Decreased libido can be attributed to many physical, psychological, and social factors. Emotional and physical health, as well as life experiences, personal or religious beliefs, socialization, and current partnership, all play a role in shaping a woman’s sex drive.
In some ways, menopause is both a physical and psychological factor that can decrease the desire for sex. During menopause, estrogen levels drop dramatically, resulting in a decreased interest in sex. Lower estrogen levels also reduce lubrication in the vagina, which might lead to discomfort or even pain during sex, which can have a rippling effect on sexual desire.
Although many women continue to have and enjoy sexual intercourse in menopause, others find that sex begins to feel like a chore. And while many women and their partners can still enjoy a sense of intimacy without sexual intercourse, other couples struggle to cope with these changes.
Some common conflicts that my patients experience during menopause include:
- Lack of intimate connection with their partner
- Conflict over sexual needs
- Difficulty in communication with their partner about sex
Talking to Your Gynecologist About Intimacy Issues and Menopause
When you come to visit you gynecologist, please know that we care about your emotional and sexual health as much as your physical health. It may feel awkward and uncomfortable to talk to your doctor about your sex life, but these types of concerns are perfectly appropriate and we hope to help in any way that we can. It is important that you talk openly to your gynecologist, as the difference in the quality of your life can be huge.
Please remember, we aren’t here to judge you, and all interactions between patients and doctors are strictly confidential.
What to Ask Your Gynecologist
Here are a few common questions that my patients have found helpful to ask:
- What treatments are available to help with my low sexual desire?
- Can you recommend any books for people in my situation?
- Will my sexual desire ever return to the level it once was?
- Can I make any changes to my daily routine that would improve my condition?
Prepare for your doctor to ask questions about your sexual response and sex life. We may ask about troubles with arousal or orgasm, vaginal dryness, pain or discomfort during sex, and feelings about your changing sex life.
Hormone Therapy for Treating Low Sex Drive
For women experiencing low sex drive as a result of menopause, hormone replacement therapy may help ease the transition. When menopause slows the production of estrogen in the body, hormone replacement therapy works by re-introducing estrogen through a pill, cream, patch, or spray. Hormone therapy can improve mood and help return a woman’s sexual desire and sexual response back to normal levels.
There are downsides to systemic estrogen replacement therapy if you have certain types of breast or endometrial cancers, which are known to respond to estrogen. In these cases, your doctor may advise smaller doses of estrogen delivered directly to the vagina via vaginal creams, tablets, or rings. These can stimulate blood flow to the genitals and aid the vagina in producing natural lubricants, which can help make sex more enjoyable and comfortable.