Sexual Health Archive

Men and women can experience many age-related changes and health conditions that can cause their sex drives to decline. Couples who deal with mismatched or missing sex drives should communicate about how they can work together to get back in sync. Both partners should share what they enjoy before and during sex, what issues may be hindering their sex drive, and what strategies they can try, such as recreating dating, planning time for intimacy, and exploring new ways to create romantic moods.

Low libido can include both less desire for and less satisfaction with sex. A variety of medications can dampen sex drive by altering hormone levels or nerve signals, dulling sensation in the genitals, or triggering fatigue or mood changes. They include some antidepressants, cardiovascular drugs, antihistamines, antiseizure drugs, opioids, chemotherapy, hormone blockers, oral contraceptives, and fertility drugs. People whose medications affect their libido can ask their doctor to adjust the dose or timing or substitute another drug without sexual side effects.

Genitourinary syndrome of menopause, or GSM, was once called vaginal atrophy. But experts changed the name to better reflect the full scope of symptoms, which include vaginal thinning and dryness; burning, irritation, and itching; pain during intercourse; urinary issues such as increased urgency and frequency; and higher risk of urinary tract infections. The majority of women with GSM symptoms don’t discuss it with their doctors. But a Harvard expert says they should, since GSM is progressive and can lead to dangerous problems.

More than 10 million of the nation’s 19 million cancer survivors are women, 80% of whom are 60 or older. Cancer survivors going through menopause may not be able to use systemic hormone therapy if their cancer was hormone-driven, but other measures can provide symptom relief. These include various medications and lifestyle modifications such as cognitive behavioral therapy, meditation, acupuncture, and regular exercise. Some women who can’t use systemic hormone therapy may still try vaginal estrogen to ease vaginal dryness, some urinary symptoms, or painful sex.

Women with unusual pelvic or vaginal symptoms should report them to their gynecologist. These symptoms include vaginal odor, itching, or burning; menstrual changes; pelvic pain or discomfort; or new bleeding.

Vaginal probiotics contain live microorganisms and come in oral and suppository forms. Some ads claim these products can prevent or treat infections. But the vagina regulates its own bacterial mix, so vaginal probiotics aren’t necessary.

Pelvic floor dysfunction in women is commonly linked to lower back pain. The odds of developing pelvic floor–related back pain increase for women as they get older due to factors such as diminished estrogen and childbirth-related pelvic floor damage. Lower back pain and pelvic floor dysfunction may also have overlapping signs, including urinary leakage or urgency, a feeling of heaviness in the pelvis or vaginal bulging, constipation or bowel issues, painful sex or urination, and pain with prolonged sitting or standing.

Gynecologic cancers, which affect the ovaries, uterus, cervix, vagina, or vulva, are less common than breast cancer. Women can guard against these cancers by learning the risk factors for each type, which include obesity, exposure to human papillomavirus, and smoking. Women should also continue pelvic exams and cervical cancer screenings after a hysterectomy or menopause, as well as watch for unusual symptoms. Women with a strong family history of gynecologic or certain other cancers should consider genetic testing.