Adding to the complexity of this issue is that the time of the menopause often coincides with several other major transitions in a woman's life. Her children move away from home, she experiences changes in career, or she takes on the role of caring for aging parents. Stress levels go through the roof, also resulting in a lack of interest or desire. Metabolism slows 10 to 15 percent at this time of life as well, and the resulting weight gain and lack of energy can make sex the last thing on a woman's mind, compounding the decrease in libido. The symptoms of menopause itself—insomnia, hot flashes and depression—also contribute to libido decline. Vaginal thinning can lead to painful intercourse, which then causes tension and fear, and subsequently less desire.
Isn't It Normal to Lose Interest?
While there is a clearly defined physical response to arousal, there is also a large psychological component. Many of my patients assume it is "normal" to lose interest in sex as they go through menopause and, therefore, do not seek out help in this area. They attribute the lack of libido to strain within the relationship or familiarity with their partner—being bored. They feel like they can take it or leave it, and unless their partner is pushing them, they may never broach the subject with anyone. We tell them it is common, but it doesn't have to be mandatory.
Learn to Live with It?
Most of our menopausal patients have learned to live with it. They essentially have given up on that aspect of their lives, and their relationships take on new dynamics. But, when asked, most of our patients say they would love to have fulfilling, fun, passionate sex lives with their partners. So, often in desperation, they ask what can be done.