Many women have problems with sex at some stage in their life. According to the Sexual Advice Association sexual problems affect around one-third of young and middle-aged women and around half of older women and to identify the reasons behind sexual issues, both physical and psychological factors have to be considered, including a woman's relationship with her partner.

Sex after the menopause

Some women say they feel more relaxed about sex after the menopause because they no longer have to worry about contraception. However, some can experience vaginal dryness and a lower sex drive which often is temporary and being able to talk things through with an understanding partner may be all that's needed.

Soap, bath oils and shower gels can aggravate dryness. Instead, use lukewarm water alone or with a soap-free cleanser and try using a vaginal moisturiser or a lubricant, which are available from pharmacies without a prescription.

However, if menopausal symptoms persist or if you have low mood, then it may be best to see your GP.

Find out more about treating vaginal dryness and reduced sexual desire after the menopause.

Sex after a hysterectomy

It takes time to get back to normal after an operation, but having a hysterectomy can have a strong emotional impact too, which can affect how you feel about sex. Having the uterus removed can cause women to worry about feeling less womanly, or losing their sexual attractiveness or have feelings of loss or sadness after a hysterectomy. However, these feelings should pass.

Sex drive may also fall if a woman's natural testosterone levels drop markedly. Although most testosterone in women is produced in the peripheral tissues from precursors, some is also produced in the ovaries and adrenal glands so levels may drop if these are removed during a hysterectomy or they're not functioning properly.

If you experience problems with sex after your operation, don't suffer in silence. There is help available – you can talk to your GP or a counsellor.