How does menopause affect a woman's sexual life?

Menopause may be associated with sexual side effects for many women.
Menopause may be associated with sexual side effects for many women.

Menopause marks the end of the reproductive era in a woman's life. Some women view it positively as periods no longer trouble them and there is no chance of getting pregnant even with unprotected sex. However, as estrogen and testosterone levels take a plunge during menopause, some women experience some of the following sexual side effects of menopause.

  • Vaginal dryness: A decrease in estrogen levels causes less blood supply to the vagina. This causes vaginal thinning and drying leading to vaginal itching and burning. As a result, penetration can become painful or uncomfortable.
  • A decrease in sexual desire, response, and pleasure: Reduced estrogen levels can also make the clitoris less sensitive. Orgasms may become weaker, take longer to come or their frequency gets curtailed drastically.

Some other problems that come with menopause can also aggravate the sexual side effects of menopause.

How can women treat vaginal dryness during menopause?

Water-based lubricants: Women can use water-based over-the-counter lubricants before and after sex. They should avoid using oil-based lubricants as these can damage the latex of the condom; if the woman is at the perimenopausal stage, she can still get pregnant or contract sexually transmitted disease (STD) from her partner.

Vaginal moisturizers: Applying over-the-counter moisturizers every few days can help increase moisture in the vaginal area.

Estrogen cream, tablet, or ring: The application of estrogen cream or inserting an estrogen tablet or ring into the vagina helps increase the sensations and moisture.

Oral hormonal therapy: Prescription medicines such as an oral pill containing estrogen and progesterone or only progestin can help combat vaginal dryness and reduce the pain/discomfort during sex.

Non-hormonal tablets: Ospemifene (Osphena) is a non-hormonal oral pill that is taken once a day and is effective in making the vaginal tissue thicker, thereby treating vaginal dryness. This is a prescription medication and consultation with a doctor is necessary before taking it. Another drug by the name of flibanserin is an antidepressant and it is also used for low sexual drive.

Bioidentical hormone therapy: These prescription medications contain natural hormones made from plant derivatives and have been shown to help treat menopausal symptoms, including vaginal dryness. But, the FDA has advised caution with their use as there are insufficient studies that prove their safety.


If menopause occurs in a woman younger than ___ years, it is considered to be premature. See Answer

How can women deal with the sexual side effects of menopause?

The following steps and lifestyle modifications can help women deal with the sexual side effects that come with menopause.

  1. Being physically active: Physical activity can lift a woman's mood and improve her body image. This can help increase sexual drive.
  2. Avoiding smoking: Smoking causes a further drop in estrogen levels making it difficult for a woman to get aroused.
  3. Avoiding drugs and alcohol: They can dampen a woman's sexual response.
  4. Treating vaginal dryness: Applying a vaginal lubricant before and after sex helps reduce pain and discomfort.
  5. Having sex frequently: Having sex more often enhances the vaginal blood supply, thereby improving vaginal health.
  6. Talking with a partner: Women can discuss issues about comfort during sex with their partner. They can ask them to be patient and allow time for getting aroused (arousal is associated with fluid secretion) which can help them have comfortable sex.
  7. Experimenting with different positions: If intercourse is painful, women can suggest their partner try new positions that may be more comfortable.
  8. Practicing pelvic floor exercises: These exercises increase vaginal blood flow and also help strengthen the muscles involved in sexual arousal.
  9. Not using harsh products: Bubble baths and strong soaps might irritate the vagina and cause infections.
  10. Vibrators: A small bullet vibrator or getting the partner to wear a vibrating ring during sex can increase the chance of having an orgasm.

Women who fail to find any improvement with the above measures and feel the need to be sexually active should visit a doctor who will help them chalk out a tailor-made therapy. The doctor may prescribe the "Eros Clitoral Therapy Device," which applies a gentle vacuum to the clitoris and increases the vaginal blood flow. This device may help provide sexual satisfaction that is lost in some women after menopause.

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Medically Reviewed on 10/7/2022
Medscape Medical Reference

"Menopause and Sexuality." Feb. 22, 2021. <>.

"Yes, you can have better sex in midlife and in the years beyond." Harvard Medical School. Sept. 30, 2021. <>.