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Sex and intimacy during and after menopause

posted 11 May 2018, 21:40 by Suzi Wallis   [ updated 12 May 2018, 16:39 ]
If you are a woman experiencing perimenopause, menopause, or a partner of a woman at this life stage, read on. It's important to know what can be going on for women at this stage of life, so adjustments can be made.


Perimenopause begins as a woman's oestrogen reduces. It usually starts in a woman's 40s, but can start in the 30s as well. It can begin 8-10 years before menopause. In the last 1-2 years, the drop in oestrogen accelerates. This is most likely when women experience symptoms. Women are still having menstrual cycles during this time, and can get pregnant.

The average length of perimenopause is four years, but for some women this stage may last only a few months. Perimenopause ends when a woman has gone 12 months without having her period.


Menopause is the point when the ovaries stop releasing eggs and women no longer have menstrual periods. At this stage, the ovaries have stopped releasing eggs and producing most of their oestrogen. Menopause is diagnosed when a woman has gone without a period for 12 consecutive months. Women can no longer get pregnant once they are fully in menopause.

Symptoms, sex and intimacy

Symptoms of perimenopause

Women may experience some or all of the following symptoms:
  • Hot flushes (a sudden feeling of warmth that spreads over the body)
  • Night sweats and/or cold flashes (this is highly disruptive to sleep, not only because of the full wakefulness that occurs, but also the difficulty getting back to sleep)
  • Vaginal dryness and discomfort during sex
  • Urinary urgency (a pressing need to urinate more frequently)
  • Difficulty sleeping (insomnia)
  • Emotional changes (irritability, mood swings, mild depression)
  • Dry skin, eyes or mouth
Women who are still in the menopause transition (perimenopause) may also experience:
  • Breast tenderness
  • Worsening of premenstrual symptoms (PMS)
  • Irregular periods or skipping periods
  • Periods that are heavier or lighter than usual

Symptoms of menopause & those worth getting checked out

Women may experience some or all of the first list above. Some women also experience the list below:
  • Racing heart
  • Headaches
  • Joint and muscle aches and pains
  • Changes in libido (sex drive)
  • Difficulty concentrating, memory lapses (often temporary)
  • Weight gain
  • Hair loss or thinning
These symptoms can be a sign that the ovaries are producing less oestrogen. Not all women get all of these symptoms. However, women affected with new symptoms of racing heart, urinary changes, headaches, or other new medical problems should see a doctor to make sure there is no other cause for these symptoms.


Women who are experiencing symptoms related to either stage, most predominantly perimenopause, may feel exhausted, irritated, less resilient, absent minded, unattractive, unimportant and have a severely reduced or absent libido. This is completely reasonable, given the impact of the symptoms they may be experiencing. It's really important for women experiencing these symptoms to have emotional intimacy with their partner. Without feeling emotionally connected, the desire to make steps towards physical intimacy is likely to be very compromised.

Sex & libido

If a woman's libido previously came about from having sexual feelings, this may no longer be the case. Sexual feelings can disappear entirely at this stage. This also affects a women's self image, as she may no longer feel attractive. 

Women at this stage of life cannot expect to feel like sex, then initiate or respond to sexual overtures. If you have no libido, you need to make a decision that you want to feel close to your partner. You can then initiate sexual contact, and desire/arousal will come about after you start a sexual connection with your partner. This will be severely compromised if your relationship doesn't have emotional intimacy, if there is disconnection, or high conflict.

One of the other things that happens at this life stage, is that the vaginal skin thins, and becomes more vulnerable to damage through intercourse. It's really important to use a lubricant during intercourse, even if you feel aroused, to prevent any abrasions or mini tears. The vaginal tissue is similar to that between the webs of our fingers. If you have ever had a wound or cut to that part of your body, you will remember how painful it was. Some organic lubes on the market include Bonk, FlowMotion, Intimate Earth, LoveSliquid, SytemJo, and Yes.

Sexual position will also be important, as some positions could work against lubrication being where it's needed. A woman on top of her partner can help natural lubrication to move down the vagina, which in turn, helps to facilitate intercourse. Experiment with different positions, and most importantly, take your time.

What do partners of perimenopausal and menopausal women need to know/do?

Your partner is going through a transition. She may feel unattractive, both to you, and out in the world. She may be seriously sleep-deprived, foggy in her thinking, and in pain. She needs your patience, love and consistent support, as you both navigate this time.

Ask her what she needs from you. Ensure there is lots of non-sexual affection between you. Compliment her on her efforts, and the things you admire about her. Reassure her that you are in this life stage together. Emotional intimacy is especially important at this time - knowing what is going on for each other, and being able to navigate each other's internal worlds. Take time out of your day to really find out how she is, without the interruptions of technology, tv, or other demands. 

If you have lost your confidence about sex

Ladies, if you have been experimenting with sex, and have had negative experiences, or you don't feel like trying with no desire, read on.

This is a meaningful time of life, and deserves to be honoured. You can experiment on your own, to reassure yourself that you can have sexual feelings, and that your body is still a source of pleasure. Read some erotic literature, buy clothes that you feel attractive wearing, change your perfume to one that feels more sensual, have candles and low lights in your home, purchase a dildo or vibrator, purchase some good lube, and communicate with your sexual partner/s! Even if your partner has gone through this life stage themselves, it will be a unique experience for you. You need to talk, laugh, and have some lightness about this topic, until you both feel comfortable. 

Most women's partners will not be expecting them to lose interest in them or sex. Keep them in the loop about where you're at. Ask them to be patient. Talk about what your turn ons and turn offs are - they may have changed since you first got together. Keep trying to connect sexually. Unless you have negotiated a non-sexual relationship, this issue can cause much conflict and disconnection in relationships. It can be very confusing for your partner to find that you no longer respond to them in the way you once did. They may feel unattractive and unwanted too.

I wish you well in your experimenting and play. You are still you, even though aspects of your body are changing. You deserve to feel pleasure, to feel safe and loved. You are a big part of co-creating an environment for you and those who share your life, that works for you all.

Suzi Wallis | May 2018