Sex & menopause

The decrease in the level of hormone oestrogen that occurs at menopause causes a range of hormonal, physical and psychological changes for women around this stage of their lives.  All women will experience menopause differently, some will have few symptoms and be untroubled by the changes that occur.

When your partner is going through menopause

Other women will experience terrible hot flushes, sleeplessness, night sweats and mood changes. There are many menopause symptoms that may impact on a woman’s relationships, especially the one with her intimate partner.

It is important that you have some understanding of what is happening to your partner and realise that she is experiencing some major life and body changes that are out of her control. It will take time for her to work out the best way to approach and manage menopause and her symptoms.

It is also worth remembering that you cannot always fix things but listening to your partner will be appreciated. Support and understanding from you can make this time much easier for her to cope with.

Sex & menopause

A key issue for couples and relationships may be that your partner is no longer keen to have sex. This can be for a range of reasons related to menopause symptoms. One key symptom is a dry vagina: Lower levels of oestrogen directly affect a woman’s vagina and can make it thinner, drier and less elastic. Also, testosterone levels fall gradually with age and this can have an impact on a woman’s level of desire at menopause.

Dry vagina treatments

There are several options to treat changes to a woman’s vagina including hormone replacement therapy and vaginal oestrogen. Discomfort during sex may also be helped by the use of vaginal moisturisers and lubricants.

Fear of sex

Because a dry vagina makes sex painful, even thinking about sex can make a woman feel anxious and then she might start to fear sex.  This can set up a negative “pain cycle” where she fears sex, avoids sex, gets frustrated and anxious, and then sex is likely to hurt more. If this is happening she will need to treat the physical symptoms first to reduce the pain, then the fear of pain during sex may also reduce.

Some women find even though they feel physically better after treatment, they still fear sex will hurt and they may become anxious even thinking about sexual activity. This is common.

If this happens to your partner, it can be helpful for her to:

  • learn and practise relaxation exercises
  • talk to a psychologist or accredited sex therapist who specialises in sexual problems in women. she may only need one or two sessions but understanding what she can do to help herself and you in this situation may stop a problem becoming bigger.
Libido & menopause

Libido tends to be lowered in some women at perimenopause and menopause.

It is difficult for her to feel desire if:

  • she has experienced pain because of a dry vagina
  • she is exhausted because of menopause symptoms
  • she feels moody or frustrated by all the changes
  • because of menopause symptoms she does not want to be touched as much

A libido problem is an important issue to discuss with her doctor. Some women may find their libido improves with a trial of hormone replacement therapy or with use of vaginal oestrogen or vaginal moisturisers to improve vaginal dryness.


It is often difficult for partners to know how to help when their loved one is experiencing changes associated with menopause. Jean Hailes has put together a list of suggestions that may be helpful:

Listening is often better than trying to fix things If your partner talks about the symptoms and challenges of menopause, you may well want to try and help to fix the problem. Often all your partner wants you to do in order to help her is for you to listen and be supportive.
Understanding ‘menopause’ Menopause can cause physical and emotional symptoms. Your attitude to this is important. Knowing the symptoms your partner may experience and what treatment options are available can help you both cope.
Menopause is an individual experience Each woman will experience menopause in her own way. Some women experience severe symptoms while others don’t realise they have gone through menopause.  How each woman deals with her menopause will also depend on her personality and coping skills. Be careful of generalisations.
Understanding the priorities Ask your partner to list her symptoms and prioritise what is causing her the most distress, this allows you to better understand her experience.
Changes you might make If your partner has symptoms of menopause that are affecting her enjoyment of life, she may ask you to make changes so she can cope better. For example she may ask you to sleep in a separate bed because hot flushes keep her up all night and she worries about disturbing you.
Consider going to the doctor together Going to medical appointments together (if you both feel comfortable with this) can help in a number of ways: Your partner will feel supported if she knows you will take the time to go with her to understand what is happening to her. You and your partner will also be able to discuss what the doctor said, which helps with decision making.
If there are relationship problems try to discuss how you’re feeling One of the most important things is to be able to discuss your thoughts and feelings openly. If this is difficult perhaps you could visit the doctor with your partner and discuss your concerns together. Another alternative is visiting a psychologist who specialises in couples’ therapy.  You may only have to go for one or two sessions and the therapist should be able to help support you in your communication.
What else is going on At the time menopause usually happens, there are often many other things going on, like changes in the family, changes to roles and work, changes in friendships, with parents and in relationships. These changes influence your partner’s health and her experience of menopause.
Communicate If something is worrying you or you are confused about something, ask your partner about it.
It’s not about you…. If your partner is not as interested in sex as she used to be it does not mean she’s lost interest in you. It may be more that she’s experiencing hot flushes, sleeplessness and/or a dry vagina that is making sex painful. She may need encouragement to seek treatment for her symptoms, and you can also suggest ways to be intimate other than sexual intercourse.
It may not be menopause Even though menopause may be an easy explanation for grumpiness, sadness and moodiness, you need to be careful to distinguish between what is menopause-related and what may be caused by other life issues. Doing this will help your partner get the right treatment, if it’s required
Seek help from a range of practitioners if appropriate There are many different ways of managing menopause and it is important your partner gets appropriate, balanced information and treatment. This may be from a doctor, accredited naturopath, psychologist, dietitian or physiotherapist.

4 thoughts on “Sex & menopause

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