Perimenopause and menopause can mark a time of significant change & transition in a woman’s life. Emotionally, we often feel the impacts of aging and other major life transitions, such as job stresses, children moving out of the home, and/or relationship shifts, before confronting other changes. Physically, over time, we notice the symptoms associated with physical & hormonal changes even more, which can significantly impact our quality of life. Relationally, menopause’s effects on sexuality can greatly affect our intimacy with our partners as well.
While many women find that menopause marks a shift in their sex lives, there are many ways to manage and cope with the effects on intimacy. The first step is understanding the breadth of changes you are experiencing and allowing space to acknowledge your experience with your partner.
What is menopause?
Menopause is the period of a woman’s life when her periods stop entirely, and she is no longer able to get pregnant. Menopause happens gradually over time, and the time period leading up to menopause is called “perimenopause.” During the perimenopause period, your periods may become more infrequent, and you will likely experience some menopausal symptoms. After it has been 12 months since your last period (including any light bleeding or spotting), you have reached menopause.
The average age of menopause in the United States is 52 years old, with most women reaching menopause between 45-58 years old. Due to the hormonal changes that happen during menopause & perimenopause, common symptoms include hot flashes, vaginal dryness & thinning, irregular periods, trouble sleeping, cognitive fatigue, bladder issues, mood changes (including increased depression, anxiety, and irritability), and less interest in sex.
During menopause, the primary change that influences quality of life is declining levels of estrogen, which can impact sex drive & sexual arousal. While not all women experience issues with intimacy during menopause (some even find sex more enjoyable!), it is common for many women to experience some sort of change in their sexual activity. According to Johns Hopkins, more than one-third of women report some sexual difficulty around menopause.
How does menopause impact intimacy?
Menopause has a multifaceted impact on many parts of a woman’s day-to-day life. While some changes are personal (such as effects on body image, self-esteem, and physical health), others can influence our ability to connect with others (such as effects on mood, sex drive, and energy).
- Physical changes: As with many hormone changes, women will likely experience changes to their bodies and physical shape with age. Women may also experience difficulties with bladder control, hot flashes, night sweats, and sleep disturbances associated with their symptoms, and lower levels of estrogen can lead to other health-related issues such as osteoporosis & heart disease. Additionally, declining levels of estrogen lead to less blood supply to the vagina, which can lead to vaginal atrophy and affect lubrication during arousal – ultimately impacting the quality of your sex life.
- Sexual changes: Loss of estrogen and testosterone can diminish one’s sex drive and ability to achieve orgasm for many women. For others, sex can become uncomfortable or even painful due to vaginal atrophy, which can be managed with the help of your medical provider. You may also find that you are not as easily aroused or are less responsive to touch, which can lead to an overall declining interest in sex.
- Emotional changes: More broadly, aging can take a tremendous emotional toll on women, and some women may find that their identity shifts during menopause. Women experience significant social pressures and cultural messages around aging & female sexuality, desirability, femininity, body ideals, and beauty standards, causing mixed feelings which can all feel compounded by menopausal changes. Other women may experience menopause early due to other health diagnoses or physical complications, which come with their own emotional impacts. Hormonally, fluctuations can lead to more emotionality, and stress & irritability are often associated with hormone changes. Depression & anxiety are also common during this time period, and external circumstances can heighten already-existing emotional challenges. With the many emotional pressures associated with menopause, it can become even more challenging to feel connected to yourself – much less to feel connected with your partner.
How can I cope with these changes during menopause?
Whether you are finding that physical, emotional, or sexual changes are impacting your intimacy with your partner, remember that there are many resources available to you during this transition. Additionally, intimacy does not have to be confined solely to your sex life, and there are plenty of ways to continue connecting with your partner outside of the bedroom. Consider some of the following ways that you can manage the larger effects of menopause on your life:
- Communicate openly with your partner. Share more about your menopause experience – including changes in emotions, self-image, and sex drive. Set realistic expectations for how your body & sexuality may change with time, and work with them to communicate what feels pleasurable, what feels uncomfortable, what you need to feel aroused, etc.
- Find other ways to connect with your partner outside of sex. Find ways to integrate playfulness into your dynamic, schedule regular date nights, explore non-sexual touch, or discover other interests to share with one another.
- Experiment with new opportunities for sexual pleasure. Switch up your routine with your partner, and find new ways to feel aroused if you are noticing changes in your sex drive.
- Stay physically and socially active. Prioritizing health both inside and out will continue to help you feel your best. Try more pelvic floor exercises and limit smoking, alcohol, and other drugs, as they can also affect body responses.
- Address any personal concerns about appearance and body changes. Consider the influence of aging on your self-image, and lean on personal and/or professional support to process any of your feelings.
- Practice self-soothing and learn skills to manage emotionality as needed. A professional can help you address any larger mood concerns related to depression or anxiety, for example.
- Look into peer support groups. Many women find respite in support groups during periods of transition, and local organizations across the country offer virtual and in-person groups for women during menopause.
- Consult your medical provider. Your doctor can work with you to find solutions associated with hormone changes, including options for hormone therapy or suggested lubricants.
- Talk with a counselor who specializes in women’s issues. By exploring thoughts & feelings around intimacy, sexuality, body image, and other concerns related to your experience, you can work toward feeling like your best, most connected self again.
