Updated December 17, 2025

When the ovaries stop producing estrogen due to menopause, menstrual periods stop. While not having periods or worrying about an unplanned pregnancy can benefit your sex life, during this period, you may also see changes in your ability to become aroused and enjoy comfortable and fulfilling sexual activity. 

How do menopause and aging affect sexuality? 

This depends on the person. Some people enjoy sex more; others find that their desire or response is less intense than before. Many people remain sexually active throughout their senior years. Just be aware that what feels good can change.

Half of women in their 50s report continued sexual activity, but this percentage declines to 27% in women in their 70s.

More than a third of women in perimenopause or menopause report having sexual difficulties. We can think about sexual dysfunction in four different categories: desire, arousal, orgasm and pain. Women may experience difficulties in more than one of these categories at a time. 

The main culprit is declining levels of estrogen, which can reduce a person’s desire to have sex and make sexual arousal more difficult. However, there are many other factors that can negatively impact how you experience sexuality. As aging progresses, chronic illness and injuries can deplete your energy, cause physical pain and change your body image — all of which affect the sex drive. Changes in mood, such as depression, changes in sleep, and history of trauma or abuse can impact your relationship with your body and how you experience sex. Interpersonal relationships and life events can also impact sexuality, including divorce, power dynamics, and partner expectations. It is important to talk to your provider about sexual dysfunction you may be experiencing and work together to explore the underlying causes and how you can address them together.

Vaginal Dryness During Sex

Some of the most common symptoms of menopause are genitourinary symptoms (GSM). Too-little estrogen can reduce natural lubrication in the vagina and cause the vaginal canal to become less stretchy, which in turn can cause sex to be painful. Additionally, surgery or radiation can result in narrowing of the vaginal canal, scar tissue, or decreased sensitivity. Together, these factors can cause sexual activities involving penetration to be painful.

Using vaginal moisturizers daily, lubrication during sex, and/or vaginal estrogen if recommended by your provider can all help with vaginal dryness and pain with sex that can arise with menopause. Your provider may also recommend seeing a pelvic floor physical therapist, gynecologist, or urogynecologist to help address your symptoms.

Sex Drive, Arousal and Orgasm in Menopause

Discomfort is one aspect of menopause that can affect sexual activity and diminished sexual drive and response are two others.

As you age, blood fills your genitals more slowly as you become sexually aroused, which means you may not have the same sensitivity you did before menopause. Also, decreases in estrogen, in addition to any number of life changes and partner dynamics can also affect sex drive. In order to address these changes, your provider may recommend seeking sex therapy to improve your awareness of your emotions around sex, reframe negative thoughts, and improve communication with your partner(s). There are also both hormonal and non-hormonal medication options that may improve sexual satisfaction and desire, and can reduce distress around sexual dysfunction, which your provider may discuss with you.

Dealing with Menopausal Changes

If you want to continue a fulfilling sex life but feel held back by menopausal changes, there are steps you can take to lessen the impact of lower estrogen, diminished desire and less sensitivity. Here are some options:

• Ask about hormones. Menopausal Hormone Therapy (MHT) can ease menopausal symptoms, but can also increase the chances of serious health problems in some people, so your doctor will help you weigh the risks versus the potential benefits.
• Review your meds. If you are taking medications such as antidepressants that affect your libido, ask your doctor if making changes to your meds can help.
• Consider products: A range of commercial lubricants and vaginal moisturizers can make intercourse and other sexual activities more comfortable.
• Try something new: Reaching orgasm can take longer and require more direct and intense stimulation of the clitoris. Rubbing, touching or using sexual tools such as a clitoral stimulation device may boost sensitivity and response. Using vaginal dilators under the guidance of a sex therapist or physical therapist can help ease pain with penetration over time
• Be true to yourself. Experts advise letting go of what you think everybody else is doing and exploring what’s enjoyable for you and your partner.

Less Sex Can Be OK

Not everyone finds sex as gratifying after menopause, and that’s OK. It is important to accept your body and your feelings and not feel pressured to continue ― or give up on ― sexual activity.

Communicating with partners is key in setting realistic expectations about your changing sexuality as you age. A spirit of compromise can help reconcile differences in sexual drive among people who want to keep their sexual connection alive.

Sexual activities are not the only ways of expressing physical love and staying connected. Other intimate activities such as cuddling, sharing a bed, remembering happy times and laughing together can underscore the pleasure of being close.

Living Your Best Life in Menopause

Sexuality during and after menopause can start with a healthy lifestyle. Feeling good, getting enough sleep, being physically active and eating well can go a long way toward keeping the spark of intimacy and sexuality alive.

Along with supportive partners and clear communication, sexuality and intimacy thrive with an accepting attitude toward change. Making room for new emotions and attitudes will help menopausal people maintain a strong self-image and redefine their roles in sexual relationships, family and society.

Medically reviewed by Ashley L. Gordon-Phillips, December 17, 2025