Beginning in perimenopause, some women may experience a gradual decline in sexual desire (libido). However, 60 percent of women experience no change in libido, 20 percent experience a decrease and in 20 percent of cases, the libido improves.
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Although no correlation has been found between oestrogen levels and libido, it appears that another hormone, androgen, may affect libido.
Other factors which may lead to changes in sexual function include:
Painful intercourse due to vaginal dryness (atrophy)
A woman’s perception of her changing body
Incontinence which could lead to sexual avoidance
Sleep disturbances from night sweats
Depression, stress and anxiety
Many medications including some anti-depressants
Reduced libido and impotence in male sexual partners
What to do
Open communication with your sexual partner is of utmost importance to prevent resentment or feelings of rejection. It is also important for you to explore other ways in which you could be intimate.
If insomnia due to night sweats interferes with your sex life, your doctor may prescribe HRT.
To relieve vaginal dryness use short-acting, water-based vaginal lubricants such as K-Y jelly immediately before sexual intercourse. Avoid petroleum-based products such as Vaseline.
It may also help to take a warm bath before intercourse. Regular sexual activity can help to improve natural lubrication, and keep the vagina moist and toned.
Counselling and support groups can provide useful strategies for coping with lifestyle stresses and poor body image, as well as with physical and emotional symptoms.
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