Will menopause ruin your sex life?

Kaz Cooke explains why it doesn't have to, in her new book.
Kaz Cooke headshot
Author Kaz Cooke, Photography by Annie Maver

For many of us in our 40s, 50s and beyond, we feel so worried about being undesirable, we forget to ask what we might desire. Is it better to feel worthy; to feel sexy; to feel at peace with not having sex?

More than 9,000 Australian women surveyed about their thoughts and feelings on menopause for my latest book, It’s the Menopause, cited their reasons for losing interest in sex as: feeling more self-conscious about body and face changes caused by time, not enjoying sex and regarding it more as a duty, hating the endless thrusting friction sort of sex that seemed to be wanted by men who took medication for long-lasting erections, having a partner who’s not interested or doesn’t make them feel wanted, part­ners who didn’t make an effort to find out how to make sex good, and the side effects of medication.

A lot of women who talk to counsellors and psychiatrists about sex say they feel they have to compete against younger women to keep the interest of their partners. A changing face and body, their shrinking self-esteem and physical and mental symptoms of perimenopause combine to make them feel unworthy and discardable. Discardable may not be a word, but never mind, it’s definitely a feeling.  

Kaz Cooke comic illustration about libido
Illustration by Kaz Cooke from her new book, It’s the Menopause.

Women are now far more likely to have sex into their seventies than they were in the past (or at least, tell anyone about it). We might have assumed it’s because they’re still enjoying it. But reliable Australian research shows that almost 90 per cent of older women (aged 65 to 79) have low sexual desire, and more sadly, about a third of women who were having sex with a partner were having a horrid – rather than a torrid – time.

Australian women told a reputable 2017 survey that their lack of interest had multiple reasons: a presumed change in hormone levels, but also distress about incontinence, dry vagina problems, feeling depressed, and though it wasn’t precisely worded in the survey, I’ll add: because they were sick of their partner being a dud in bed.

  • Depression and anxiety.  
  • Being responsible for two or three generations of family stuff. 
  • The synthetic progestins in most kinds of the Pill, and some MHT, are suspected of mood-flattening, which can affect libido.  
  • Side effects of some other medications. 
  • A menopausal dry vagina – for some helpful solutions, see the November issue of Australian Women’s Weekly or Kaz Cooke’s new book, It’s The Menopause.
Possible reasons for a lower libido:

Hormones & your libido

Testosterone has been suggested as a libido cure, but the problem is, it doesn’t work like that: you can’t just take some testosterone medication and turn into a sexual raver. Some women say a boost of testosterone, using a prescribed approved cream delivering a calibrated amount every day, has helped them feel more desirous of sex and less anxious about it; others say it makes no difference, and that instead, getting their estrogen level up again really helped. Others say they’re so bored with what their partner is doing to them they could scream, and no amount of her taking testosterone has made him be any more inventive or attentive.

So far, there’s no evidence that taking testosterone does anything to help most women who have a standard uninterest in sex they’re quite happy with. One leading researcher found that 50 per cent of women given a placebo instead of testosterone in a clinical trial said it had improved their libido.

The jury is out on whether the extra estrogen in Menopausal Hormone Therapy (MHT) or otherwise affects libido. Some women say yes, some say no.

  • Despite rumours, you could eat dates, ginger, chillies and oysters all day and you’d be much more likely to feel sick than automatically want to have sex.  
  • Unproven ‘natural’ supplements.  
  • In-vagina digital or app-related devices.  
  • Non-testosterone medical attempts at changing a woman’s libido are mostly in pill form and sometimes oddly referred to as ‘women’s Viagra’. Generally, they’ve caused side effects that include vomiting, or a contraindication. 
What doesn’t do anything significant to libido

‘Natural’ supplements for libido

Non-medical so-called libido supplements are also unproven, which is doctor-speak for doesn’t work, otherwise somebody would have proved that it does. The only proven known consistent change that has an effect on women’s inter­est in sex is shown in study after study: when men do more housework and share more of the emotional and family organisational burden, the couple has more sex.

  • Not being so bloody tired.  
  • Being mainly healthy.  
  • Not drinking more than healthy levels of alcohol.  
  • Maybe estrogen or testosterone supplements.  
  • Shared household chores and responsibilities between partners.  
What might boost libido:

If a lower libido around the time of menopause is a problem for you, see your GP or gynaecologist for solutions. If a lower libido isn’t a problem, have a cup of tea instead. If your libido has increased, have at it.

This is an edited extract of It’s the Menopause by Kaz Cooke (Penguin).

The information in this article is of a general nature. For specific health conditions or before altering your diet see your doctor or health professional.

Related stories

Is this weight-loss club a cult?

Is this weight-loss club a cult?

It’s a global nutrition company known for weight-loss teas, protein shakes and sports supplements. But those who’ve been part of the Herbalife machine say it's like being in a cult, and lawyers say it may be breaking Australian laws.