How menopause can affect libido

Mood changes are so common during peri-menopause and menopause, but for many of us, the problem is not just feeling moody, but not being in the mood. Our attitudes towards sex and relationships can change drastically during the menopause for many different reasons, some psychological, some physiological. It’s not easy to feel sexy, bold and excited about sex if you feel quite the opposite. Libido can considerably decline during the menopause, for reasons such as vaginal dryness – but there’s plenty we can do about it! Read on to find out more, and what we can do to improve our love life.

Falling testosterone levels

Lower levels of testosterone can affect many aspects of our lives as this hormone helps to boost mood, energy levels, concentration and libido. When levels of testosterone fall, sex not only becomes less appealing, but less physically enjoyable, no matter how emotionally connected and attracted we are to our partner.

How to increase testosterone levels

Taking testosterone is a highly personal choice (and not often commonly available on the NHS). Though not all women find it helpful, for some it can be a lifesaver both in terms of clearing brain fog and boosting sex drive. Some women find themselves suddenly firing on all cylinders in the bedroom and the boardroom, while others find it can make them uncharacteristically argumentative. The crucial factor here is the dose: testosterone is usually prescribed as a gel and it’s often left up to you (in discussion with your doctor) as to how much to use. The most common amount is about pea-sized. If you start sprouting unwanted dark hairs on your chin, it may be time to scale back, but if you’re heading away for a romantic weekend, you may decide to apply a little more…

Vaginal discomfort

The various physical changes we go through during the menopause can have a considerable effect on how we feel about sex. Not only our overall body image, but in specific areas too. Lower oestrogen levels reduce the collagen that keeps the vagina elastic and flexible, so it may shrink and expand less easily, making spontaneity difficult. The vulva may become thin, dry and itchy, and you may notice a reddening and soreness. Our internal pH balance also changes and, now that oestrogen is no longer dominant, we may be at greater risk of recurrent vaginal infection such as thrush, UTIs, cystitis and itching.

Vaginal dryness is a very common symptom of the menopause – and not one we should find embarrassing. It’s not just about sex – even exercise regimes or activities such as cycling can be curtailed as a consequence. Treating it can bring a huge improvement to our quality of life and can also reignite our sex lives. Exceptionally dry skin, lethargy and weight gain, as well as a low libido could also be caused by an underactive thyroid, which can be diagnosed by a blood test by your GP.

How to treat vaginal discomfort

Use gentle, non-scented soaps and pH-balanced washes to avoid irritation from cleaning – in fact, sometimes water is all that is needed. Synthetic chemical products, including biological washing powder, bath and shower gels plus scented panty liners may make the problem worse too. Wear cotton or natural-fibre underwear that fits well but isn’t too tight, and the same goes for tights and clothing, especially jeans. If thrush and itching is a recurrent problem, try eliminating sugar from our diet, as this can trigger an overgrowth of yeast and contribute to itching, and boost gut health with more cultured foods such as yoghurt and kefir.

Vaginal dryness

Probiotics in general really come into their own during the menopause, not just for gut health but for good vaginal and pelvic health. Taking a probiotic will increase the levels of good bacteria, which can also guard against thrush and vaginal and urinary infections that affect so many menopausal women. Try the strains L. rhamnosus and L. reuteri which are believed to be especially effective here.

How to treat vaginal dryness

If sex becomes really tricky because of vaginal dryness, do see your GP, who can prescribe a topical oestrogen either as a pessary, cream or vaginal ring. Vaginal oestrogen is an effective treatment (different from HRT) although HRT alone can make a huge difference to this symptom if you’re able to take it. Body identical oestrogen (made from the wild yam) is widely available on the NHS and is the kind that’s found in all oestrogen creams and patches (but not the tablet form of HRT). You do not need an expensive private prescription for un-regulated bio-identical hormones.

Lubricants are also helpful – but do opt for one that is designed for the vagina – now is not the time to experiment with anything from the kitchen cupboard! Avoid overly synthetic or perfumed products, especially stimulating varieties, as these can cause further irritation. Check that the lube is between pH3.8 and pH4.5 as products that are too alkaline can also trigger thrush. While KY jelly may be a familiar brand, it’s not that great for vaginal dryness. Instead try YES, an organic, hydrating, water based lubricant, or Replens, Sylk or Regelle.

Quality not quantity

Good news – a study has found that while women and their partners report lower libidos after the menopause, the sex that they were having was the best of their lives! Many women feel sexually liberated after the menopause because they’re no longer at risk of getting pregnant. Having spent a lifetime getting to know our bodies, we likely to have a better understanding of how we work – and what we want when it comes to sex. This knowledge can help us feel more comfortable and secure in our relationships, so it can be an exciting time to explore sexually with your partner. Instead of worrying about how much sex we are having, focus on the quality instead.

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