Physical problems associated with ageing may mean that sexual intercourse feels different now and most menopausal women notice some changes in the way their bodies respond during arousal and sex. This is often due to the physical changes in the urogenital tract. These include the thinning of the vagina or loss of lubrication, which may make intercourse uncomfortable but this is not a result of a decreased emotional desire for sex. After the menopause and a decline in oestrogen, blood does not flow as quickly to the genitals and breasts during arousal as it does in young women, causing less sensitivity and a more subdued arousal.

It is important to remember that many menopausal women will have partners who are also experiencing changes in their own sexual behaviour due to changes in his hormones too. As men age, testosterone-inhibiting factors increase, causing a decline in the frequency of erection. Some men find that they cannot maintain their erections for as long as they used to. This allows more time for foreplay so that you are both aroused at the same time. Many men become anxious about their sexual performance as they get older which can make them start avoiding sex altogether.