Sexual Health – Women's Mid-Life Health Program

Your questions, answered.

We have gathered a list of the most common questions women ask regarding topics that affect your overall health and well-being.

Sexual desire decreases naturally with age in both men and women. Women report lower desire in their 40’s and 50’s, but this varies between women.

Menopause and aging does affect sexual function:

Body perception – age changes in body appearance can affect a woman’s feelings about her attractiveness and desirability
Vaginal changes and pain – as a woman enters into menopause the lining of the vulva, vagina, and urinary tract begins to thin due to the decrease in estrogen (Genitourinary Syndrome of Menopause). This can result in pain during intercourse and may also cause skin tears. Lubricants, moisturizers and vaginal estrogen (creams, tablets or rings) may be used to restore the tissue to health and make sexual activity more appealing. It is important to discuss these issues with your doctor and have a gynecological assessment to rule out any other conditions that may be causing your discomfort.

Previous attitudes – whether you enjoy or do not enjoy sex impacts how you feel about it during menopause.
Available partner – lack of a partner or having a partner who has lost interest or the ability to have sex affects a woman’s sexual desire.
Relationship challenges – tension and emotional or physical distance, anger and frustration, disappointment or boredom in the relationship, lack of trust, and infidelity can account for lack of desire.
Surgical causes – after surgery such as hysterectomy or mastectomy, a woman may avoid sexual intimacy due to pain or feelings of being less attractive.
Health issues – sleep problems, depression, chronic pain, incontinence and fatigue interfere with desire. Stress and being “too busy” also decrease interest.
Medications – some medications used to treat depression or high blood pressure and the use of alcohol may interfere with sexual desire, intensity of orgasm or the ability to achieve orgasm.
Low androgen hormone levels (primarily testosterone) – women also have testosterone levels that gradually decrease with age (not menopause) which may decrease desire. Surgical menopause (removal of the ovaries) or treatments that damage the ovaries can speed up the decline of testosterone levels.

Think positively about sex. A woman’s brain is her most important sex organ, so fantasize a little! Take care of your emotional wellbeing and your relationship.
Stay sexually active. Regular sex with a partner or self-stimulation can help maintain vaginal elasticity and lubrication. Vaginal lubricants may be helpful such as Waterslide (water base) or O‘My (hemp oil base), or other water based lubricants.
Communicate with your partner. Let your partner know what works to help with stimulation and remember that good quality sex takes more time.
Schedule a physical exam and discussion with your health care provider to identify causes of sexual problems. If vaginal dryness and painful intercourse are your problems, simple self-help strategies may not be enough. Some women will need assistance with vaginal hormone therapy, androgen therapy or a referral to a specialist in sex counselling.

We highly recommend this excellent online resource “Sexual Health and Menopause” on the North American Menopause Society’s website

Other good resources are:

Society of Obstetrics and Gynecology of Canada, “Sexuality and You”

National Women’s Health Resource Center, Inc. (US), “Sex & Intimacy”

The causes of sexual problems and the most favourable treatment will be different for every woman. To stay vibrant, seek help to find your best course of action.