What should you know about libido loss after menopause?

Oestrogen changes can make vaginal tissue drier and more sensitive, so sex may become uncomfortable and desire may fall in response. Hot flushes and night sweats can disturb sleep, while mood changes, anxiety or low mood can affect interest and energy. Pain, pelvic floor symptoms, some medicines, long-term health problems and relationship stress may contribute as well. A lower sex drive is a symptom worth discussing when it causes distress; it is not a personal failure or an inevitable loss of intimacy.

Tell a healthcare professional whether the main issue is desire, dryness, pain, orgasm, mood, sleep or a change in medication. Lubricants can reduce friction during sex, and regular moisturisers may help ongoing dryness. More time for arousal, non-penetrative intimacy and open communication can reduce pressure. A clinician can discuss local vaginal treatment, systemic menopause treatment or other options when appropriate, after reviewing your health history and preferences.

Arrange an appointment if low desire persists, causes distress, follows a new medicine, or occurs with pain, vaginal bleeding after sex, unusual discharge, urinary symptoms or marked mood changes. Seek prompt advice for bleeding after menopause, particularly if it is new or recurrent. Pelvic pressure or a bulge may point to pelvic organ prolapse and deserves assessment rather than self-treatment.

Ask what may be driving the change, whether dryness or pain needs treatment, which options suit your medical history, and whether a medicine or mood symptom is affecting desire.