Sexual Health in Menopause

Medicina (Kaunas). 2019 Sep 2;55(9):559. doi: 10.3390/medicina55090559.


Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40-55%), poor lubrication (25-30%) and dyspareunia (12-45%), one of the complications of genitourinary syndrome of menopause (GSM). Declining levels of sex steroids (estrogens and androgens) play a major role in the impairment of sexual response; however, psychological and relational changes related with aging and an increase in metabolic and cardiovascular comorbidities should also be taken into account. Although first-line therapeutic strategies for menopause-related sexual dysfunction aim at addressing modifiable factors, many hormonal and non-hormonal, local and systemic treatment options are currently available. Treatment should be individualized, taking into account the severity of symptoms, potential adverse effects and personal preferences.

Keywords: dyspareunia; female sexual dysfunction; genitourinary syndrome of menopause; hormonal therapy; hypoactive sexual desire disorder; vulvo-vaginal atrophy.

Publication types

  • Review

MeSH terms

  • Atrophy / drug therapy
  • Central Nervous System Agents / therapeutic use
  • Estrogen Replacement Therapy*
  • Estrogens / deficiency
  • Female
  • Humans
  • Menopause / physiology*
  • Menopause / psychology*
  • Sexual Dysfunction, Physiological / drug therapy
  • Sexual Dysfunction, Physiological / therapy*
  • Sexual Health*
  • Vagina / pathology


  • Central Nervous System Agents
  • Estrogens