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Thirai Sorgam > Reproductive Health > Sex after menopause: How to deal with dryness, desire and self-image issues
Reproductive Health

Sex after menopause: How to deal with dryness, desire and self-image issues

July 20, 2025 6 Min Read
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Sex after menopause: How to deal with dryness, desire and self-image issues
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Postmenopausal gender can be a physical and emotional challenge for women. Gynecologists and psychiatrists share tips to facilitate this transition.

Postmenopausal sex doesn’t have to retire in the background, but that’s the truth that many women face quietly. In menopause, when a woman’s menstrual cycle ends forever, a wave of unexpected changes often occurs. Variable emotions that can make your vagina dry, lowered sexual desire, or intimacy unfamiliar or even uncomfortable. Experts say that with proper information, a little patience and self-assurance it is possible to revive your physical and emotional connection with your partner. Once you reach menopause, explore what actually happens to your body and how to navigate desires, dryness and deeper connections since 45 years.

What happens to postmenopausal sex drives?

As women reach the mid-40s and beyond, the body undergoes a variety of hormonal changes associated with menopause and menopause.

Explaining these changes, Dr. Rubina ShanawazZ, gynecological oncology expert, told HealthShot: Comfort and testosterone during sex also affect sexual desire and overall sexual response.

Sex and menopause: Side effects on sexual health

Here are some common sexual health issues that women face after menopause:

1. Dry vaginal

Facing with a dry vagina is one of the most common experiences for women over the age of 40-45. “This occurs because estrogen helps maintain the natural lubrication and structural integrity of the vaginal tissue. As levels decrease, the vaginal walls become thinner, less elastic and more fragile. These changes can make sexual intercourse uncomfortable or painful,” says Dr. Rubina.

2. Low libido or sexual desire

This occurs due to reduced blood flow to the vaginal area, which affects sensitivity and arousal.

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3. Vagina PH shift

Changes in vaginal pH balance increase the risk of irritation and infection. Maintaining overall hydration is somewhat helpful, but topical treatments such as estrogen creams and lubricants are necessary to relieve discomfort and improve sexual well-being.

4. Painful sex

Many women experience painful intercourse after age 45 due to a condition known as vaginal atrophy, or more widely, menopause urogenital syndrome (GSM). This is due to a lower estrogen level, leading to thinning, dryness and inflammation of vaginal tissue. As a result, sex can be uncomfortable and even painful.

The expert adds: “It is often the case that women often wonder if it is normal for them to lose interest in sex after menopause. The short answer is yes. It is a natural and common experience. Hormonal decline directly affects sexual desire, especially the reduction in estrogen and testosterone. Unpleasant, women may begin to avoid it unconsciously.”

However, a decline in sexual interest does not mean an end to intimacy or pleasure. Many women have discovered that with appropriate support, whether medical, emotional or relational, they can rediscover or redefine their postmenopausal sexual life.

Couples refraining from sex
Couple with a lack of sexual desire. Image provided by Adobe Stock

How to increase sexual desire during menopause?

Open communication with your partner, the use of vaginal moisturizers or hormone therapy, and even simple lifestyle changes can make a huge difference. Several effective treatments are available to alleviate discomfort and restore sexual pleasure.

  • Water-based lubricants and vaginal moisturizers can instantly reduce dryness.
  • Topical estrogen therapy (creams, rings, tablets, etc.) can help reconstruct vaginal tissue over time.
  • A non-hormonal option, DHEA is also available in a cave style and has been shown to improve lubrication and sexual satisfaction.
  • Other nonhormonal approaches include laser therapy, pelvic bed therapy, and mindfulness-based sexual therapy.
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Links between menopause, mental health, and gender

Psychiatrist Dr. Sachin Bariga said that emotional and psychological victims of menopause can have as much impact as physical changes.

“Hormonal changes can cause mood swings, anxiety, and even depression. All of these contribute to a lower libido. When you are emotionally detached or overwhelmed by the demands of life, intimacy can feel more like a burden than a joy.”

Psychological happiness plays an important role in sexual desire, and seeking support through treatment, support groups, or open conversations can help ease your journey.

Menopausal symptoms can have a deep impact on a woman’s body and self-image.

“Weight gain, hot flashes and other visible changes can reduce body confidence and self-esteem. In addition, it tends to cause psychiatric problems such as depression and anxiety due to the lack of protective estrogen she had in these years,” adds Dr. Barriga.

These changes can affect intimacy that you feel emotionally unattractive and less connected to your partner, as well as physically.

Communication and security from loved ones play an important role just as important as self-compassion.

Women have low sexual desire
There are many reasons why women have low sexual desire. Image provided by Adobe Stock

Sex after postmenopausal tips

Simple lifestyle changes can greatly improve sexual health and overall well-being by supporting hormone regulation. These habits are as follows:

  • Keeping physically active to increase blood flow and energy levels
  • Practice stress-reducing activities such as yoga, meditation, and outdoor walking can improve your mood and body awareness
  • Eat a balanced diet
  • Maintain hydration
  • Get plenty of sleep
  • Develop emotional intimacy
  • Creating time for intimacy
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