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As women enter menopause, they may have changes in their libido, or sex drive. Just how menopause and hormones affect the loss of a woman's libido isn't clear.
What are some physiological changes in sexual function for women in menopause?
When women reach menopause, a drop in estrogen levels leads to changes in the vagina. Vaginal dryness and thinning of the vaginal wall can make intercourse uncomfortable. Diminishing levels of estrogen have not been linked to the loss of sexual desire. However, research has identified the hormone androgen as a major player in a woman's sex drive throughout her life. But just as estrogen falls during menopause, androgen levels also drop, leading to less sexual desire. Other factors that cause androgen levels to decline include surgical removal of one or both ovaries before menopause, pituitary or adrenal insufficiency, corticosteroid therapy and chronic illness.
What other things affect sex drive?
Many factors affect a woman's sexuality in midlife and during menopause, including:
- Previous attitudes about sexuality: If a woman did not enjoy sex prior to menopause, she may have a lower desire for sexual activity.
- Age-related changes: The rate and extent of sexual desire is affected by age and depends on the woman.
- Body image: A change in physical appearance can occur simultaneously with menopause. A positive self-image usually accompanies a positive sexual attitude.
- Health concerns: Serious illness or surgery may affect physical appearance and emotional well-being. A woman whose uterus is removed may feel less attractive.
- Incontinence. This condition could lead to sexual avoidance.
- Sleep problems: Hot flashes during the night could interrupt sleep and lead to fatigue, irritability and less interest in sexual activity.
- Depression: Anxiety or stress could overwhelm a woman's emotional state and decrease libido.
- Medications: Medications for depression or high blood pressure could affect sexual interest or performance.
- Induced menopause: The abrupt, surgically induced state from removal of the ovaries could result in depression and lack of interest.
- Hysterectomy: Losing the uterus could be a relief from bleeding and pain, promoting libido, or decreasing libido by making a woman feel less feminine and undesirable.
How can a woman improve her sex drive?
According to the North American Menopause Society (NAMS) the hormone testosterone has improved sexual satisfaction in several populations of women who have no other issues or ave had their issues resolved. However, the Food and Drug Administration has not approved any testosterone products for the treatment of low androgens in women.
The Food and Drug Administration has studied but did not approve a testosterone patch for women because there isn't enough research about its safety. Some research suggests testosterone may increase the chances for breast cancer probably because it is changed into estrogen in the breast.
Too much male hormone may cause feelings of agitation, aggression and depression. Higher dosages also can cause hair growth on the body and face, acne, an enlarged clitoris, a lowered voice and muscle weight gain. These are side effects that may not go away after you stop taking the hormone.
What else contributes to a postmenopausal women's love life?
The journal Modern Maturity surveyed 1,384 adults (including postmenopausal women) 45 years and older to examine sexual behaviors and attitudes. One major finding was that satisfying sex was important to their quality of life, but relationships were more important than sexual activity per se. The survey also found that 64 percent of men and 68 percent of women were extremely or somewhat satisfied with their sex lives.
This article was reviewed and updated June 2007.
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