Symptoms
WHAT IS IT?
As they enter perimenopause, some women have less interest in sex than they used to. They may have less of a sex drive. Some people call this “lower libido.” Women may have less pleasure and fewer orgasms during sex.
If you are less interested in sex because it is painful, then the first solutions should aim to decrease pain during sex. Otherwise, the solutions aim to increase pleasure in sex.
WHAT’S HAPPENING TO MY BODY?
Sexual desire decreases with age in both sexes, and low desire is common in women in their 40s and 50s, but not universal. As our nerves and blood vessels age, it may take longer for the nerve signals to work. This happens throughout the body, including in our vaginas. As a result, we may have less feeling, less lubrication, lower arousal, and it may be harder to have an orgasm. Some women have increased interest, while others notice no change at all. What’s important to remember is that there is a full range of psychological, cultural, personal, interpersonal and biological factors that can contribute to declining sexual interest. This may or may not seem like a problem to you.
Read about vaginal pain during sex.
Read about vaginal pain when not having sex.
WHAT TO EXPECT
Sexual desire decreases with age in both sexes, and low desire is common in women in their 40s and 50s, but not universal.
Some women have increased sexual desire post menopause. They report feeling more spontaneous. They no longer have to worry about birth control.
Treatments that are inappropriate or have not been studied for this symptom are not listed.
Kagan R, Kellogg-Spadt S, Parish SJ. Practical Treatment Considerations in the Management of Genitourinary Syndrome of Menopause. Drugs Aging. 2019;36(10):897–908. doi:10.1007/s40266-019-00700-w
Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society Menopause: 2013;20:888-902. DOI: 10.1097/gme.0b013e3182a122c2
Labrie F, Archer DF, Koltun W, et al. Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause. 2018;25(11):1339–1353. doi:10.1097/GME.0000000000001238
Labrie F, Archer DF, Martel C, Vaillancourt M, Montesino M. Combined data of intravaginal prasterone against vulvovaginal atrophy of menopause. Menopause. 2017;24(11):1246–1256. doi:10.1097/GME.0000000000000910
Rahn DD, Carberry C, Sanses TV, et al. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014;124(6):1147–1156. doi:10.1097/AOG.0000000000000526
Scheffers CS, Armstrong S, Cantineau AE, Farquhar C, Jordan V. Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database Syst Rev. 2015 Jan 22;1:CD011066. doi: 10.1002/14651858.CD011066.pub2. PMID: 25879093.
Simon JA, Altomare C, Cort S, Jiang W, Pinkerton JV. Overall Safety of Ospemifene in Postmenopausal Women from Placebo-Controlled Phase 2 and 3 Trials. J Womens Health (Larchmt). 2018;27(1):14–23. doi:10.1089/jwh.2017.6385
Tuiten A, van Rooij K, Bloemers J, et al. Efficacy and Safety of On-Demand Use of 2 Treatments Designed for Different Etiologies of Female Sexual Interest/Arousal Disorder: 3 Randomized Clinical Trials. J Sex Med. 2018;15(2):201‐216. doi:10.1016/j.jsxm.2017.11.226
Last updated: April, 2021.
