Menopause and Sex

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Unfortunately, some of the common medicines used to treat depression may also impact your sex drive- or your partner's. Other common medications such as medicines for high blood pressure may have the same effect. Talk with your physician about this; there may be simple changes that can be made which can have very positive outcomes. It’s also important—although it may be embarrassing--to talk with your physician about any physical difficulties you may be having related to menopause that may impair your sexual activity. Many of these difficulties can be improved or resolved with medical therapy, such as hormone replacement therapy (HRT), vaginal lubricants, aids for incontinence, or making changes to existing medication regimens.

It is clear that HRT has a positive benefit on treating menopausal symptoms in the short term (less than 5 years), which in turn may improve sexual desire and satisfaction. Some studies have also shown that a combination of estrogen and testosterone, the male hormone that women normally manufacture, may improve sexual desire. All medical treatments have advantages and disadvantages, however. Results from the Women's Health Initiative indicated that women whose average age was 63.5 who took a combined estrogen-progesterone combination therapy had an increased risk of invasive breast cancer, heart attacks, strokes, and blood clots. Estrogen-testosterone replacement may also reduce the cholesterol benefits that estrogen alone provides and have other side effects. More studies are needed to evaluate fully the benefits/risks of combined estrogen-testosterone therapy, as are studies to elucidate the benefits of estrogen or its alternative therapies on menopausal sexuality in general. Only your physician can give you individual recommendations as to what’s best for you given the information we now have and your own personal risk profile.

One approach to learning more about menopause and sexuality is to ask menopausal women themselves. According to a recent survey of 1001 women by Yankelovich Partners (sponsored by Wyeth-Ayerst Laboratories), a majority of women ages 50-65 say their sexual desire and interest in sex is just as robust or has increased since before menopause. Menopausal women surveyed cite greater overall balance in life (77%), less child rearing responsibilities (61%), and decreased risk of pregnancy (52%) as key reasons for maintaining their sexual energies. Another interesting finding was that of this group, women taking hormone replacement therapy (HRT) reported greater sexual activity than their counterparts not on HRT.

The findings of the survey make sense medically -- HRT can relieve the symptoms caused by reduced estrogen levels that can make sex uncomfortable for many women after menopause, including hot flashes, sleeplessness, night sweats and vaginal dryness. According to the survey, women who have partners but are not on HRT cited menopausal symptoms and low sex drive as reasons they may be having less sex now than before menopause, which may explain why more women on HRT are enjoying sex more.

Contrary to “conventional wisdom”—i.e. myths—surrounding menopause, more than 87% of the women surveyed have a positive attitude toward menopause. These women also play an active role in managing their health-they indicated that good nutrition (98%), exercise (95%), and plenty of rest and sleep (91%) are some of the keys to remaining healthy and vital during and after menopause. Of the women surveyed, 80% reported feeling more independent and in control of their lives since entering menopause.

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When comparing sex before and after menopause, 82% of women taking HRT said that their sex life improved or has stayed the same, whereas only 68% of women not taking HRT feel the same way. The women on HRT cited comfort with their partner, physical fitness, no fear of pregnancy, and HRT as the top four reasons for their satisfying sex life. Perhaps most interestingly, the majority of women on HRT said that their HRT (60%) is more important than sexy lingerie (35%) to maintaining their satisfying sex life.

There is so much that women can, and should, do to protect their health—physical, emotional, psychological, and sexual--during and after menopause. Exercise, nutrition, good relationships and a positive attitude will all help women live vital and healthy lives. Sex is just one part of the equation. Women entering menopause and even those already in menopause should speak with their doctors—and their partners--about what’s best for them.

Next: You Can Have A Good Sex Life Despite Menopause

Last updated: 9/2000.  Last reviewed: 11/05.

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