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JAMA Patient Page
February 14, 2007

Women's Sexual Concerns After Menopause

JAMA. 2007;297(6):664. doi:10.1001/jama.297.6.664

Menopause, also known as the change of life, occurs when a woman's ovaries stop producing eggs and hormones. A woman entering menopause soon stops having regular menstrual periods and is no longer capable of conceiving a child. Menopause is a normal phase of a woman's life. Because menopause can also occur when a woman's ovaries are removed by surgery (called oophorectomy) or stop working because of chemotherapy or other medications, menopause may also occur in younger women. Since the ovaries and the hormones they produce are linked to sexual function, women may have questions about their ability to have a healthy sex life after menopause. The February 14, 2007, issue of JAMA includes an article about sexual concerns after menopause.

Concerns after menopause

  • Decreased libido (sexual desire)

  • Difficulty with sexual arousal

  • Inability to have an orgasm, or decreased orgasmic sensations

  • Vaginal dryness and thinning of the vaginal walls causing pain during intercourse

  • Hot flashes

  • Mood swings

  • Decreased sense of sexual attractiveness

A healthy lifestyle (see below) is important for maintaining a healthy sex life. Treatment of medical problems (such as diabetes, high blood pressure, and cardiovascular disease) may improve sexual function. Blood vessels and nerves are part of the complex control of sexual response. Because of this important involvement of blood vessels, diseases such as diabetes affect sexual health. Some medications can have adverse effects on sexual desire, response, and ability to have an orgasm. Your doctor may suggest alternatives if sexual response changes with the use of particular medications. When sexual problems are part of relationship issues or there are emotional concerns, counseling may be suggested. Not all women have sexual concerns after menopause, and some may feel more sexually free since there is no further chance of pregnancy. Also, women may gain self-confidence as they age. That can improve mental health and often translates to more confidence and comfort with sexual matters.

Healthy living during and after menopause

  • Eat healthy foods, including whole grains, plant-based fats (like olive oil), and fresh fruits and vegetables. Limit intake of high-fat animal products.

  • Maintain a healthy weight.

  • Do not smoke.

  • Exercise regularly, since this reduces risk of cardiovascular disease, diabetes, and cancers and helps improve mood and overall well-being. Specific pelvic floor exercises improve fitness of the muscles used during sex and may increase sensations during orgasm.

  • Talk with your doctor about symptom relief from vaginal dryness, hot flashes, and decreased sexual desire. Make sure you tell your doctor about any alternative or over-the-counter treatments you use.

For more information

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. A Patient Page on perimenopause was published in the February 19, 2003, issue, and one on hormone replacement therapy was published in the August 21, 2002, issue.

Sources: National Women's Health Information Center; North American Menopause Society; American College of Obstetricians and Gynecologists

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.