Summary
Read the full fact sheet- Menopause may affect your sexual desire.
- Menopausal hormone therapy (MHT) is not a form of contraception.
- Use contraception until at least one year after your natural periods stop.
- If you are under 50 at the time of your last period, use contraception for another two years.
- Condoms provide the best protection from sexually transmissible infections (STIs).
- Talk with your partner about sex and the effects of menopause.
- Seek advice from a professional if you need help with any sexual problem.
On this page
What is menopause?
Menopause is when your periods stop. This happens when your reproductive hormones (e.g. oestrogen) are lower and there are no eggs left in your ovaries. Most women reach menopause between the ages of 45 and 55. In Australia, the average age to reach menopause is 51 to 52.
How does menopause affect your sex life?
Changes around the time of menopause can affect your sex drive (libido) and sexual experience.
Physical changes with menopause
Menopause symptoms
You may be less interested in sex due to symptoms such as hot flushes, night sweats, low energy levels, sleep problems and low mood.
Vaginal changes
A drop in oestrogen levels causes the walls of the vagina to be thinner and drier, which may cause vaginal irritation and pain during sex.
Bladder and pelvic floor changes
Changes to bladder tissues and pelvic floor muscles can cause continence problems (e.g. wee leakage), which can reduce sexual desire.
Sexual experience
Physical changes and lower sexual desire can make it harder to have an orgasm and sexual experiences may feel less pleasurable.
Body image and menopause
You might feel differently about your body around the time of menopause. This may be due to:
- social attitudes – modern society rarely portrays older women as sexual or desirable, which can affect the way women feel about themselves sexually
- weight gain – many women gain weight around their belly (abdomen) at this stage of life, which may make them feel less sexually attractive.
Life stages
Other factors can affect your sexual desire at this stage of life. For example:
- poor health
- anxiety and depression
- medicines and their side effects
- sexual problems.
Other factors may include:
- relationship issues
- loss of a partner through death, separation or divorce
- work and financial pressures
- caring for elderly parents.
Managing low sexual desire
If you’re concerned about how menopause is affecting your sexual desire, talk to your doctor. They may suggest menopausal hormone therapy (MHT), vaginal moisturisers, lubricants or oestrogen to improve vaginal dryness.
Testosterone therapy
Some women become very distressed about their loss of sexual desire. This condition is called hypoactive sexual desire disorder (HSDD). Treatment with testosterone therapy may help. This therapy should be supervised by your doctor.
Pelvic floor physiotherapy
Sometimes pelvic floor muscles can tighten or lose tone at menopause. This can cause painful sex, aching, incontinence or prolapse (i.e. the bladder, uterus or bowel protrudes into the vagina). A pelvic floor physiotherapist can teach you pelvic floor muscle exercises and show you techniques to help reduce pain.
Other practical ideas
There are practical things you can do to help maintain or improve your sex life after menopause. For example, if you have a partner:
- talk to them about your symptoms and how they affect you
- try different ways to be intimate, like spending time together doing things you both enjoy
- consider relationship counselling if needed.
Contraception
As you age, your fertility declines. But it’s still possible to get pregnant in your late forties or early fifties if you’re still having periods.
If you’re under 50 and don’t want to get pregnant, you should use contraception for at least two years after your final period. If you are 50 or older and don’t want to get pregnant, you should use contraception for at least one year after your final period.
You can talk to your doctor about different contraception options.
Note that MHT is used to manage menopausal symptoms - it is not a contraceptive.
When to see your doctor
Talk to your doctor if menopausal symptoms affect your daily life. For example:
- if symptoms affect your sex life
- if you have urinary or vaginal problems
- if you are distressed about your loss of sex drive
- if you are feeling anxiety, depression or big mood swings.
More information
For more detailed information, related resources, articles and podcasts, visit: jeanhailes.org.au/health-a-z/menopause
Where to get help
- Your GP (doctor)
- Jean Hailes for Women’s Health Tel. 1800 JEAN HAILES (532 642)
- A gynaecologist
- A pelvic floor physiotherapist
- A relationships counsellor
- A local reproductive & sexual health clinic
- Sexual Health Victoria
- Sexual difficulties in the menopause, 2016, Australasian Menopause Society
- Menopause: Mental health and emotions, 2017, Jean Hailes for Women's Health.
- Sex and the perimenopause, Women’s Health Research Program, Monash University, Australia.