Q: Why does the clitoris shrink and get less sensitive?

You say that the changes to your clitoris have affected your sex life and made you feel embarrassed. Let me assure you that this is not your fault. It’s a natural part of aging.

Here’s how it happens: Perimenopause and menopause cause a decrease in estrogen. The decrease in estrogen causes a decrease in the blood supply to the genitals, and this leads to a decrease in size of and loss of sensation to the clitoris and the genitals, in general.

If the cause is related to a loss of estrogen, restoring estrogen to the genitals (localized therapy) may be just the ticket!

Another factor could be the amount of intimacy you’re having. I always say “use it or lose it”—and that definitely goes for the vagina and surrounding tissues. The less you use them, the more likely it is they’ll get smaller and less sensitive.

For those women who are not in a relationship, this is a great reason to use a vibrator. It keeps all those tissues healthier. Remember that this is a totally normal part of aging (but there are things you can do to make it better)!