sex therapy or relationship counselling to help you embrace your new sexual self and even help you open up to your partner.
• Take a break from your usual sexual routines and talk to your partner about trying new things that excite you.

And if you don't feel like having sex or feel like taking a break from it during or after menopause, that's completely fine, too! There are plenty of other ways to be intimate with yourself or your partner. You can always try taking yourself out on a date, spending time away from your phone and the TV, or taking an exotic vacation — remember, intimacy is not all about sexual activity.

Whether sex is the last thing on your mind right now or you've felt your libido skyrocket (or if you're somewhere in between!), dealing with the changes that come leading up to and during menopause can be tough. So try not to put too much pressure on yourself when it comes to sex, intimacy, and your level of desire. Instead, take some time to focus on yourself and rediscover what feels good and what doesn't — sexually and beyond.

Curious to find out more about the changes we go through around menopause? Discover how your hormones change during menopause and how they can impact your mental health.

The medical information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your doctor for guidance about a specific medical condition.

^[1]  Yes, you can have better sex in midlife and the years beyond

^[2]  Vaginal dryness after menopause: how to treat it?

^[3]  How does menopause affect sex drive?