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If you like chatting about taboo subjects, take a seat, because it’s time to talk about menopause — and its effect on your sex life.
Unfortunately, menopause, defined as the end of a woman’s reproductive years, or when a woman stops having a menstrual cycle, goes hand in hand with some serious physical changes. And those physical changes can impact your libido.
But fortunately, this is 2025, and women are sick of whispering behind closed doors about how menopause has killed their sex life. When I posted about this topic on Threads, asking people to share their stories about sex and menopause, before I knew it, countless women were opening up about their experiences. Everyone’s enthusiasm blew me away: Instead of quietly DMing me and asking that I use a pseudonym, women dropped their postmenopausal treatment plans into my comments like they were their favorite Pedro Pascal memes. For the record, hormone replacement therapy (HRT) and divorcing their husbands were the two top responses.
Before we delve into these women’s stories, however, it’s important to understand why menopause can destroy your libido. (And to keep in mind that menopause doesn’t necessarily affect everyone’s sex life; I heard from several women who reported no changes.)
Hormones. It’s always the hormones. Oh, and your age
According to the Johns Hopkins Medicine website, more than a third of women in perimenopause (aka the years leading up to menopause) or menopause “report having sexual difficulties, from lack of interest in sex to trouble having an orgasm.”
And you can blame good ol’ hormones (and, yay, aging) for this condition: Declining levels of estrogen — which occur during both perimenopause and menopause — can reduce the desire for sex, as well as make sexual arousal more difficult.
Also, as you get older, blood fills your genitals more slowly as you become sexually aroused, so you may not experience the same amount of sensitivity as you did pre-menopause.
On top of affecting your desire, lowered estrogen levels can be the reason why postmenopausal sex is suddenly so painful. This is called dyspareunia, or pain during intercourse, and it affects about half of postmenopausal women. Less estrogen causes the lining of the vagina to thin out, it reduces the natural lubrication in the vagina, and it can also cause the vaginal canal to be not-as-stretchy than it once was. Next thing you know, you’re likely experiencing vaginal dryness, burning, or itching.
Hooray hooray for HRT!
Now that we know why menopause killed our sex lives, it’s time to discuss how to get your dormant libido back. (Only if you want, that is: A few women responded to my Threads post saying it’s perfectly okay if you’ve lost your sex drive as a natural progression of aging — and that’s 100% true!)
First of all, remember that everyone is different, so be sure to schedule an appointment with your healthcare provider and/or a sex therapist to discuss options that are right for you.
That being said, the majority of responses I received to my initial Threads post sang the praises of hormone replacement therapy (HRT). HRT replaces the hormones that your postmenopausal body isn’t making enough of anymore, and helps treat menopause symptoms like vaginal dryness and hot flashes. Most HRT comes in several forms, including, but not limited to, pills, skin patches, gels, creams, and sprays.
While HRT usually means either estrogen or a combination of estrogen and progesterone therapy, many of the women who commented on my Threads post specifically spoke about how testosterone therapy — in addition to estrogen and/or progesterone therapy — helped reignite their libido. Here are just a couple of testimonials from pro-testosterone therapy advocates:
@teresaanngwinn: “I’m on HRT. The estrogen and progesterone help with a lot of the symptoms, but testosterone was a game-changer. I’m on a fairly good dose, but not enough to have negative side effects. I haven’t felt as comfortable in my body as I do now in years! And our sex life has 🚀!”
Julie, aka @the_curvy_company (who also insists edibles are a great addition to an HRT regimen): “Edibles 8 years ago brought it roaring back now that I am 2 years post menopause estrogen testosterone and progesterone are doing the job beautifully but I still have way better Os with a little edible in me lol!”
Hope, via Instagram DM: “I feel it is so important for women to know that, if they are interested in a more vigorous libido and sex life, there is help. I'm on progesterone and a weekly 0.1ml shot of testosterone cypionate. The testosterone has made a HUGE difference in my life. My libido has returned. My husband of 41 years and I often remark that this is the best time of our lives together. Our history, mutual love, trust, and yes, testosterone, definitely help!”
Remember, HRT isn’t a magic bullet
Although most responses to my Threads post were positive reactions to HRT, it’s still essential to consult with your healthcare provider in detail about your options.
The first reason concerns testosterone therapy: While many of the women I connected with couldn’t stop gushing about how testosterone was the missing piece of the estrogen-progesterone therapy puzzle, it may be more of a quick, rather than a long-lasting, fix.
According to the Mayo Clinic, some postmenopausal women may experience a sex-drive boost after taking testosterone, but there’s not enough research available on testosterone therapy regarding its safety or long-term success. Testosterone therapy can also cause side effects like acne, hair growth on the face and body, hair loss (on the head), and weight gain.
In addition, the Food and Drug Administration hasn’t approved testosterone therapy for women, though doctors can prescribe it for low libido. Most of the women who shared on my Threads post said they had been prescribed a low dose of testosterone. These prescriptions usually come in the form of a gel, pellet, or pill.
The second reason why HRT isn’t the best course of action for some postmenopausal women is that it’s not recommended for anyone who has been treated for breast cancer. Studies have shown that breast cancer survivors taking HRT were more likely to develop a new or recurrent breast cancer than women who weren’t taking HRT. At least two women brought this to my attention on the Threads post, both of whom offered differing, yet equally empowering, perspectives.
@shadyoakslane_fashion: “Some of us can’t take HRT — my case was breast cancer — and I’m ok with not having much of a libido. I feel attractive and I’m ok with my life changing. We go through different stages in life and that’s ok. To each her own! Without all the surging hormones involved with a libido, I actually have never felt calmer and more content!”
@deborahpopolizio: “Couldn’t take HRT because I carry the genetic for breast cancer and I’m a survivor so I did Mona Lisa Touch laser treatment and it made all the difference. Tough to share this but women are too quiet about these matters. You don’t need to continue to be sexually active after menopause, but if you choose to, making it physically satisfying is the key to wanting to engage.”
The MonaLisa Touch laser treatment is a noninvasive laser therapy used to treat vaginal atrophy (aka genitourinary syndrome of menopause). This is a thinning of the vaginal lining, which, as previously mentioned, occurs due to the lack of estrogen from menopause. The MonaLisa Touch addresses common vaginal atrophy symptoms like vaginal dryness and pain during intercourse by healing the vaginal tissues. This treatment is a good alternative to estrogen-based therapies like creams, lubricants, or medication, especially for those who have undergone treatment for breast cancer.
Open communication and self-esteem are key
No shade on modern, science-backed treatments like HRT, but having open and honest conversations with your sexual partner(s) about postmenopausal intimacy is more important than any medical prescription. Share with your partner if you’re experiencing pain from intercourse, or if your libido isn’t what it once was. This actually could be a great time for the two of you to experiment with new positions and techniques, or seek out a sex therapist who specializes in postmenopausal concerns.
@mullenmj: “I wouldn’t say that mine went away, but I was so anxious and tired that my brain wasn’t in the game a lot of the time. I was dealing with hormonal stuff long before peri/menopause stuff started, so I think I was already farther down that path. I’m just grateful that my partner rolled with it as he has health issues of his own so we could be honest with each other and stay close in other ways.”
Ultimately, no amount of hormones can make you love yourself and your body the way they deserve to be loved. Learning to love your postmenopausal self, with all its imperfections, is the greatest gift you can give yourself — and your libido!
@tastefullymunich: “HRT all the way…. AND to be completely fair… I started to love and accept my body, along with believing I’m as vibrant as ever as a woman! The combination turned it all around. 🤍”
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Subscribe to her Substack, the Critical Communicator, and follow her on Instagram, BlueSky, or Threads.