Menopause and sexuality: No longer in the mood for pleasure?

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It's supposed to be the most wonderful thing in the world: having sex. Making love. Enjoying pleasure. Why should it be any different during menopause ? A legitimate question. However, in midlife, sex often becomes secondary. Or doesn't happen at all. It's a shame, really. So where does this lack of desire come from?

How are menopause and sexuality related?

Menopause is characterized by a decline in the production of sex hormones . However, this does not happen in a nice, orderly and linear manner; instead, it results in complete hormonal chaos . The process basically works like this: A while before menopause, the last menstrual period , the progesterone level begins to decline slowly. After the last menstruation, the estrogen level then drops abruptly (reading tip: our article on menopause explains the processes in more detail). This is because when there is no longer a cycle, and no more eggs in the ovaries that can mature and be released into the fallopian tubes, hardly any estrogen and progesterone, the female sex hormones, are produced.

How does this relate to sexuality and libido? This question hasn't been particularly well researched yet. What is certain, however, is that our sense of pleasure is not only neurally (i.e., emanating from the nervous system), but also hormonally controlled . Arousal increases the activity of the autonomic nervous system and hormone release. For example, blood flow to the intimate area increases, and glands in the vagina secrete a substance that acts like the body's own lubricant. However, hormones that are no longer present cannot be released and ensure proper lubrication. Hormonal fluctuations, such as those typical during menopause, therefore have an indirect effect on your sex life.

To make matters worse, a whole host of menopausal symptoms can occur during the menopause. Although only one in three women is severely or very severely affected, even relatively mild symptoms can dampen desire during this phase .

What are the possible reasons for the loss of libido?

The aforementioned menopausal symptoms that occur during this phase of life can be roughly divided into physical or psychological symptoms , and they often combine. Both types can affect your love life.

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• Tiredness – Honey, I'm tired! And that's no excuse. The exhaustion and lack of energy that some women experience during menopause can stifle feelings of desire.
• Vaginal dryness – Due to hormonal changes and, above all, the lack of estrogen, the skin all over the body becomes thinner, drier, and more sensitive. As already mentioned, vaginal secretions are absent in the intimate area. Even when you're emotionally aroused, the vagina remains dry, and penetration becomes very painful.
• Joint pain – When skin and mucous membranes become thinner and drier, this also affects the connective tissue in the joints. While pain during movement is often age-related, hormonal changes after menopause can also contribute.
• Mood swings, irritability – The hormonal imbalance during menopause can be similar to the emotional rollercoaster of puberty. Moods plummet rapidly, and depressive moods can spread and become a life-killer.
• Stress – Menopause often occurs during a period of life that is marked by major upheavals in one's personal life. Perhaps children are moving out or one's own parents are becoming dependent on care. Feelings like grief, loss, and worry sometimes leave no room for sexual desire.
• Relationship problems – Who says it's always just a matter of hormonal changes? Perhaps love has faded over the years and given way to boredom. Or maybe you've been single for a while and simply don't have the energy or desire to date or get involved with someone new.
• Side effects of medications or chronic illnesses – Certain medications (such as antidepressants and painkillers) can dampen your sex drive. Read the package insert and talk to your doctor if you are uncomfortable with this side effect. Alternative medications may be available, or the dosage may be adjusted.

The psychological component of certain physical menopausal symptoms should not be underestimated either. If you no longer feel comfortable in your body, perhaps consider yourself unsexy , it's difficult to give in to desire. Even if you secretly think it's wrong and wish it were different.

• Weight problems – Because metabolism changes along with hormone levels, women who don't change their diet from before usually gain a few kilos (also read our article on weight gain during menopause ). Figures change, and a belly grows. Even if our minds tell us that our appearance isn't what makes us lovable and we know we should accept our bodies as they are, it's hard to override our emotions with our minds. It may take time to accept the new, curvy silhouette, the unfamiliar excess weight, and to be happy showing off to our partner (again).
• Hair loss/growth in unwanted places – This may sound superficial, but thinning hair on the head and increased body hair, for example, on the legs or the growth of a mustache, can be the last straw. In other words, it's better to pull the covers over your head than enjoy physical lovemaking between the sheets. Because there's never just one cause that can be traced back to a lack of desire. Undoubtedly, several factors always come together.

Local hormone therapy, which raises estrogen levels, can help with hormonal symptoms, especially vaginal dryness. Vaginal creams or suppositories supply the area with estrogen, thus resolving the problem: The vagina can become moist again (lubricated), and sex is no longer painful. Because the hormones are absorbed through the skin and bypass the digestive tract, the potential risks of hormone administration are significantly reduced. Talk to your gynecologist about treatment options for estrogen deficiency . Our article explains more about the pros and cons of hormone replacement therapy .

If the reasons are more psychological, the desire often returns on its own once your well-being improves . Targeted stress reduction through relaxation techniques such as autogenic training , Qi Gong, or meditation, a change in diet, or even psychotherapy can be very helpful. But be patient! Unfortunately, there's no switch you can simply flip. Talk to your partner about what you like and don't like. Maybe things are different now than they used to be.

Is there also the opposite case, that libido increases during menopause?

There is. Some women find it downright liberating when the topic of contraception is finally off the table. Or when their children leave the nest and they can focus more on themselves and on an intimate, loving relationship. Perhaps a new love comes into their lives. Butterflies in the stomach usually quickly revive their libido .

How long do I need to use contraception?

When the egg supply is irretrievably depleted and the last period has occurred can only be determined retrospectively. If a woman is 50 or older, it is assumed that after 12 months without a period, she has entered menopause and can no longer become pregnant. For women under 50, expert advice is to continue using contraception for two years after their last menstrual period. While pregnancy at this age is relatively unlikely, it is not impossible.

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Brigitte

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