Sex After Menopause: There's Still Life in the Libido

A middle-age couple stands smiling at each other.
Menopause may not put much of a dent in women's sex lives, compared to the years preceding the change, a new study finds. (Image credit: Middle-age couple photo via Shutterstock)

Women who are in early menopause are just as interested in sex as women who are just a bit younger, and derive as much pleasure from it, suggests a new study from France.

Researchers found that about one-third of the women in the study said sexuality was essential for their "personal equilibrium," though 60 percent admitted they would eventually lose interest in sex. There were no significant differences between women in menopause and those in their 40s and 50s who had not yet experienced the change, the researchers said.

There were also no differences between the two groups of women in terms of the percentage who had two or more sex partners during the previous 12 months (about 4 percent), the percentage who said they had sex fewer than six times monthly (about half of both groups) and the percentage who said they were "very satisfied" with their sex lives (about a third), according to the study.

What's more, a comparable number of pre-menopausal (17.2 percent) and post-menopausal women  (19.7 percent) reported not having sexual intercourse for three months.

"Our results confirm that for middle-aged women who are at the onset of menopause, the biological/hormonal changes that characterize menopause do not negatively affect sexual life," the researchers wrote in their study. "The effect of menopause at this point in women's lives may be more symbolic than biological, expressed by a form of anticipation of old age." [5 Key Nutrients Women Need As They Age]

For the study, the researchers asked 277 post-menopausal women about their sexual practices and beliefs. Of these, 68 were using hormone replacement therapy and 209 were not. Their responses were compared to those of 408 pre-menopausal women.

Menopause is defined as not having had a period for 12 consecutive months. After that milestone is reached, a woman is considered post-menopausal. Hormone therapy can be prescribed to treat the symptoms of menopause such as hot flashes and night sweats. Taking hormones may also reduce the risk of vaginal thinning and dryness, which can make sex painful.

All the women who participated in the study were ages 45 to 55. Among women who had never used hormones, the mean average age at menopause was 49; for hormone users, it was 47.5.

The researchers found that being post-menopausal did not markedly affect a woman's sexual activity, practices, ability or satisfaction.

By contrast, women did differ about what they said it meant when a couple didn't have sex for three months. Overall, just 35 percent of post-menopausal women reported that this was a red flag for difficulty in the relationship, compared with 48 percent of pre-menopausal women. But 54 percent of post-menopausal women who used hormones regarded three months without intercourse as a problem whereas 30 percent of non-hormone users did.

Dr. Michelle Warren, a professor of women’s health and of medicine at NewYork–Presbyterian Hospital/Columbia University Medical Center, said the findings "bother" her.

"There are a lot of details missing from the study," Warren said.

"The researchers didn't define [in their study] what menopause is, and didn't ask the women exactly where they were in menopause," said Warren, who was not involved in the study. Nor did the researchers ask the women what types of hormones they were using, or consider their menopausal symptoms  such as vaginal dryness, which can affect sexual enjoyment.

Because the post-menopausal women in the study were still relatively young, they may not have yet developed the problems that prompt many women to avoid intimacy, Warren said. For example, a recent study published in the journal Menopause found that 64 percent of North American women ages 55 to 65 report pain when they have sex.

The researchers acknowledged that the small number of hormone users in the study made it difficult to draw firm conclusions about how hormone therapy might affect sexuality.  However, they  suggested that post-menopausal women who use hormones "desire in some way to erase their menopause, to continue as if nothing had changed with it, including their sexuality."

Warren disagreed that sex was a primary motivation for women to take hormones. "Nowadays, women are much more circumspect about whether or not to use hormones," she said. "The great majority take them because they are suffering. It is not sex that brings them to the doctor, for the most part."

The study appears in the July issue of the Journal of Sexual Medicine.

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Contributing writer