Not feeling in the mood lately? You’re not alone—and there’s nothing wrong with you! Low libido in midlife, or diminished sexual desire is a fact of life for up to 87 percent of women as they get older. “For many women, as we age and our relationships age, we just don’t feel spontaneously horny anymore, and that is a completely normal change,” says Laurie Mintz, Ph.D., a professor of psychology at the University of Florida and the author of A Tired Women’s Guide to Passionate Sex. “We think we’re supposed to feel like we did when we were 20 rather than accepting changes as they occur. What might have turned you on at 20 is going to be different than at 40, 50, or 60.” Understanding these changes in libido and how to get help—there are remedies for most sexual issues—could make this the perfect time to reawaken your sexual self and improve your sex life.

“Menopause does not have to be a death sentence to your sex life,” Mintz says. Many people report that the best sex they ever had started at age 50 when they got more comfortable with their bodies and with communicating their needs, according to research by Peggy J. Kleinplatz, Ph.D., a sex therapist and co-author of Magnificent Sex.

Why does sexual desire decline with age?

Sexual desire isn’t just about lingerie and candlelight. It’s complicated and menopause is only part of the story. Many factors can affect your sex drive:

  • Hormones (a decline in estrogen can put out the flame)
  • Physical conditions (vaginal dryness, joint pain, or a decrease in flexibility can make sex less desirable or even painful)
  • Mental health (depression and anxiety can dampen desire)
  • Situational issues (a fight with your partner is not the best foreplay)
  • Your body image (menopausal weight gain may be making you feel less sexy)
  • Your environment (a sink full of dishes and baskets of dirty laundry can be a turn-off)
  • Your relationship (if you’re not attracted to your partner, it’s going to be harder to get in the mood)
  • Your sexual attitude (the belief that it’s all about satisfying your partner doesn’t make sex as fun as it can be for you)
  • Medications (antidepressants, blood pressure, and other medications can hinder desire)
  • An underlying medical condition (disease like diabetes, heart disease, or multiple sclerosis that affect blood flow and nerve function can reduce sexual responsiveness)

To further complicate sexual desire, there isn’t a one-size-fits-all definition of low libido. “There’s no criteria,” says Mintz. “It’s so individual.” For one woman, sex once a month may be fine, but anything less than once a week is a problem for another. If you and your partner are satisfied with the frequency of your sexual encounters and level of intimacy, don’t compare yourself to others. However, if your lack of desire, frequency, or quality of your sexual encounters is bothering you, there are ways to improve your love life.

There are two types of sexual desire

Unfortunately, most women are only aware of one type of desire, the spontaneous kind, where suddenly you feel horny and want to have sex. When this doesn’t happen as often or at all, women feel guilty and think something is wrong with them (even though it’s a normal part of aging).  But there is another type of desire, called responsive sexual desire, which is just as important—maybe even more so in midlife.

Responsive sexual desire starts with your brain instead of your genitals. Your brain says sex is a good idea for whatever reason. (According to one study, people gave 237 different reasons for having sex, and being horny was only one of them.) Think of it like reversing the equation; you have sex to get horny. Sexual arousal springs up as a result of stimulation like being touched. “It’s like starting your car in the winter,” says Mintz. “You can still have a pleasant ride, but you have to warm it up first. A lot of times, if you wait to have sex until you’re horny, you’ll never have sex, especially at this stage of life.” And the more sex you have—including with yourself--the more sex you want.

What to do when sex hurts

Focusing on responsive desire can improve your sex life, but sometimes you need additional help. If you’re not getting aroused once you and your partner get going or sex hurts, you need to consider underlying conditions. Sometimes it may be as simple as a lubricant to solve the problem, but other times you may need to talk to your doctor.

As estrogen declines during menopause, blood flow to the vagina decreases, and vaginal tissue thins, causing a decrease in arousal and lubrication. These changes can make sex less enjoyable, orgasms harder to achieve, and penetration painful. About half of postmenopausal women experience pain during intercourse, called dyspareunia. It’s one of the most common reasons women shy away from sex. But, there ways to stop the pain. If a lubricant doesn’t help, talk to your doctor about other options. If dryness is causing the pain, a topical estrogen can help. Your doctor can also determine if another condition such as a urinary infection or skin condition is causing the pain and treat it appropriately.

How to rev up your libido

Sex is important for a relationship. Yes, some people are happy in sexless relationships, but that’s probably not you if you’re reading this. Unfortunately, even though we say or think sex is important to us, many of our actions say otherwise. Too tired for sex? But are you staying up late binge-watching your favorite show or scrolling on social media? To get your sex life back on track, here are some steps to take.

Believe sex is important. There are physical, emotional, and relational benefits to having sex. When you’re hugging and touching each other, your body releases the feel-good hormone oxytocin, which reduces stress, anxiety, and irritability. Neurochemicals released during an orgasm can provide pain relief and help you sleep better. You’ll feel more connected with your partner, and you’ll get less annoyed and be less snippy with each other outside of the bedroom. Sex boosts immunity. “This is just the tip of the iceberg,” Mintz says. “There was a 25-page paper written summarizing all the physical, mental, and emotional benefits of sex.”

Make sex a priority. Scheduling sex is one of the most effective therapies that sex therapists prescribe. “I call them trysts rather than scheduled sex because it sounds a little sexier,” says Mintz. “If you look it up in a dictionary, a tryst is a planned meeting between lovers. People think of it related to having affairs, but it can be with your long-term partner as well.” Remember, desire doesn’t have to be spontaneous, and you don’t have to be horny to get it on.

Think about intimacy, not just sex. There’s more to a sexual relationship than just intercourse. Building connections with your partner outside of the bedroom can make your connections in the bedroom more fun and satisfying. Exercising, cooking, holding hands while taking a walk, going on a date, or dancing together can bring you closer. In or outside of the bedroom, hugging, kissing, cuddling, giving or getting massages or foot rubs, even having your hair brushed can enhance intimacy and sensual stimulation. And remember there are lots of ways to pleasure each other, including oral sex, using a vibrator together, or even masturbation. Thinking about sex as a spectrum of activities can help take pressure off of both of you, especially as you get older.

Focus on you. Take time to take care of yourself. All types of exercise can improve sleep and reduce stress, two factors affecting your sex drive. Working out, especially strength training, may also help with body image issues that can come up when your body is changing. Eating a healthy diet can boost your energy and improve your mood. Pleasuring yourself by masturbating can also be a vital part of self-care. It can help you relax, and getting in touch with your body enables you to direct your partner for more satisfying encounters for both of you.

Use your brain. “Most of us need genital stimulation, but it doesn’t matter how you’re being touched; if your brain isn’t in the game, it’s not going to happen,” says Mintz. For the best sex, you want your mind to be present in your body, not worrying about how you look or thinking about your to-do list. One of the best ways to learn to be more present in the bedroom is to practice meditation or mindfulness outside of the bedroom. Yoga can also help you become more mindful, and the flexibility you can gain from the practice can be an asset in the bedroom. One study even found that women who do yoga are more orgasmic. Another way to use your brain is to fantasize about sex even when you’re not doing it. Fantasizing can be like a form of foreplay, and doing it during sex can help keep distracting thoughts out of your head.

Be adventurous. Reminisce about how fun sex was and look for ways to spice it up now. Try different positions, read erotic books, or watch woman-centric erotica. Sex toys like vibrators offer a whole new element. Even something as simple as a blindfold or feather can enhance your experience. Or try role-playing or book a hotel room to change things up.

Talk about sex. “You can’t solve a problem, sexual or otherwise, without talking about it,” says Mintz. Let your partner know what’s going on. They’ll be much more supportive knowing that it’s the hot flashes or discomfort that’s turning you off and not them. If your partner is part of the problem, you should talk to a therapist who can help you address the topic. It can also help if you speak with your doctor about sexual issues. Don’t be embarrassed because they’ve probably heard it before. “We used to die before we hit menopause,” says Dr. Mintz. “Now, we are outliving our uterus. We are outliving our estrogen. If we’re going to have a healthy sex life after our estrogen has decreased, we need assistance from knowledgeable health care providers.” As one of Dr. Mintz’s patients summed it up, “Communication is the bedrock to make your bed rock.”

Learn more about low libido in midlife

Have you experienced changes in your libido?  Wonder if what you are feeling is normal?  Speak with a Gennev board-certified Ob/Gyn to get your questions answered and learn about proven treatments that can help manage changes in your libido. 

Listen to Dr. Mintz in the Gennev podcast where she talks about Sex, Midlife and Menopause

Check out Sex After Menopause: It is really good for you to learn about the benefits of a healthy sex life.

Are mood swings getting in the way of romance? Learn more with Menopause, Marriage and Mood Swings


The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.



Michele Stanten

February 15, 2022

Medically Reviewed By

Dr. Ghazaleh Moayedi

Dr. Moayedi is a Board Certified OB/GYN and subspecialist in Complex Family Planning.

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