ages 55 and over

    Sexual health after menopause

    What about STDs/STIs?

    Talking to your healthcare provider

Sexual health after menopause

What are some concerns about sexual health after menopause? For one, less estrogen can lead to vaginal dryness, which may make intercourse uncomfortable or painful. Try using a water-soluble lubricant. Libido may also change, for better or worse, but many factors besides menopause -- including stress, medications, depression, poor sleep, and relationship problems -- affect sex drive. Talk to your doctor if sex problems occur -- don't settle for a so-so sex life. And remember, sexually transmitted diseases or infections (STD/STIs) don't end with menopause; "safer" sex still counts.

Does Menopause Affect Sex Drive?

The loss of estrogen following menopause can lead to changes in a woman's sexual drive and functioning. Perimenopausal and postmenopausal women may notice that they are not as easily aroused, and may be less sensitive to touching and stroking -- which can result in decreased interest in sex. In addition, lower levels of estrogen can cause a decrease in blood supply to the vagina. This decreased blood flow can affect vaginal lubrication, causing the vagina to be too dry for comfortable intercourse. Don't forget to use lubricants.

Does Menopause Lower Sex Drive in all Women?

No. In fact, some postmenopausal women report an increase in sex drive. This may be due to decreased anxiety associated with a fear of pregnancy. In addition, many postmenopausal women often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

What Can I Do to Treat Vaginal Dryness?

Vaginal dryness can be treated with water-soluble lubricants such as Astroglide® or K-Y Jelly®. Do not use non-water soluble lubricants such as Vaseline® because they can weaken latex (the material used to make condoms, which should continue to be used to avoid pregnancy until your healthcare provider verifies you are not producing eggs and to prevent contracting STDs/STIs).

Can I Improve My Sex Drive?

Currently, there are not any good drugs to treat sexual problems in women. Estrogen replacement may work, but research has yielded conflicting results regarding its effectiveness. Estrogen can, however, make intercourse less painful by treating vaginal dryness. Researchers are also studying whether a combination of estrogen and the male hormones, called androgens, may be helpful in increasing sex drive in women.

Counseling?

Although sexual problems can be difficult to discuss, talk to your doctor; there are options to consider, such as counseling. Your doctor may refer you and your partner to a health professional who specializes in sexual dysfunction. The therapist may advise sexual counseling on an individual basis, with your partner or in a support group. This type of counseling can be very successful, even when it is done on a short-term basis.

Do I Still Have to Worry About Sexually Transmitted Diseases and Infections?

Absolutely (see more here). Just as you must use protection if you do not want to become pregnant, you must also take measures to protect yourself against STDs/STIs. It's important to remember that your risk of contracting STDs/STIs is a possibility at any point in your life during which you are sexually active, and this risk does not go down with age.

How Can I Protect Myself From STDs/STIs?

Here are some basic steps that you can take to help protect yourself from STDs/STIs:

• Use a latex condom consistently and correctly every time you have sex. (If you use a lubricant when using condoms, make sure it is water-based (not oil-based, like Vaseline®.)
• Limit your number of sexual partners. The more partners you have, the more likely you are to get an STD/STI.
• Practice monogamy. This means having sex with only one person. That person must also have sex with only you to reduce your risk.
• Choose your sex partners with care. Make sure both of you have been tested (before having sex).
• Don't abuse alcohol or drugs before you have sex. You may be less likely to practice safe sex if you are drunk or high.
• Learn about STDs/STIs. The more you know about STDs/STIs, the better you can protect yourself.