Menopause and no sex drive

A change in oestrogen can cause vaginal dryness and soreness, which may make sexual contact uncomfortable. Hot flushes and night sweats can disturb sleep and leave little energy. Mood changes, stress, body-image concerns, chronic illness and some medicines may also affect interest. Low sex drive is a common presentation of menopause, but no sex drive does not identify one cause on its own. Your experience may change over time.

Start by naming the main problem: pain, dryness, fatigue, low mood, worry or lack of interest. A clinician can review medicines and discuss options for vaginal symptoms or other menopause concerns. Lubricant may reduce friction during sexual activity, while a moisturiser may help ongoing dryness. Give yourself permission to choose non-sexual closeness and to stop if something hurts. A supportive partner can help by listening rather than applying pressure.

Arrange a review when the change is persistent, distressing or affecting a relationship, or when it comes with painful sex, bleeding, discharge, pelvic pressure or low mood. Seek prompt care for bleeding after menopause, severe pelvic pain or thoughts of self-harm. If symptoms began after a new medicine, contact the prescriber before making changes.

Which symptom may be driving this change? Could my medicines or mood be involved? What can improve vaginal comfort or sleep? Are there reasons a treatment may not suit me? What should I monitor before follow-up?