Age, hormones, personal experiences, everyday stressors, and partner dynamics are just a few of the many factors that can affect your sex drive. The influence of these factors evolves as women age. But aging shouldn’t mean compromising on sexual fulfillment and intimacy.
This article will review the physiological and psychological changes that occur with aging and share tips on how women can enhance sexual desire. After all, sex in your 40s and beyond should still be fun, exciting, and satisfying.
The Physiology of Sex Drive As Women Age
Throughout a woman’s reproductive years, some research shows that sexual arousal peaks mid-menstrual cycle before ovulation.(1) However, the physical and mental changes that occur as women reach their 40s, 50s, and 60s can cause a shift in their sexual life. With age, you may find that sexual desire ramps up or slowly declines.
In perimenopause and menopause, fluctuations in hormone levels can affect libido. Specifically, women experience changes in the levels of estrogen, progesterone, and testosterone in their bodies. Together, these hormones influence women’s sexual and reproductive health. Below is a breakdown of the roles of these hormones in the body:(2)
Estrogen: The female body produces three types of estrogen: estradiol, estriol, and estrone. Estrogen supports reproductive health, sexuality, and healthy sexual development.
Progesterone: This is a key hormone that helps regulate menstruation and supports healthy pregnancy.
Testosterone: While testosterone is the primary steroid hormone in men that promotes the development of male sex characteristics, women also produce this hormone in lesser amounts.
During the menopause transition, it’s normal to experience decreases in sex drive as levels of these hormones decline. However, as you approach postmenopause, hormone levels begin to stabilize, and you may find yourself desiring more sexual activity.(3) Your libido may even reach a new high during this phase of life when pregnancy is no longer a concern.
Sex As Women Age
Women may choose to engage in sexual intercourse for a variety of reasons beyond reproduction. Research published in a scientific review showed that some women were more inclined to have sex for the purpose of satisfying physical attraction, relieving stress, experiencing pleasure, or gaining a new experience.(4) Other reasons included love or expression in relation to committed relationships. Sexual motivations remain similar regardless of sexual orientation.(4) Knowing this, your motivations for sex may change with age, potentially influenced in part by different types of relationships.
Sex may become more or less enjoyable over time as women’s lives naturally change throughout their 40s, 50s, and 60s. The development of physical health conditions, mental health struggles, or the loss of a spouse may cause a loss of sexual appetite.(5) Meanwhile, children leaving home, fewer work responsibilities, or greater feelings of self-acceptance are all factors that may enhance your sex life.
Sex for Women Over 40
Many women over the age of 40 continue to be sexually active. In a research letter published in JAMA Internal Medicine, researchers found that for women between the ages of 40 and 65, the more important they claimed sex was to them, the more they engaged in regular sexual activity.(6)
However, aging can sometimes pose challenges to sexual function and satisfaction. Arousal sparks blood flow to the genitals and increases vaginal lubrication. However, drops in estrogen, progesterone, and testosterone levels during the menopause transition can cause symptoms of vaginal dryness and thinning vaginal tissue, which can lead to painful sex.(3) Depending on the severity of the discomfort, untreated vaginal pain that occurs during sexual intercourse (dyspareunia) can have a negative impact on women’s quality of life.
Women over 40 experience painful sex differently. Sensations may be different for you than they are for a 45-year-old woman or a 60-year-old woman. In some cases, pain may only be felt during penetration. Other women may experience a burning or throbbing sensation that persists after penetrative sex. Discomfort can also include a feeling of vaginal dryness, itchiness, or tightness.(7) As a result, it may take longer for women to become sexually aroused. Achieving orgasm may also become more difficult.
It’s estimated that anywhere between 20% and 59% of perimenopausal and postmenopausal women are affected by dyspareunia.(8) Research also suggests that women may be more likely to experience painful sex during the late perimenopause stage or postmenopause stage. These vulvovaginal changes are natural, but you can get treatment for your symptoms and enjoy a pain-free sex life.
Ways to Avoid Painful Sex During and After Menopause
The key to great sex after 40 is knowing your body and understanding the changes it goes through throughout your life. Understanding the physical and psychological shifts that come with aging can help you discover what pleases you sexually. Knowing this information can help you confidently communicate your sexual needs to a partner.
The following are tips to avoid painful sex and improve your sex life after 40:
1. Consider hormone replacement therapy (HRT).
Hormone replacement therapy (HRT) can help relieve vulvovaginal symptoms as well as other common symptoms of menopause. Systemic HRT treatments, such as body creams, patches, or capsules, are available, along with localized, topical products like vaginal estrogen creams, which can help reduce vaginal dryness and pain during intercourse.
2. Try a topical sexual enhancement product.
Another option is to use products made to enhance intimacy for women - similar to what Viagra does for men but made specifically for women. These products are vasodilators that encourage blood flow and sensation for enhanced sensitivity and more intense orgasm.
3. Practice sexual activity more often.
Despite common misconceptions, research shows that decreased sexual activity does not directly link to increased susceptibility to painful sex.(8) How often you want to have sex as you age is a personal choice. For those wanting to engage in sexual activity more frequently, there may be benefits that apply to more than just penetrative sex.
Kissing, caressing, and massage are all forms of sexual activity that can boost your libido. In fact, researchers also found that arousal and oral sex are two protective factors that actually lower the risk of painful sex.(8)
4. Use lubricant.
Using over-the-counter (OTC) vaginal lubrication products can make sex more physically comfortable for women at any age. While women using HRT can also benefit from using lubricant, these products may also be a good fit for menopausal or postmenopausal women experiencing vaginal dryness who cannot or do not wish to use HRT.
The best lubricant for sex after menopause is one that reduces vaginal dryness without causing irritation. There are different types of lubricants, including those made with water, silicone, plant oils, and more. Some products contain ingredients that may cause genital irritation or upset the vagina’s natural pH balance. So using a fragrance-free, water-based lubricant during sexual activity is recommended.(9)
5. Explore new sex ideas.
Keep it interesting; try something new. Adding a little variety to your sex life may jumpstart libido. Again, this doesn’t have to be exclusive to penetrative sex. Using sex toys or engaging in mutual masturbation with a partner are alternate ideas that can be fun to explore and may be less physically painful.
6. Consult a doctor and seek help.
Remember that there are other potential causes of sexual problems that may be unrelated to aging or menopause. Certain health conditions like endometriosis, bacterial infections, or chronic pain conditions can also cause sex to be painful.(10) Similarly, depression, certain medications, or substance use can impact sex drive. Talk to your healthcare provider to rule out any underlying causes of sexual health problems.
How to Enhance Sex After 40: Treatment Options
The good news is that painful sex can be managed as women age. With appropriate treatment, you can enhance your sexual health and improve your quality of life.
Depending on the cause, treatment suggestions for painful sex or low libido may include HRT or the use of sexual lubricant. Implementing stress reduction techniques and lifestyle changes or receiving support from a partner may also help increase sexual desire. Whether symptoms are related to stress, menopause, or natural aging, treating women’s sexual health holistically can help women enjoy sex in new and exciting ways. There is no reason you can’t have a wholly satisfying sex life after 40 and throughout postmenopause.
