Q: I'm not interested in sex at all. Is it all in my head, as my husband says?

A declining interest in sex as we age is typical for women, but many face a couple of additional factors that are really big: 1) It is painful; and 2) the event itself may not be particularly engaging. Is it any wonder that there isn’t much motivation to participate?

If you have pain, you need to find a practitioner who can help solve that issue. There is almost always a solution for pain with intercourse. NAMS (The North American Menopause Society) is a good resource for finding a certified menopause practitioner if you feel your provider isn’t able to find a solution--or you're not comfortable discussing the issue with him or her.

The other issue is more difficult to address. After years, maybe decades, of a less-than-fulfilling sexual relationship, it is hard to reinvent, but most women would agree it is worth trying. For some menopausal women a great sexual relationship doesn’t even need to include vaginal penetration, but that takes a caring, nurturing partner.

Your partner needs to understand that romance and emotion are key to improving your libido--and you need to feel confident that you deserve that... because you do. For some women testosterone, in addition to that intimacy and foreplay, can make a remarkable difference in libido. Again, finding the right provider to investigate that option would be beneficial for you.

Some women have told me that visiting our site with their partners has been helpful. You might review the bonding behaviors together to start a conversation about what kind of foreplay and attention you need for a better opportunity for comfortable--even satisfying!--sex.

Your lack of interest is not in your head! I have yet to see a woman with pain with intercourse for which I couldn't find some cause and some solution options. Things to explore with a menopause care provider are atrophic vaginitis, vulvodynia, or vaginismus. Sometimes localized estrogen is required in addition to HRT to fully estrogenize the vagina.

There are solutions out there! Please explore them fully. Good luck, and don’t give up!


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