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Decreased Arousal

What is arousal? Arousal involves the physical signs of sexual readiness. Blood flow to the genitals increases, causing the labia, clitoris, and upper vagina to swell. The vaginal lining becomes moist, providing lubrication. The vagina grows longer and the inner and outer labia pull apart, exposing the vaginal opening. Breathing and heart rate speed up, muscles tense, and nipples grow erect. You are ready for sex!

For many women, particularly after menopause, sex drive may no longer be the first phase of sexual response.

Although sexual desire often triggers arousal, for many women, particularly after menopause, sex drive may no longer be the first phase of sexual response. Instead, desire will follow arousal. Arousal may occur first, resulting from seduction or suggestion by your partner. Arousal also can come from a conscious decision to respond to your partner’s approach.

The changes in hormone levels and vaginal changes discussed earlier can significantly affect arousal in midlife women. The vaginal atrophy and dryness associated with low estrogen can cause arousal to take longer or be harder to achieve. In fact, the first noticeable change associated with menopause is often reduced vaginal lubrication during arousal. Less estrogen results in reduced blood circulation to the vulva, the clitoris, and the vagina. 

The first noticeable change associated with menopause is often reduced vaginal lubrication during arousal.

When arousal difficulties become an issue. If you are distressed by a consistent lack of vaginal lubrication and related physical signs compared to what you experienced in the past, you may have what has been called "female sexual arousal disorder."

Arousal problems that cause distress or concern affect about 5% of women in the United States, according to a large nationwide survey.1 In that survey, the rate of bothersome arousal problems was higher (7.5%) among women ages 45 to 64 than among those 65 or older (6%) or those younger than 45 (3%).

In addition to being more likely in midlife women, bothersome arousal problems were more common among women who were married or living with their partner, women who had experienced surgical (rather than natural) menopause, and women who were in worse overall health.

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