Many women may notices changes in their sexual function later in life which may include declines in libido, sexual responsiveness, comfort level and sexual frequency, . About 1 in 10 people undergoing menopause do experience a decreased sex drive. Many people in menopause get vaginal dryness, itchiness, or some pain or discomfort with sex. Water based lubricants and vaginal estrogen can help with vaginal symptoms.

Vaginal estrogen comes in the form of a cream, a ring or tablet inserted into the vagina. Vaginal estrogen can also help with urinary symptoms like bladder infections, and frequency of urination, but does not reduce accidents or the feeling of urgency. Providing estrogen just to the vagina does not seem to lead to increased risk of cancer to the inner uterine lining (endometrial cancer) in the same way that the oral estrogen therapy can. 

Ironically, your preferred form of sexual arousal may help with vaginal symptoms as it increases pelvic blood flow. Some people find they end up enjoying their sex life more after menopause. Without periods or pregnancy risks, and because many people no longer have children at home, they are free to be more spontaneous!

This post was authored by Oriana Shaw, medical student at the University of Alberta. The post was reviewed by Yuliya Koledenko, MD, CCFP, BSc, Stephanie Liu, MD, MSc, CCFP, BHSc and Erin Manchuk, BScPharm, BCGP.

References

Suckling, J., Lethaby, A., & Kennedy, R. (2006). Local oestrogen for vaginal atrophy in postmenopausal women. The Cochrane Database of Systematic Reviews4, CD001500. https://doi.org/10.1002/14651858.CD001500.pub2