Perimenopause (the time when your body makes the natural transition to menopause) and menopause are phases in women’s lives that can bring about significant physical changes, including the experience of sex. Desire, arousal and overall sexual fulfillment can all be affected. Learning about and proactively addressing these issues can make all the difference.
Here are some strategies that have worked for my Charlotte sex counseling clients before, during and after The Change:
Reduced sexual desire
Fluctuating hormone levels during menopause can mess with your libido bigtime. Communicate openly with your partner about these changes and explore other ways to connect intimately, such as
- activities that bring emotional closeness,
- sensual touch and
- non-genital sexual activities.
Your doctor may help you decide if hormone therapy or other interventions are appropriate for you.
Vaginal dryness and pain
As your levels of estrogen decline during menopause, vaginal dryness, itching and discomfort during intercourse can follow. Water-based lubricants can provide temporary relief. Vaginal moisturizers, which can be used regularly, may provide a longer-lasting solution, as they improve vaginal moisture and elasticity. If symptoms persist, consult with your healthcare provider to discuss potential treatments like estrogen therapy or laser therapy.
Dryness and thinning of the vaginal walls can contribute to painful intercourse, also known as dyspareunia. Three things can help:
- incorporating sufficient foreplay
- using lubricants
- experimenting with different sexual positions
Orgasm changes
Menopause can make orgasms feel different. It may take longer to climax, the intensity may be less and the sensations can change. Extended foreplay, vibrators or other sex toys may help. Again, talking openly with your partner about your changing needs is critical.
Body image and self-esteem
Menopause is so fun (not!). You may gain or lose weight, find you need a different bra size, or notice your skin is changing texture. No surprise, these can all impact how you feel about your body!
Cultivating self-acceptance and practicing self-care are important during this time:
- Practice positive self-talk
- Engage in activities that help you feel good about your looks (wear flattering clothes, try a fun new haircut)
- Move more, doing things you enjoy
- Look at your diet: Could you incorporate more whole grains, lean proteins, fruits and vegetables, and take fewer trips to your favorite fast-food places?
These can all contribute to improved well-being and confidence over time.
Mood swings
You may notice mood changes (irritability, anxiety or depression), which can do a number on sexual well-being. Healthcare professionals, including therapists or counselors (search “best sex therapists near me,”) can give you tools for managing emotions.
Stress-reducing practices can make a dramatic difference if done regularly (at least 20 minutes every day).
- Mindfulness
- meditation and
- relaxation techniques
can level out your mood and improve sexual satisfaction.
Communication and education
Knowledge is power. Our society does not do a good job of explaining menopause. Until recently, it was not even talked about in polite society, even though half the population experiences it!
Books, videos and articles from reputable sources (your doctor or counselor may have suggestions), along with workshops and support groups focused on menopause can help you understand what is happening to your body, and provide strategies for coping. At the very least, you won’t feel as alone!
Sharing your changes, concerns and desires can empower your partner to help as well.
Each woman’s experience of menopause and perimenopause is (unfortunately) unique. What works for one person may not work for another. Approach this time of life with patience, self-compassion, and a willingness to explore different strategies and interventions.
Charlotte sex therapists can provide guidance and support tailored to your specific needs and concerns.