Menopause—and the hormonal changes that accompany it—can definitely put a damper on a woman’s libido. In fact, up to 40% of women over age 60 report having low libido.

To find out why so many women lose interest in sex after menopause—and determine if there are other factors beyond menopausal changes that make sex less appealing to postmenopausal women—researchers at University of Pittsburgh recently conducted a qualitative study. (This type of research involves a small sample of participants to gain a thorough understanding of a topic.) A total of 36 women ages 60 to 71 with low libido were interviewed privately or in group sessions.

Not surprisingly, vaginal symptoms, a well-known by-product of menopause, were a common complaint among the study participants. The symptoms, including vaginal dryness and a feeling of tightness, often made intercourse painful, which dampened the women’s sexual desire. While some of the study participants were helped by vaginal estrogen or natural lubricants, such as coconut oil, the results were not consistently positive. However, women who tried pelvic floor exercises—also known as Kegels—on their own or with a trained physical therapist reported generally good results.

Other factors that contributed to the study participants’ low libido…

  • Erectile dysfunction (ED) in male partners. When a woman’s partner has sexual difficulties, it often causes her to lose interest in intimacy. For some women in the study, their partners couldn’t maintain an erection long enough for satisfying sexual intercourse. For other study participants, the partner was unwilling to discuss his problem, which led the woman to put aside her own sexual needs. When women encouraged their partners to take an ED drug, such as sildenafil (Viagra), the planning involved in using medication often eroded the romance. Successful alternatives to ED drugs involved other forms of intimacy, such as manual pleasuring, oral sex or using a vibrator.
  • Fatigue and pain. Painful physical conditions, such as spinal cord issues or diabetic neuropathy, joint pain or having less stamina, in general, curbed sexual desire for many of the study participants. To address these issues, some women said they got an adjustable bed and/or tried different sexual positions.
  • Life stressors. External demands, such as caregiving for older parents, made sex less of a priority for some of the study participants. Being retired didn’t necessarily free up time for sex, and the stress levels sometimes got worse—not better—over time. Scheduling time for sex was helpful for some, but this strategy took away some of the romance for others. Taking vacations and using mental focus to ignore stressors during sex also helped.
  • Poor body image. While some study participants noted that age made them less concerned about added weight and other body changes, others were troubled by their physical appearance and said they felt less attractive, which thwarted their interest in sex.

Study takeaway: Because low libido in women over age 60 can have a variety of causes, health-care providers should not automatically attribute it to “normal” aging or menopause. There are ways to keep intimacy alive, but it takes experimentation—what works for one woman doesn’t necessarily work for another. Good communication between sexual partners is a must. If it’s lacking, couples-based therapy or counseling on how to discuss sex with your partner may help.

Want to know what really happens during a sex therapy appointment? Read here.