5 Ways to Have Better Sex During Perimenopause

Dr. Susan Hardwick-Smith

During perimenopause and the menopause transition, hormonal changes, caused by vascillating estrogen and progesterone levels, can wreak havoc on your emotional and physical well-being — and, in the process, significantly impact your sex life. In researching my book, Sexually Woke, I studied more than 1,000 women between the ages of 40 and 65 — more than 70 percent of whom identified as perimenopausal or menopausal. The single most common complaint about perimenopause? Decreased sex drive (51 percent). Fatigue, insomnia, weight gain, and vaginal dryness rounded out the top five.

While it’s true, the effects of perimenopause can derail your sex life, there’s good news too. My research revealed that women can not only recharge their libidos and get their relationships back on track, but they can also have the best sex of their lives after 40, 50, and beyond.

Below are five insights about perimenopause and sex I derived from both research for my book and also from my longstanding career as a gynecologist specializing in women and midlife. Understanding these insights and implementing (with a healthcare provider’s guidance) some of these solutions can help you to restore your sex drive and your sex life, pretty much for good.

  1. Embrace change: As we enter into perimenopause and menopause, and especially if we’ve had children, our bodies and sexual anatomy change. In order to move forward and experience pleasure in new forms, we have to accept those changes. Truth is, what used to feel good sexually might not anymore, and that’s OK. This is often the case with vaginal intercourse, especially as you experience dryness and other physical changes due to fluctuating hormones and aging (in fact, only 4 out of 10 women — less than half — regularly orgasm through vaginal intercourse). Which means, you may need to redefine sex for yourself, cultivate openness and curiosity about sex, and introduce new techniques, such as sex toys and vibrators, to the bedroom. Look at these changes as an exciting opportunity to get to know yourself and your partner again z or for the first time
  2. Love your body — and get to know it too According to my research, the women in midlife with the most vibrant sex lives are those who are truly comfortable in and familiar with their bodies. And they’ve learned to identify what they like and don’t like when it comes to sex. Perimenopause is an ideal time in your life to get to know your body (invest in a vibrator!) and to do some exploring!
  3. Abandon resentments Resentment is the #1 libido crusher for women, so forgiveness and restoring our relationships or beginning healthy new ones are key for mainatining satisfying sex lives in our fifties and beyond. Journaling and meditation can help with this process. So can therapy.
  4. Let go of expectations, emphasize connection Putting expectations or pressure around how frequently you should be having sex, and the quality of your sex life, can dampen your libido (and your partner’s). Instead of focusing on intercourse as the end all be all for a successful intimate life, prioritize connecting with and being intentional with your partner. Small, daily moments of presence, attention, and recognition can keep passion alive. Commit to giving a partner your full attention — research shows that this communication can increase desire in your physical relationship.
  5. Talk to your healthcare provider about treatment

There are multiple potential medical treatments and interventions for a decrease in libido as we age. For some people in perimenopause, bio-identical hormones (estradiol, progesterone, and testosterone) can be a safe and effective option for treating menopausal symptoms, including boosting your sex drive. Certain patients should not take hormones for menopausal relief, particularly those with a prior history of breast cancer or epilepsy. But for most other patients, correctly administered hormone replacement can improve quality of life dramatically, as well as helping with bone density and reducing colon cancer and Alzheimer’s risk.

Additionally: Women’s sexual wellness products and treatments are finally catching up to men’s (it’s about time that women have the equivalent of Viagra!). There are a number of products available to improve sexual desire, both topically (in the form of creams) as well as more in depth treatments such as the O-Shot, among others. Be sure to talk to your doctor about which procedures or products might be best for you.

The information provided on StateOfMenopause.com is not intended and should not be construed as medical advice, treatment, or diagnosis. Always seek the guidance of a qualified healthcare provider with any questions or concerns regarding your health.

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