10 Ways for Women to Increase Sex Drive During Menopause

It’s completely normal to have a lower libido in menopause. Some 40 to 55 percent of menopausal women report low sex drive.¹

There’s no shame in valuing your book group, pilates class, or gardening project over your sex life. But if you wish things were hotter in bed, there are ways to boost your libido during menopause. 

“We have excellent options now to address vaginal dryness, pain, and low libido,” says Mary Jane Minkin, M.D., OB-GYN, Clinical Professor of Obstetrics, Gynecology at Yale University School of Medicine in New Haven, CT. “Women do not have to ‘just live with it.’ Vibrant intimacy is possible well into midlife and beyond.”

We share the latest science on exactly how to increase your sex drive during menopause and take control of your sexual health at every stage.

About the Experts

• Mary Jane Minkin, M.D., is an OB-GYN and Clinical Professor of Obstetrics, Gynecology at Yale University School of Medicine in New Haven, CT.
• Victoria Petruzzi, M.D., is an OB/GYN at Houston Methodist Willowbrook Hospital.

What Causes Low Libido During Menopause

Big hormonal changes during perimenopause and menopause, most notably declines in estrogen and progesterone, can lead to changes in sexual function and desire. These normal shifts affect almost every system in your body, and they can make sex during menopause challenging, to say the least. 

Genitourinary syndrome of menopause (GSM)

A common reason for problems with sex during menopause is Genitourinary Syndrome (GSM), a cluster of symptoms that make midlife sex painful. This syndrome—which affects some 24 to 84 percent of postmenopausal women—includes vaginal dryness, burning, and irritation, discomfort or pain with penetration, and urinary issues.²

GSM is caused by declining levels of estrogen, which otherwise helps maintain vaginal tissue health, blood flow, and lubrication.

Even if you don’t have full-blown GSM, you may notice vaginal dryness. “It’s all tied to a decrease in estrogen,” says Victoria Petruzzi, M.D., an OB/GYN at Houston Methodist Willowbrook Hospital. “It can make vaginal tissues thinner and less lubricated and intercourse more painful.” 

While vaginal dryness may be seriously uncomfortable, a brand-new study in the Journal of Urology reveals that low-dose vaginal estrogen can effectively manage many of these symptoms.³

Hypoactive sexual desire disorder (HSDD)

Persistent low libido can also be a sign of hypoactive sexual desire disorder (HSDD). More than a little dip in libido, HSDD involves a persistent lack of sexual thoughts and interest in sex lasting six months or longer.

Although HSDD is considered a psychological disorder, low libido can have many root causes, including low testosterone. We often think of testosterone as a male hormone, but it plays a crucial role in women’s sexual functioning, and it declines in the years leading up to menopause. Many studies support women taking testosterone in menopause as a treatment for low libido.⁴

Beyond testosterone, treatments for HSDD include neurological medications such as flibanserin (Addyi) or bremelanotide (Vyleesi), and cognitive behavioral therapy or other forms of psychotherapy.

Comparing GSM and HSDD in Menopause

Other causes of low sex drive in menopause 

Low libido can be a side effect of some medications, including SSRIs, a type of antidepressant often prescribed to women in the menopause years. In fact, sexual side effects from the drugs are more common during the prime perimenopause and menopause years, according to a 2025 study published in Georgetown Medical Review.  The researchers investigated SSRI-related gynecological adverse events and found they were most prevalent in women aged 40–59.⁵ 

Lifestyle habits, including smoking, consuming excessive alcohol, and not exercising regularly, may also depress our sex drive, as do many common menopause symptoms, Minkin says. A 2023 study found that 52 percent of menopausal women have sleep disorders.⁶ “Poor sleep, hot flashes, mood changes, and the stress of midlife responsibilities can all dampen desire. If you’re exhausted or not feeling well, sex often moves down the priority list.”

Natural Ways to Increase Sex Drive During Menopause 

The good news is there are many strategies for boosting your sex drive and making sex comfortable again during perimenopause and menopause. Here’s how to increase your libido naturally, by addressing factors associated with body and mind.

1. Talk to your partner 

The first step to better sex with your partner in menopause is discussing your needs. “Communication is crucial,” Minkin notes. “Letting your partner know what feels good, what doesn’t, and what you need can reduce pressure and build intimacy. Couples who talk openly tend to find solutions together,” she says, whether that means trying new things in bed (such as positions that don’t involve penetration) or more foreplay, or teaming up to seek medical support or counseling.

If part of the problem is that you don’t even know your own desires when it comes to sex, there are questions online to help couples uncover what they might want to try. Or, if a couple has been sexually disconnected, it can feel safer to start with sensual closeness exercises—like eye gazing, giving each other massages, and showering together—before diving into traditional sex. It’s important to acknowledge that emotional health in relationships plays a role in your ability to enjoy sex after menopause and during perimenopause.

2. Practice self pleasure

Masturbation can help women in menopause become more comfortable with sex and understand their libido on their own terms. “Self-pleasuring increases blood flow, maintains vaginal elasticity, and keeps tissues healthy,” Dr. Minkin explains. “It also helps women stay in touch with their bodies, which can improve desire and make partnered sex more enjoyable.” 

Keep the vibe going by making a point of noticing things in everyday life—textures, tastes, and sounds, for example—that feel good, and see how you might bring them into the bedroom in some way.

3. Lubricate

Regular use of lubricants is enough for some menopausal women to feel more interested in sex, particularly if they are experiencing symptoms like dryness or discomfort. Products like over-the-counter vaginal lube or vaginal inserts help moisten tissue, reduce pain, and support overall enjoyment in sex. 

• Lubes: Look for unscented, water-based lubes, which are less likely to cause skin irritation. Apply to the vaginal area or the penis right before sex. Remove any stigma associated with its use by giving it a fun nickname like “secret sauce.”
• Vaginal moisturizers: Available over-the-counter, vaginal moisturizers come in many formulations, including gels, ointments, and suppositories. Usually inserted at bedtime a few times a week, they can help you feel more comfortable during sex and in day-to-day life. Look for a vaginal moisturizer with hyaluronic acid, a natural substance that helps with moisture retention, Petruzzi says.

4. Get regular exercise

Exercise sends mood-boosting chemicals called endorphins through the body and increases circulation, which helps sex drive during menopause. A 2016 study found that physical activity improves low libido by up to 80 percent in menopausal women because of its positive impact on hormones, mood, and nervous system. ⁷ It can also boost your body image, which can increase your interest in sex.

Hitting the yoga mat may be especially beneficial: A 2024 study review, published in BMC Women’s Health, found that yoga helps relieve urogenital symptoms in menopause.⁸

5. Tailor your diet

Eating a healthy, balanced diet is a natural way to balance hormones in the body during perimenopause and manage other conditions that might impact libido. Here are a few ways that specific types of foods can improve menopause sex drive.

• Foods rich in phytoestrogens mimic your body’s natural estrogen and may provide some relief from menopause symptoms like low libido.⁹ Soy, in particular, has been shown to increase vaginal blood flow and lubrication. Add these foods with phytoestrogens to your shopping cart: flaxseeds, soy, apples, legumes, and whole grains.

• Foods that boost testosterone levels might support a healthier libido. Research on the benefits of testosterone therapy for libido in women is extensive, and maintaining a testosterone-healthy diet may naturally supplement hormone levels. Foods with zinc may give you a boost of testosterone, as may red meat, beans, whole grains, dairy, and eggs.
• Foods with omega-3 fatty acids can support vaginal lubrication, improve blood flow to the genitals, and combat oxidative stress.¹⁰ Some omega-3-rich options include oily fish like salmon, walnuts, and fruits rich in antioxidants—including blueberries, raspberries, strawberries, and pomegranates.

6. Prioritize mental health

Women with depression, anxiety and other mood disorders are prone to low libido and pain during sex.¹¹ Fluctuating hormone levels during the menopause transition can zap your energy and leave you feeling moody and uninterested in sex, Petruzzi says. 

At the same time, experiencing sexual issues can bring on anxiety. If you notice you’ve lost interest in things you used to enjoy, or regularly have trouble sleeping or eating, be sure to talk to someone, whether it is your doctor, a mental health provider, or even a close friend. Getting help is critical for feeling better in all areas of your life, including your relationships and sexual health.

Medical Treatments for Low Sex Drive During Menopause

There are more medical treatment options for sex issues during menopause than ever before. “Some changes in your sexual desire is normal, but if it’s starting to impact your personal life and relationships, you should discuss it with your doctor,” Petruzzi says. “Low libido can be due to many factors, but the good news is we have ways to treat them.” 

1. Hormone replacement therapy

Hormone replacement therapy (HRT) can treat low sex drive in menopause by supplementing the body’s production of hormones like estrogen and testosterone. During perimenopause, these hormones fluctuate more dramatically during the menstrual cycle until the body reaches menopause one year after your last period.

The main types of HRT are: 

• Low-dose vaginal estrogen, a cream used to relieve debilitating symptoms like vaginal pain and burning, as well as urinary issues
• Systemic estrogen therapy, via a pill or patch used when a woman has multiple menopause or perimenopause symptoms
• Testosterone therapy for libido, often prescribed as a cream

The North American Menopause Society recommends vaginal estrogen as the first-line of treatment when women are experiencing only sexual or urinary symptoms.¹² Estrogen patches can also provide some benefits for vaginal health and libido, but not always to the same extent.¹³ 

2. Rx vaginal creams

Hormone-based treatments like estradiol cream can improve vaginal tissue moisture and elasticity and make sex more comfortable. “Vaginal estrogen cream is the best medical treatment for dryness,” Petruzzi notes. It can help restore the vagina to its pre-menopausal condition, she adds, helping with lubrication. 

There are several types of vaginal creams available to support better menopause sex:

• PT-141: Available as an injection or a nasal spray, PT-141 is a peptide taken 30 to 60 minutes prior to sex. It works by activating receptors in the central nervous system to increase desire.
• Vaginal estrogen: This comes in a ring, a cream, a tablet (which is inserted vaginally), or a vaginal suppository, which is more of a melt-away capsule.
• Vaginal DHEA (dehydroepiandrosterone): This steroid hormone is prescribed to reduce pain during sex in menopause.
• Ospemifene (Osphena): This selective estrogen receptor modulator (SERM), taken orally, has an estrogen-like effect on vaginal tissue, increasing lubrication, elasticity and collagen, reducing pain during intercourse and increasing arousal.
• Arousal cream: Also known as Scream Cream, this topical medication is a blend of Sildenafil (generic Viagra®) and natural stimulants like L-Arginine that enhance blood flow to the clitoris.

3. Ask about medications

If you are struggling with low libido during or after menopause, talk to your doctor about the best treatment plan, which will likely be a combination of medication and lifestyle changes. 

Flibanserin (Addyi) and bremelanotide (Vyleesi) are two prescription drugs given for hypoactive sexual desire disorder (HSDD) that affect brain chemicals linked to sexual desire. They’re both FDA approved for premenopausal women and used off-label for menopausal women. Flibanserin is an injection you give yourself, while bremelanotide is a pill.

Another important step: Make sure you’re not taking a medication for another condition that is actually dimming your sex drive. Some SSRI drugs, such as Paxil, blood pressure medications, and other drugs can cause unwanted sexual side effects. Your doctor may be able to switch your prescription to a drug that doesn’t hinder your libido. Don’t stop taking any prescriptions, of course, without first consulting your doctor.

4. Try pelvic floor therapy

Pelvic floor exercises can make sex easier during menopause by increasing blood flow to the pelvic area and strengthening muscles involved in orgasm. “A strong, healthy pelvic floor improves blood flow, sensation, and comfort,” Minkin says. 

“Pelvic floor physical therapists can also help women who experience pain with penetration by teaching relaxation and muscle control techniques.” To find an experienced pelvic floor therapist, ask your OB/GYN for a referral or check specialized directories like the Academy of Pelvic Health Physical Therapy’s PT Locator.

When to Seek Professional Help to Increase Your Low Sex Drive

Tending to your sex drive is no different than taking care of an injured knee. There’s nothing wrong with getting help—in fact, it’s a healthy move that can make a big difference.

A psychologist, couples therapist, or sex therapist may be able to help you increase sex drive during menopause by addressing root causes and offering a treatment plan customized to your specific needs.  

If your doctor can’t give you a referral, search the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) provider finder.  You can also consult the Menopause Society’s directory to find a Certified Menopause Provider.

Navigate Menopause With Confidence

Get expert guidance and support on symptoms, treatments, and lifestyle changes, delivered every Monday.

"*" indicates required fields

Name*

Email*

Subscribe to*

Hone In: Men’s health, performance, and longevity

Hone Your Life: Women’s health, hormones, and well-being

Join The Hone Newsletter

About the reviewer

Marilyn Lajoie, M.D., is an internist who specializes in hormone therapy for men and women. She holds degrees in integrative medicine from Saba University School of Medicine and chiropractic medicine from Northeast College of Health Sciences.