When you look ahead to sex in midlife, you might think of it as winding down. But what if you’ll actually be reaching a sexual peak? What if we care less about how our bodies look and more about how they can give us sexual pleasure? We’re examining all of this in our series THE MIDLIFE PLEASURE RENAISSANCE, brought to you by Peaches and Cream, New Zealand’s place for pleasure! In this edition we’re chatting perimenopause and the fact that it can be a real cow when it comes to your sexual pleasure. But here’s how to combat that, and how your partner can help!
Melanie, a financial analyst from Wellington, used to have sex with her husband maybe once a week. She’s never had a huge sex drive. “I enjoy sex, and only ever orgasm through clitoral stimulation which my husband is more than happy to provide.” Melanie experiences responsive desire rather than the spontaneous desire her husband has. With responsive desire, you need the right context and connection to get things going.
Then at age 44 Melanie hit what she now knows is perimenopause. Her libido didn’t just drop – it went off the radar. “I actually saw sex as a chore. You just don’t want to have sex when you’re having hot flushes, night sweats, mood swings and poor sleep. Also I experienced vaginal dryness and a stinging feeling during sex. Plus gaining five kilos made me feel yuck. I started breaking down crying in the bathroom at work.”
Her GP wasn’t much help, just trying to prescribe anti-depressants. When Melanie went to see a functional medicine doctor, she went straight on HRT (hormone replacement therapy) and got a personalised treatment plan with other steps to take.
“My husband had thought maybe I no longer found him attractive so was very happy I talked about all this openly and he wanted to do anything he could to help. Which is because 1) he loves me and 2) he wants to get it on still! I said ‘hey this problem with libido is actually really common for perimenopausal women, it’s not a reflection of how I feel about you. Could you sit down and read this information so you understand better?’”
They tried various lubricants and she found her favourite. “I suggested we try various sex toys – something I was worried to bring up in case he felt inadequate. But he was totally up for it!”
And yes she’s now having pleasurable sex. “It’s just as good as it ever was. In fact, getting some sex toys involved has actually made it better. Let’s just say we’ve ‘overcome’ the problem.”
Clap emoji (and check out our previous story about reigniting intimacy here!).
What we’re dealing with
We’ll get to the ways you can recover your libido during perimenopause. But first, let’s note that the average length of perimenopause is about four years, but can last up to eight years or as little as a few months (if so lucky you!). The age you enter perimenopause can really fluctuate but it usually starts about 45. Menopause begins when you’ve had no periods for a year.
Let’s look at the physical problems perimenopause can pose, particularly as levels of two key hormones oestrogen and progesterone start to fluctuate and reduce (plus testosterone levels decline gradually after age 30 and continue to drop through perimenopause).
GSM, Genitourinary Syndrome Of Menopause, affects 50-70% of midlife women. As an online article for John Hopkins Medicine states, “GSM is a common condition caused by low estrogen, affecting vaginal and urinary tissues. Symptoms include vaginal dryness, painful sex, urinary urgency and recurrent UTIs. Effective treatments exist, including non hormonal options and ultra low dose local estrogen”.
Geez, it’s no wonder women go off sex. Can you imagine if perimenopause happened to men?
It’s not surprising (and definitely annoying) that low libido in perimenopause is one of the most under-discussed transitions of midlife, despite affecting roughly 40% of women in the 40-55 age window according to longitudinal data from the U.S.-based Study of Women’s Health Across the Nation.
Oh and BTW, most women climax from clitoral stimulation. As women age, the small nerve endings that respond to light touch decline, but the larger nerve fibres that respond to vibration remain highly functional (drmaryclairehaver.substack.com/p/the-truth-about-menopause-and-orgasms). Vibrator time!
What can help?
Jo Robertson, an Auckland-based sex and relationship therapist with a Master of Science in Medicine, says it’s very common for women to have low libido during perimenopause. “It might be down to skin irritation, vaginal dryness, lack of arousal, or lack of enjoyment.” Other aspects of perimenopause may have an indirect impact, such as poor sleep meaning less energy for sex.
As well as vaginal dryness, there can be burning or stinging during sex, or bleeding. “That’s because the skin is getting thinner, and the muscles are getting weaker. You might be getting micro-tears or irritation, or there’s transfer of bacteria from the vagina to the urethra more easily, causing UTIs. So the whole zone is less resilient.”
Who does she suggest women talk to? “Pelvic-floor physios can often help with a whole bunch of strategies. It’s great to get a little warrant of fitness on your pelvic floor, check how it’s functioning, what the muscles are like, what the state of the skin is. Then get some advice around your needs. So if, for example, you’re getting some beginnings of prolapse, or your cervix is hanging a bit lower, there are different kinds of products you can use on a penis to make sure it doesn’t go as far up.” Yes let’s make men do some of the hard yards!
And look into vaginal estrogen, a hormone replacement therapy (HRT) medicine that contains the hormone oestrogen. “Topical estrogen is what people use either in pessary or cream form.” A pessary is a small tablet you insert into the vagina using an applicator. “You typically apply topical estrogen twice a week then it builds up the resilience of the skin, then you’re more likely to self-lubricate as well.”
Talking to your partner
Jo talks to couples about their intimacy “if it’s not going to plan. It might be they’re not enjoying it, or that they have different desires.”
“We have these different way of understanding sexual responses. One is spontaneous, where people just feel like having sex. Then there’s responsive, so it’s only once they start kissing or massaging that they, ‘oh, this is nice’.”
Perimenopause also means it typically takes longer before orgasm. “You struggle to get aroused in the same way, and you struggle to reach that peak.”
Do women have to drag their partners along to see her? “I find that partners, even if they’ve never seen a therapist in their life, are really responsive to their partner saying, ‘hey, this is important to me. You’re important to me. I know this isn’t going well so I’d like some help with it.’ It’s not like you’re saying ‘I don’t want you’. Often men I see are uncomfortable as they’ve never talked about sex before, but they’re usually really stoked to know that their female partner still wants them.”
“The way you phrase it to your partner is really important because you’re pursuing them. It’s actually an act of romance.”
Body and brain
Also, some perimenopausal women who gain weight (it’s often around five kilograms) feel less confident about their body. “You’re more likely to want to turn the lights out or get things done quicker. But if you’re rushing, not mentally present, not prioritising pleasure, that decreases your desire for those things in the future. Also why would you want something that’s average? You might rather watch TV. So you have to invest into it [sex], in order to have a better experience, in order to want more.
“The majority of people continue rather than stop sex during perimenopause. But there are different priorities and frequency. The focus is more on quality than quantity.”
Is ‘penis and vagina’ old-school? “I think it’s just one thing you can participate in. I tell clients that when you go to a playground as a kid, you don’t always do the same thing every time. There’s a sense of exploration and play. But typically old-school playgrounds had wooden surrounds, and you can see them as boundaries, as safety, as security that you can try different things.”
“Maybe penetrative sex doesn’t become the most important thing. Maybe you use your imagination more or get more creative. Maybe you try lubricants and find one you really like. Maybe you decide to introduce a vibrator or sex toy.”
“What I sometimes explain to men who are feeling a little insecure when a sex toy gets proposed is that this is an aid in the same way that, if you hurt your knee, you’d strap that up. It’s a support, not a replacement.”
Novelty is important
A friend told me: ‘I love my partner, but my sex drive’s gone, it’s another job on my to-do list. I’m scared this is just how it is now’.
Jo suggests she talks to a sex therapist. “Or take a slightly more creative approach. Lots of those people tend to do quite well with scheduled sex, because often a partner suggests sex when we’re tired, and not ready. If we know [scheduled] sex is happening, we tend to be in a better headspace.
“I also recommend they rotate introducing something new or interesting, and attached to fun each time. Maybe make a new cocktail for each other or eat your favourite food or watch your favourite TV show. Get creative with what you do. You might start in the shower, have a bath together, or do a different type of massage. Or try a new position. Novelty sparks our body. And take the pressure off it being phenomenal. It doesn’t have to be theatrical, loud, crazy orgasms. It’s really about connection. It’s not necessarily about where you end, it’s about having a fun, nice time with your partner.”
And yes, for some women, libido has actually increased in perimenopause. “Once I did a talk and this woman asked a question, I answered, then she said, ‘I could basically orgasm right now, I could just take it there in my mind’. It was so cool that she was this model of somebody who says ‘things are still really positive and I’m really enjoying myself’.”
Ready to embrace your own midlife pleasure renaissance? Whether you’re rediscovering intimacy with a partner or simply getting to know your own body better, these Peaches & Cream favourites are designed to help you explore pleasure with confidence at whatever stage of life you’re in.
Lelo Mona Spectra LED Intimate Wellness Massager and G-Spot Vibrator, $314.99
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Astroglide Water-Based Liquid Personal Lubricant 74ml, $29.99
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Loveline Budsie Compact Clitoral Air Pulse Vibe Pink $52.49
Budsie may look like a cute little earbud, but it’s packed with powerful pleasure. This compact vibrator combines 10 stimulating functions with AirTap® Technology to deliver tapping and sucking sensations through its removable head. Whether you’re on the move or staying in, Budsie is your discreet, travel-ready companion.
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