Sex and Menopause: A Six Point Plan

Most women notice a change in their sex drives, and maybe their sex lives, as they start to enter menopause. But just because these shifts are natural doesn't mean there aren't things you can do to make sex better, and maybe even your best yet.

I recently had a great conversation on this subject with Jennifer Landa, MD, an Orlando-based Ob-Gyn who is the Chief Medical Officer of BodyLogicMD, which connects both women and men with doctors trained in identifying and treating hormone imbalances. Jen is the author of the new book The Sex Drive Solution for Women: Dr. Jen's Power Plan to Fire Up Your Libido, and she has some interesting, very do-able advice on how to keep your sex life as satisfying as ever:

Redefine Great Sex

You're probably not ripping your partner's clothes off the way you did in your 20s, but is that really a problem? Landa told me about a recent study published in the American Journal of Medicine, which polled women over 40 (and up to 100) about their sex lives and found that libido (as in the urge to have sex) declined with age far more than sexual satisfaction did. Meaning that even though the women were less interested in having sex than they once were, when they had it they had no problem becoming aroused or achieving orgasm.

"When women think of libido they think about the libido of their 20s, which at that age is very much a Darwinian drive like eating and sleeping, but in your 40s and beyond you don't really need that drive any more, from an evolutionary perspective," she says. "So we need to ask ourselves if there's really a problem with that—as long as you can still become aroused when you do have sex, maybe it's okay that you don't crave it quite as much as you once did. So many women come into my practice and say that they don't care if they ever have sex again, but when they do they enjoy it and have orgasms easily."  That's why Viagra doesn't work in women, says Landa. "Viagra doesn't change desire, it just helps with arousal, the blood flow to the genitals—but most women don't have problems with arousal, it's the desire that's missing."

Try a Pro-Libido Lifestyle

A "pro-libido lifestyle" is what Landa calls her plan for boosting your libido as much as you can, and enjoying sex as much as ever, or more. "You can still have the best sex of your life, but it's more of a process," she says. Here are some of the key points:

Stress less. Stress not only distracts you, it has a very negative impact on your sex drive on a hormonal level. "There's a hormone called pregnenolone which is the precursor to the rest of your hormones, and when you're stressed out too much of it goes to make the stress hormone cortisol, and there's not enough left to make sex hormones like testosterone," says Landa.

Eat pro-libido foods. Nope, not Valentine's Day standards like chocolate or champagne, but cruciferous vegetables such as cauliflower, broccoli, cabbage and Brussels sprouts. "These contain a compound called Indole 3 Carbinol which balances hormones and reduces estrogen dominance," says Landa. For more on estrogen dominance, which can be a cold shower for your sex drive, read my recent post on the subject. 

Exercise (of course). Yep, you know you should exercise, but did you know that working out improves your sex life both my increasing circulation (to, uh, every part of your body) and by upping testosterone levels? "Strength training is especially good for boosting testosterone," says Landa. "I suggest that women go work out with their partners before a date, or as a date in itself, because they'll have better sex afterwards."

Cut back on sugar. "It's one of the worst things for your body, and that includes your sex drive," says Landa.

Stay in the moment. "My secret ingredient for good sex is mindfulness," says Landa. "You need to take time to focus on the moment, and on your five senses. We are all so busy and stressed that sometimes we'll eat a great meal and not even really taste the food. I encourage women to set aside time to get into a space of mindfulness and focus on their senses, maybe in a bath with candles and music, or whatever it takes." She recommends the classic book The Power of Now by Eckhart Tolle. "It can be read a little bit at a time, and gives you an idea of how to still the mind's chatter and just be present. It's one of the best things you can do for libido."

Bring something new into your bedroom.  "You can't expect to eat at the your favorite restaurant three times a week for decades and not get a little bored by it, so it's super important to bring novelty into your sex life," she says. "When you do new things with your partner it releases different chemicals in your brain, like dopamine, which is great for sex. Whether it's something mild like new lingerie or something more wild, anything new and different is good."

But if you're finding at menopause that libido isn't the only thing that's not working, and you're having trouble with arousal and orgasm too, you should consider getting your hormone levels checked. Because, as the women in that research show, it's not natural for menopause to equal the end of great sex.

More about Sex and Menopause:

Sex and Menopause: What to Expect

DHEA = Better Sex for Women?

True Tales of Sex After 50