Why Sex Drive Changes — and What You Can Do About it

Just like the moon, a woman’s level of sexual interest and sexual satisfaction waxes and wanes throughout her lifetime — only the changes a woman may experience are much harder to predict. Understanding the factors that can affect sexual arousal, desire and overall sexual satisfaction, along with what you can do to support your sexual wellness, might help you  feel more empowered as you go through the natural, normal ups and downs of changes with your sex life. 

Arousal, Desire and Satisfaction: What’s the Difference? 

Sexual desire and arousal are similar, but not the same. Desire refers to an interest in sex, and is often used interchangeably with libido. Arousal is about the physiological response to sexual stimulation and is characterized by physical signs such as increased vaginal lubrication and blood flow to the genital area. And sexual satisfaction has to do with how much pleasure a woman receives from sex (which can include her ability to orgasm), and how she perceives her sex life. 

“Sexual desire, otherwise known as libido, is predominantly mental. Sexual arousal, where things are happening that make your genitals and body feel like something is happening, is predominantly physiological,” explains Julie Bottarini, a physical therapist specializing in pelvic floor therapy who is also a trusted medical advisor for Tabu, a wellness company dedicated to supporting women’s sexual health as our bodies change over time.  

Why Do Sexual Interest and Satisfaction Change? 

There are many factors that affect a woman’s interest in (and enjoyment of) sex, according to Dr. Alyssa Dweck, MS, MD, FACOG, Chief Medical Officer of Bonafide. “It’s not only about hormones,” Dr. Dweck says.  

“Sexual function involves biologic factors like blood flow and nerve function, hormonal factors, especially declining estrogen, psychologic and emotional issues, situational factors and of course medical conditions and medications. Relationship satisfaction and trust are highly associated with sexual satisfaction as well.  If somebody is having an issue with their partner, their libido naturally is going to not be quite as high, or even present at all,” Dr. Dweck advises 

In other words, the question of why sexual interest and satisfaction changes is a broad one, “with lots of different variables intertwined,” Dr. Dweck continues. Other factors that can affect sex drive and satisfaction include: 


Surging reproductive hormone levels and increased blood flow during pregnancy can boost libido and make sex more pleasurable, while side effects such as nausea and fatigue may decrease a woman’s interest in sex while pregnant. 

After delivery and during lactation, estrogen levels dip dramatically, which can contribute to lowered libido — mainly as it can impact feelings of exhaustion and postpartum mood changes. Breastfeeding may also effect  sex drive, since the flow of hormones such as oxytocin that create a bond between mother and baby may decrease desire for sexual intimacy. 

Perimenopause and Menopause   

As hormone levels fluctuate during to the time leading up to menopause, known as perimenopause, so can a woman’s sexual desire and overall sexual satisfaction. Decreasing estrogen can increase symptoms like vaginal dryness which can make sex less enjoyable – possibly even painful – and lead to avoidance.  

Pain, whether related to menopause or other health issues, physical challenges such as pain during sex or an inability to orgasm can take a hefty toll on a woman’s sex life and overall confidence. “If a woman is experiencing pain and or discomfort (in her genitals, her pelvic floor or elsewhere), that pain and discomfort are a significant block to thinking sexy thoughts and getting in the mood. Therefore, desire can be impacted,” Bottarini explains. “If a woman is repeatedly experiencing painful and uncomfortable sex, it puts the mental brakes on; for one thing because the body likes to protect itself and for another because we don’t tend to like doing things that are repeatedly uncomfortable.”  

Prescription Medications  

Certain medications, including some types of hormonal birth control and antidepressants, can negatively impact sex drive. The issue with antidepressants can be tricky, Dr. Dweck advises, because women who are experiencing low libido due to depression may find their libido further lowered by their antidepressant. In addition, low libido can be a symptom of worsening depression. “It’s really a balancing act to help to treat the problem but not treat it to the point where you're causing a secondary problem,” she says.  

Body Image  

When a woman doesn’t feel sexy, she may be less inclined toward sex, Dr. Dweck explains. Body changes related to pregnancy or menopause — or just low self-esteem — can affect how a woman sees herself, which in turn may impact her libido.

Supporting Healthy Sexuality  

Fortunately, there are steps women can take to help them through the ups and downs of sexual interest and satisfaction. Dr. Dweck points to lifestyle changes like eating well and exercising that help women feel good, in the bedroom and beyond. She adds that lowering stress can be extremely helpful; “I often recommend using an app, such as Calm or Headspace, for stress reduction,” she says. 

If vaginal dryness is affecting your sex life, Dr. Dweck strongly suggests starting with a nonhormonal moisturizer such as hyaluronic acid inserts. “I find Revaree® to be an absolute game changer for my patients,” she says. 

Establishing a sexual wellness routine that includes self-pleasure can also help make sex a normal, positive part of your life. And Dr. Dweck recommends scheduling regular “date nights” as a way to prioritize regular connection with your partner. If you don’t have a partner, you should still make time to connect — with yourself.  

Adds Bottarini, “One of the most important things a woman can do to boost her sex drive and satisfaction is make her sex life a priority!” 

Aside from prioritizing sex, one of the best ways to support healthy sexuality is by sharing any concerns about libido or sexual satisfaction with your healthcare provider. “As a patient, you want to feel normalized, like you're not the only one suffering from this issue,” Dr. Dweck says. “And when you see your healthcare provider, you'll recognize  that there's actually many  tools that can be used  to address these issues.” 

“Talking about sex empowers you around sex,” Bottarini says. “Alone, it’s a struggle, but together, wisdom can be shared, and it feels so much less isolating.”  

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