A huge number of women going through menopause feel like they’ve said goodbye to their libido forever, but it doesn’t have to be this way.
Lay aside the sexy lingerie, don your comfiest pyjamas, grab a hot chocolate and let’s get to the heart of this issue. I think of sex drive like a jigsaw. The jigsaw pieces are what makes up the libido, or sex drive. If one piece is missing, the picture isn’t complete and your sex drive suffers. Let’s look at the pieces and work out how to help you.
Your mind
Where’s your head at right now?
Humans are hardwired to want to have sex when they are feeling rested, healthy, relaxed, and happy.
Are you tired all the time? Exhausted by the pace of your life? Not sleeping? Are you embarrassed by flushing and sweating? Feeling self-conscious about the changes in your body shape? Have you got teenagers invading your privacy and emails pinging on your phone?
Anxiety levels naturally rise around menopause due to the brain being essentially steeped in stress chemicals. Depression is more common around this time of life, which can have a direct effect on squashing your sex drive.
“Is it any wonder then that some of us aren’t all that keen on swinging from the chandeliers on a weeknight?”
What can you do?
Recognise where you are on the menopause journey and how this is affecting your mind and body.
Look at your lifestyle and routine to see if there are any simple changes to make, like a lock on the bedroom door to keep kids from barging in for example?
Consider mindfulness. Try an app or take a course. There is a huge body of evidence to show it really does work in lowering our stress chemicals. Lower stress levels mean higher sex hormones.
For anxiety and depression, always seek help from a healthcare professional, but remember that it might be hormones you need, and not necessarily an antidepressant.
Your hormones
How balanced do your hormones feel right now?
If you’ve answered this by flinging your phone or laptop across the room, then I think we have the answer. Perimenopause is a true rollercoaster ride for many women. Once your periods stop, this does not necessarily bring relief. Flushing, insomnia, palpitations, mood swings, period problems, brain fog, breast tenderness, vaginal dryness, joint and muscle aches can all combine to make us feel pretty unsexy at times.
What can you do?
You do not have to put up with these symptoms. The science is clear that for women under 60 the benefits of taking HRT outweigh the risks. Sometimes HRT is like finding the right shoes – if one HRT does not suit, you can try another. Testosterone is our ‘va va voom’ hormone and levels fall with menopause. This affects some women more than others. Testosterone replacement is possible, but the key is getting the oestrogen levels right first. If you cannot take HRT or would prefer not to, there are many alternative and prescribable options.
Your vagina
How healthy do your vulva and vagina feel right now?
Do you have itching, prickling, or soreness? Does sex feel like sandpaper? Do you get cystitis, especially after sex? Does your vagina feel less wet before sex? Is it less sensitive? Is it more difficult to reach orgasm?
If sex is not comfortable then it’s the most natural reaction in the world to feel less like ‘doing it’.
And don’t even get me started on what happens when we add all of this trouble to the Viagra-powered erection!
What can you do?
This is my favourite piece of the jigsaw because it is so vital and so easy to fix.
- Consider vaginal oestrogen
The key to getting your sex drive back is rejuvenating the vagina. For perimenopausal and postmenopausal women, the vaginal and vulval skin may become thin. This is because of a lack of oestrogen. Seriously consider asking for a prescription for vaginal oestrogen if you want to reverse this change. It is agreed to be safe for so many women that vaginal oestrogen is available without a prescription in some other countries. It comes in the form of cream, vaginal tablets or a soft vaginal ring. This can potentially be used long term if you get on well with it.
- Care for your vulval skin
Take as much care, if not more, of your vulval skin as you would your face. Avoid soaps, perfumes and irritants. Wash with a moisturiser – you don’t need bubbles. Pat dry and apply more moisturiser. Read our guide to vulval skincare.
- Use the right lubrication for you
Sex and menopause without lube does not equal a great idea. There are safe, naturally derived options available, that are safe to use with condoms. Oil-based lubes are really moisturising and protective, but NEVER use them with latex condoms, as it can cause them to break. There are also organic personal lubricants of both varieties available. For a home-made solution, coconut oil that you use for cooking is a good oil-based lube – just pop a chunk inside your vagina and allow it to melt. Odourless coconut oil is available, if you don’t like the exotic aroma!
Your relationship
How are things in your relationship? Are you going through big changes in who you have sex with? Are you back to dating after a relationship has ended?
Do you feel safe and secure when you are having sex? Do you feel you can talk about how you are feeling?
What can you do?
Only you have the answers about your sexual relationships. No amount of HRT is going to make you want to have sex with a partner you are not happy with. On the other hand, if difficulties with sex are causing problems in your relationship, please don’t lose hope.
If possible, try to talk about how you’re feeling with your partner. If not, ‘share the load’ with other women online in safe groups or in person with friends. You can listen to our podcast which explores sex, hormones and navigating intimacy when everything feels different.
By taking some time to look after your mind and body, you may be pleasantly surprised to find your sex drive and relationship flourish.
The big picture
Remember, it takes each piece of the ‘jigsaw’ to fit together in order to make your sex drive whole and healthy.
Women can be women’s greatest enemies but also their greatest strength. Please stand together on this one, talk to each other, support each other and let’s allow ourselves to enjoy happier, safer menopausal sex.
