Menopause Community

This is a very common question, to which there is no answer: what is the cause of low sex drive? Is it menopause related or not?? The answer in women is extremely complex. Even the best respected author in this area, Canadian professor Dr. Rosemary Basson, has written that the best enhancer of libido for menopausal women is a new partner!! But that's obviously not a possible answer in most circumstances; but what it does emphasize is that sometimes novelty is a good thing; boredom is a bad thing; many relationships have been ongoing for many years, and that something new in the relationship might help. Most importantly, the couple needs to communicate to each other what each one of them might enjoy to spice things up.

Also, in menopause, many women experience vaginal dryness, making sex uncomfortable. And only an abnormal person would want to have sex if it hurt. So you have to have good vaginal moisture with sex. Some women do fine with a lubricant at the time of sex. Many do better with a long lasting moisturizer. There are over the counter moisturizers like Replens, which you insert vaginally two or three times a week. And if that doesn't supply sufficient vaginal moisture, vaginal estrogens, in the forms of vaginal tablets, creams, or rings are extremely safe and usable by almost all women quite safely. They have never been associated with any type of cancer risk, and can be used on an ongoing basis. You need a prescription for these; so speak with your health care provider.

Now let's say you are communicating great, and your vagina feels quite moist: but you could just care less. There may be some hormonal issues at play; no one knows just what. Theories included estrogen, testosterone and other hormones like DHEA. The major problem with testosterone, which is the most widely discussed, is that there is no current prescription form for women approved in the US by the FDA. But one can get testosterone from a compounding pharmacy, or using a tiny amount of the very concentrated form available for men. (Go to the website of the North American Menopause Society, menopause.org, for a longer discussion of testosterone). But you need to discuss this with your health care provider. There are also some over the counter remedies, like Zestra or Hot Plants for Her. You can go to their websites to read more about them, and again, do discuss this with your health care provider.
So there are options out there; but nothing replaces communication in a good relationship.

Good luck,
Mary Jane