There are a lot of reasons sex might be off the table in midlife. Thanks, menopause.
"Hormonal physical changes in menopause and perimenopause can impact a woman's sex life hugely," says explains Marie Morice, Clinical Sexologist. "The most common symptoms include vaginal dryness, which can cause discomfort or pain during intercourse and the thinning of vaginal tissues, which can make the area more prone to irritation and discomfort. This can lead to vaginal atrophy as well as a decreased blood flow to the genitals which reduces sensitivity and arousal."
Marie also explains that other physical menopausal symptoms such as hot flashes, night sweats, urinary incontinence and weight gain can also indirectly impact a woman's sex life. Emotional changes such as mood swings, anxiety or depression can also contribute to a shift in sexual desire, too. "No wonder sex might not be a priority for a lot of women in their midlife," says Marie.
The good news is that there are ways to transform your sex life during midlife, and Marie suggests that the best way to start is to recognise the things that are affecting your intimacy. "Set a clear action plan to address them," she advises. "Address physical changes proactively. Use lubricants to combat vaginal dryness, explore aids such as vibrators or other sex toys that can enhance pleasure for both partners, and if pain or discomfort is an issue, work with a healthcare provider to find solutions."
READ: How to fix your sex and relationship issues during menopause
Solo sex is medicine
Maintaining regular sexual activity and stimulation, particularly self-stimulation, is crucial. "Masturbation is medicine," Marie says. "Not only does it help maintain vaginal health and elasticity, it also helps with your overall well-being because orgasms are good for us.
"Clitoris stimulation is essential for women to climax. The vagina is a muscle that needs to be exercised like any other muscle or it can lead to problems. Without regular penetration - sex toys or/and penile - the vagina itself can contract. Stimulation and orgasms can keep the tissues lubricated and relieves the dryness and itching naturally. They strengthen the pelvic floor muscles, maintain the anatomy of the vagina and the vulva and help retain or regain bladder control. The more we orgasm, the better our vaginal health will be."
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Use diet and exercise to boost testosterone
If you're just 'not in the mood' Marie suggests looking at your lifestyle to boost your testosterone levels, which play a major role in your libido.
"Ensure you have a well-balanced diet as not enough zinc, vitamin D and omega-3 fatty acids can result in low testosterone levels. Take part in regular exercise as strength-training exercises can help to stimulate testosterone production in the body." Marie also recommends trying to keep your stress levels down as elevated stress triggers the release of cortisol, the stress hormone that can lower testosterone levels.
"This might be easier said than done," she recognises. "But it’s all about engaging in calming practices such as mindfulness, yoga and meditation. And finally, ensure good quality of sleep - it is one of the most effective ways to improve our testosterone levels, as sleep influences the production of hormones."
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Consider HRT
"Hormone replacement therapy can have significant positive effects on women’s sexual health during menopause, whilst carrying some potential risks," Marie explains. "It's important that every woman finds what works for her - there is no one size fits-all. Benefits in terms of sexual health might include improved vaginal health, enhanced arousal and sensitivity, mood stabilisation and reduced hot flashes and night sweats, positively impacting sex life."
READ: Am I too old to call my partner my 'boyfriend' at 50?
Sex doesn't have to be penetrative
While Marie recognises that there are many sexual techniques and positions that can enhance pleasure during menopause, she also says that sex doesn't always have to be penetrative. "There are many alternatives and knowing that helps take the pressure away. Focus on clitoral stimulation, extended foreplay, use of lubricants, pelvic floor exercises during intercourse which can increase sensation and incorporate sex toys." If you are having penetrative sex, Marie says that being on top allows you to control the depth and speed of penetration which reduces the pressure on your vagina, while side-by-side is less intense and is great for intimacy, and seated and standing positions allow for easier clitoral access.
READ: Why women in their 40s are more confident voicing their desires
Explore intimacy outside the bedroom
"The challenge for many couples is to redefine intimacy beyond sexual intercourse and explore a broader view of intimacy that doesn't necessarily lead to sex," Marie says. "Increase non-sexual touch in your daily life - more hugs, kisses, hand-holding, and cuddling can maintain physical closeness without sexual pressure. Consider giving each other massages as a way to stay physically connected. Prioritise quality time together. Plan regular date nights or shared activities. Take up a new hobby or class together. Create rituals for connection, like a daily walk or weekly game night or a sexy night."
