I am in my forties and not that interested in sex, it that normal?

Perimenopause is the time period your body transitions, hormonally, physically and emotionally into menopause. Every woman’s experience is different and can last up to 10 years prior to getting into full blown menopause which accounts for women/people in their 40’s.  If you have irregular and heavy periods, emotional ups and downs, night sweats and insomnia you should not be surprised that you are also not that interested in sex. Your hormones, including estrogen and testosterone, are erratic which effects your interest in having sex. This is very common and completely normal.

Can I take testosterone to help boost my sex drive?

Testosterone therapy may be helpful for low libido. It’s best to first get your testosterone levels checked by your healthcare provider to see if there is a hormonal explanation for your low sex drive. Even if your levels are normal, testosterone therapy has been shown to improve your sex drive in perimenopause and menopause. 

Now that I am in menopause, I have no interest in sex, am I a freak?

When you enter the next chapter of life, called menopause, your estrogen and testosterone levels both drop affecting your desire to be sexually and intimate.  Over 60% of women will report losing their libido.  You are being bombarded with physical and emotional symptoms that directly affect your mood in the bedroom. This can create a lot of disruption in a relationship since over 30% of women stop having sex all together.   Treatment options include hormone replacement therapy-both oral and vaginal, Addyi (the “pink” pill for women), testosterone therapy, lubricates, self-awareness and education that can ease this normal hormonal cycle.

Why is sex so painful in Menopause?

Menopause typically occurs around the age of 51year. When you transition into menopause and decide not to be on hormone replacement therapy, use estrogen or DHEA vaginally, the vagina can suffer dramatically. Often, the hot flashes will improve over time but vaginal dryness only worsens.  In the vagina specifically, estrogen increases blood flow to the tissue, thickens the vaginal walls and helps with overall lubrication.   With menopause and the loss of estrogen stimulation in the vagina, the tissue becomes dry, thin and pale.  The medical term for this is genitourinary syndrome of menopause (GSM).  As a result, intercourse and other forms of vaginal contact become painful and, often, impossible. Tears in the vaginal opening are common which can lead to bleeding and pain. There are many treatment options including vaginal estrogen or DHEA, internal moisturizers, lubricants, hormone replacement therapy and vaginal lasers that can help with these common symptoms of menopause that can ruin your sexual experiences.

Why is estrogen helpful for sex?

Estrogen plays a critical role in our female sexual response especially in peri-menopause and menopause. Estrogen is responsible for our vaginal tissue sensitivity, elasticity, secretion, pH balance, establishing healthy microorganisms in the vagina, urinary continence, pelvic muscle tone and joint mobility. All of these affect our female sexual functioning. In perimenopause and menopause, estrogen levels are erratic or go away all together. Using oral or vaginal estrogen can help maintain all the helpful qualities that estrogen provides us for a healthy sexual response.