Genitourinary syndrome of menopause (GSM) refers to a collection of changes linked to decreased estrogen levels, which can lead to sexual issues during menopause, such as vaginal dryness, discomfort, or pain during intercourse. It impacts nearly half of all women. However, reducing female sexuality solely to these symptoms would merely scratch the surface. As explained by nutritionist and educator Marta Marcè, sexologist Ana Lombardía, and gynecologist Bárbara Fernández del Bas, this key moment does not necessarily signal the end of desire, but rather a shift in how pleasure is experienced. To grasp bodily changes, key signs to watch, and ways to keep enjoying sex, they offer 10 essential tips for embracing sexuality with greater knowledge and less anxiety. Desire doesn’t vanish—it evolves. A prevalent fear during menopause is that sexual desire will vanish, yet nutritionist and menopause specialist Marta Marcè disputes this notion. Hormonal shifts affect libido and sexual response not just by impacting the genital region, but also by altering brain functions related to desire. As estrogen (and testosterone) levels decline, changes can occur in vaginal lubrication, tissue elasticity, or genital sensitivity. Additionally, estrogens help regulate neurotransmitters like dopamine, which is linked to motivation and reward, and oxytocin, which is tied to emotional bonding. When these levels drop, many women notice that desire no longer arises as automatically as before.
