Menopause & Sex Drive

By: Good Vibrations

"Dear Good Vibrations,

My wife has gone through menopause and is 55 years young, and now has no interest in sex. What can I do?"

There are several things that might affect a woman’s sexual interest in mid-life, and I’ll try to lay them out here. To find out which elements are likely to be affecting your wife, you’ll need to talk to her — she herself might not know, and if she’s interested in addressing this, she may need to see a professional. But let’s take a tour of the most common sexual issues for post-menopausal folks, which are not limited to those that identify as women. Anyone who has menstruated may also go through menopause, including trans men and non-binary people.

First, her interest may be low for physical reasons. Menopause involves hormonal changes, sometimes (though not always) very substantial ones. Some definitely notice that these changes adversely affect both their sexual interest and their orgasm intensity. It’s possible that hormone replacement will make a difference. (If her doctor recommends HRT, she should know that many women favor plant-based estrogens rather than traditional Premarin, which is animal-derived.)

Hormones will affect other things besides sex drive; they can affect the mental and emotional effects felt by some of those going through menopause, and they tend to slow the effects of age on vaginal tissues and skin. I am not recommending HRT here — for some, it is ill-advised for health reasons, while others prefer not to take hormone supplements at all. By the way, cis women do not just have so-called “female” hormones (such as estrogen and progesterone); they also have the “male” hormone, testosterone, and some women have had good luck boosting libido with it.

A partially hormone-related issue that requires no trip to the pharmacy is that some mid-life people have become sedentary and exercise very little. Weight aside, if your partner doesn’t move around much, this hidden libido-killer might have affected her. Try to get her out of the house for walks a couple of times a week, or take the stairs together instead of the elevator when you go out. The body’s hormone production is stronger when one is active, and it also boosts circulation to the pelvis — healthy blood circulation is what allows one vital part of physical arousal, the engorgement of the genitals.

When one’s ability to become aroused has been compromised, sometimes sex drive wanes right along with it. In fact, I think doctors ought to recommend exercise (as well as quitting smoking and over-indulging in alcohol and fatty foods) instead of drugs like Viagra — many problems in our ability to get aroused and interested in sex could be helped by these changes, regardless of our gender and age.

Since I mentioned pharmaceuticals, I should mention that Viagra, while used by a few cis women, doesn’t get at libido in people of any gender. There are a couple of medications on the market intended to help women with libido problems. But these are not a fix for everyone, and if anything else in my answer rings a bell for you and your wife, I would urge you to follow up on that before she considers trying a pharmaceutical drug.

Midlife is also a time when latent health problems can begin to emerge, things like heart problems, diabetes, and other fairly-common ailments. One of the earliest warning signs of system-wide illness is a loss of interest in sex. This is also something that can be associated with mental health, especially depression. If your partner has not seen a doctor for a physical lately, it would be advisable to do so just to rule this out. She should definitely tell her physician that loss of libido is an issue for her, because some docs will not ask about this unless a patient brings it up. (And if the doctor seems to think she’s fine with no libido, as some conservatively-trained MDs even today might assume — get a new doctor!)

Speaking of health and pharmaceuticals, here’s another possible culprit: If your wife is already on meds for something else, it’s possible that those drugs are actually causing, or at least exacerbating, this issue. Commonly, physicians don’t warn (or sometimes even know) that a drug they’re prescribing will cause such a problem. If your wife is taking antidepressants, there is an especially high likelihood that this undesired dampening of libido is a side effect. She should ask her doc about any meds (and combinations of meds) she might be taking.

Second, there may be psychological factors at play. Some women honestly believe that sex is for the young — in fact, some believe that sex is fundamentally about childbearing and the possibility that sex will result in conception. Whether she thinks she’s too old for it, or she is no longer associating it with the possibility of motherhood, it may be that her mental attitude has always been pre-set to menopause as a time when she would no longer be a sexual woman. Some women also feel less sexual as they age because they feel less attractive. A woman with body-image issues, whether she has gained weight or is upset at finding grey pubic hair, may just have too little comfort when naked to want to have sex. (If this is your wife’s issue, my book Exhibitionism for the Shy may have useful, supportive information for her.)

It’s also pretty common for women to assess everything at midlife, and sometimes this means becoming newly critical of issues in work and relationships that they have not formerly spoken up about or prioritized. I have heard post-menopausal women talk about relationship discontents that range from communication issues to problems with their partners’ physical hygiene or alcohol consumption; this is also a time of life when women sometimes realize they feel taken for granted, or when they allow themselves to be angry about a past infidelity or a relationship that has lost its romance.

I have no idea whether any of these things might be going on for you and your wife — but if they are, you must tackle them positively if you want to rekindle sexual intimacy with her. Sometimes it takes a visit or two to a relationship therapist to unpack such emotional issues. But if such issues are there, they won’t go away without some changes, at least, in your relationship patterns — if only a renewal of your courtship of her so that she feels newly loved, valued, and desired. Some women (and others!) are just wired this way — they deeply need to feel emotionally secure to have access to their sexual feelings. If you’re in a rut, you can get out of it together — but not if you don’t change some of your patterns.

So if you have not already talked to her directly about all this, it might be a good idea to do so — but you can try courting her anyway! If you don’t know what that would entail, she may be able to tell you; but in any event, if she gives you feedback about her needs, take them seriously. (Does this mean you don’t get to have needs of your own? Of course not, and we’re actually addressing one of them now: your need to retain/regain sexual intimacy with your partner. But if your and her needs seem to be mutually exclusive, I’d suggest getting into a therapist’s office so a trained specialist can mediate this discussion for you.)

Finally, it may be that your wife does not think any of this is a problem. She may be content with the level of sexuality in her life and she may not be willing to do anything to change her status vis-a-vis this issue. If so, you have some choices to make. Are the two of you committed to monogamy? Would you be open to discussing the possibility of opening your relationship? There are lots of resources online about polyamory, some good books about it, and support groups that can help you open a relationship. But it’s not for everyone, and some partners deal with a serious sexual desire discrepancy by making sure they have lots of other expressions of love and sensuality in their relationship, and by making sure masturbation is an accepted (in fact, a respected) outlet for the partner whose libido is higher. Bottom line, though, you won’t know what underlies her low interest, or what you might be able to do about it, unless you talk to her. Share this with her, go for a walk, and try to figure out some strategies that might work. Best of luck!