Hormonal and vaginal changes can significantly affect arousal in midlife women beginning in their 40’s.

Along with hotflashes/nightsweats, the first noticeable change associated with menopause is often dryness and thinning of the vagina - the most common cause of painful sex at midlife and beyond.


Too many women suffer in silence which is tragic given there are proven safe and effective solutions. 

Despite how often women are troubled by sexual problems, most women don’t discuss these problems with their healthcare providers. In a survey of US women ages 57 to 85, only 22% reported that they had discussed sex with a physician since they had turned 50.

If you’re in your 40’s or 50’s and find you’re not as excited as you once were about sex, you’re not alone. Many women report painful sex (aka “sandpaper sex”), difficulty connecting intimately, and an overall ‘meh’ attitude about sex. Difficulty in reaching orgasm changes the whole dynamic too, making sex literally anticlimactic. 

Add hot flashes, night sweats, chronic lack of sleep, physical fatigue, weight gain, mood swings, depression, incontinence and brain fog and it’s understandable why so many mid-life women give up altogether on intimacy. 

Stress, as ever, plays a key role: The New York Times reports that many women between 50 and 74 years old feel far too busy for a relaxing sex life. Some care for or have stress in relations with older children or parents, some have partners with serious health issues that make “normal” sex more difficult, and some are simply….exhausted and overwhelmed.

Vaginal Lotions and Moisturizers Are Proven Safe and Effective

Your doctor can prescribe an estradiol vaginal cream, applied on a daily basis.

Research has shown that you can use hormone replacement therapy in the vaginal and vulvar tissues, and it does not circulate into your system. Many breast cancer survivors can use [vaginal hormone cream] safely as long as required.  

Talk to your doctor about your specific limitations to see if topical hormone therapy is right for you.

Otherwise, doctors can suggest a topical lubricant without estrogen, like Vagifem. While a non-estrogen vaginal lotion won’t help in the same way as an estrogen lotion, it can restore moisture temporarily.

With vaginal lotions and moisturizers, it’s important to use them regularly to reduce symptoms over time. These are not lubricants for sex – think of them more like skincare.


Supplemental Research 

International Society for the Study of Women’s Sexual Health (ISSWSH), the International Society for Sexual Medicine (ISSM)

Pelvic floor pilates https://www.leminou.com/virtual-events