Nowhere To Hide: What Perimenopause Reveals About Intimacy That Nobody Talks About
While I’m primarily speaking to heterosexual dynamics in this piece, many of these patterns discussed can show up across different types of relationships. I used AI to help me with structure but all words are my own.
In perimenopause, the physiological, mental, emotional, energetic changes that we go through impact our desire and arousal. Very broadly speaking, this happens in two main ways…
Over time, perimenopause releases the parts of you that have held you back from having your needs met, so you’re able to be open about what you want and ask directly for it with no qualms about making demands and putting your needs first. You’re able to hold your boundaries, and care less about what others think. The wild, fierce part of you that has been suppressed is freed so you no longer feel inhibited—and you go for it. This is the reason why many women say that they have a sexual awakening in midlife.
For whatever reasons (there are some below) this doesn’t happen and desire and sexual enjoyment limps along or drops away, leaving women experiencing unsatisfying - often very painful sex - that does nothing for them. Many, many women are in this position, and this is what I’m talking about in this blog.
Of course, it’s not as clear cut as this and there’ll be plenty of you having sex that sits somewhere between the two. But for others this is not the case. For them, sex has become stale, formulaic, too quick, unexciting, maybe for partners too.
In midlife, many women feel somewhat hopeless and stuck in this situation. They may stuff their naturally wild, sensuous and erotic nature in a sealed box, shove it away somewhere hard to reach, and resign themselves to the status quo. These women may question if this is really the best sex they’ll get to experience (knowing that it could be so much more). They may seriously consider leaving their partners and look elsewhere for the depth of intimacy their soul craves, or stay put and suck it up (some often do leave, such is the cost of settling).
If you’re finding that your enjoyment of sex has disappeared, I want you to know that perimenopause has not broken you. You’re not inherently bad at sex and it most definitely can get better.
The sex that many women tend to have is not aligned with how female desire and pleasure works.
When our sex drive and libido slows down or disappears altogether (remember, very often it doesn’t and women find the absolute opposite), so often the focus is on hormones, including testosterone, which can help with drive and mood. It’s an important support, but they don’t touch the true, deeper reasons why sex can be so unsatisfying in midlife. How good the sex is that you’re having is a significant factor that isn’t discussed nearly enough.
Desire in midlife can be complex: how perimenopause can be a perfect storm.
Desire, arousal and interpersonal dynamics are nuanced and complicated, sometimes requiring a degree of outside support. Yet there are some really good reasons why intimacy can become particularly challenging at this point of our lives. If you’re struggling, I hope you find some validation here:
The drop in oestrogen changes the environment in the vagina and lubrication, so that for many, intercourse can become incredibly painful. In this situation, please seek advice from your GP - it is so common and painful sex needs support.
Even in a loving relationship, revealing that you’re not enjoying sex may be too difficult; without professional guidance it can be hard to find the words to express your feelings about sex safely and respectfully (to you both). We’re conditioned to be agreeable, to not make a fuss, or place demands and we become used to internalising our feelings. So opening up, taking the lead or asking for something specific, may feel too scary and awkward, and nothing changes.
Perimenopause is a pinch point for multiple sources of life stress. Ageing parents, careers in full flush, children to care for, teenagers pushing the boundaries; for these demands the onus is usually on us and it’s stressful. When under chronic stress like this, cortisol tends to dampen our sex drive, making it much harder to respond and feel erotic - especially if there isn’t enough time to open up. How many times have you tipped into bed, after a full day and feeling exhausted, only for your partner to want to get intimate (his physiology works differently). For us, when we’re run ragged, when our capacity is full and there has been no erotic preamble, we simply aren’t able to open up to an intimate exchange and reach the erotic depth we want, and often crave.
Not only are there multiple sources of stress, but as progesterone, the buffer to those stresses, declines (buffering being one of progesterone’s major benefits) the effects of the stress lands more heavily, and situations we could manage well before leave us overwhelmed and frazzled; we’re less able to cope.
There are further pressures on our nervous system. If you have any trauma, shame, abuse or other wounds that so far haven’t been addressed, these often surface during perimenopause, and add their own layer of complexity, disruption, and stress.
Maybe related to both these points: you’re probably the one who does the invisible work at home and are the emotional regulator of the house. Female desire needs space and time to open and expand. When the emotional load is too much, where is the space, time, and bandwidth to nurture your desires and be open to sex?
As your hormones are changing, so too is your body; wrinkles develop, maybe there’s a little extra weight, and possibly more droop or wobble in places you wish you didn’t. You may not feel nearly as attractive as your body evolves—which is especially challenging when we’d heard our whole lives how our value is entwined with being attractive and youthful. With these changes marching on therefore, we may feel invisible, passed over and even less than.
And a big one, again with our body changing in function; it can be difficult to sleep well so you might be extremely fatigued. Often IBS kicks in or get worse, you may have hot flushes, and other symptoms may emerge. None of this is conducive to being turned on. (If you are experiencing these btw, you need to come and see me.) At the same time, there will be months when you don’t ovulate, and then you stop ovulating altogether. So there are increasingly fewer opportunities to benefit from that natural uptick in arousal and interest which so often peaks mid-cycle or pre-bleed.
In long-term relationships particularly, the effort required to keep an intimate, physical relationship charged can get subsumed by the pressures of life when other priorities seem more immediate - for both partners. It’s too easy to push sex on to the next night, and then the next.
Even if you’re not in a long-term relationship, the dynamics between a couple can stagnate. Life is busy and we have to talk to each other, be interested in each others lives, ambitions, ideas, support each other through problems and grow as a couple; tend to the union and stoke the closeness that is not directly related to sex, but is so important for it.
Equally, many women find that they’ve reached the limit with the acquiescing, putting the needs and feelings of others above their own, staying small and agreeable, and not rocking the boat, and make it known clearly, no longer able to put up with the bullshit. The rage and lashing out is not only scary for many women (who has a healthy female role model for expressing rage?), but can be extremely shame- and guilt-inducing, given the conditioning all had. And of course your partner may not understand this, and so it impacts your relationship dynamics.
Perimenopause, for many, is a time of major identity shift. The result of declining oestrogen and progesterone is that the accommodating veil that hormones offer is lifted and we see things more clearly. This can leave us feeling exposed, vulnerable, rage-full, weepy, questioning who we are and everything in between. This may lead to some women being more open to experiment as they play with who they are becoming. Others need safety, trust and emotional intimacy—which they may not be getting because few partners, who are not either also going through it or have gone through it, may understand.
Many women realise that sex isn’t fulfilling and enjoyable, but they’re not clear why…
Though it’s complicated and nuanced, the truth is: sex must evolve to stay enjoyable. If the sex isn't good, if it isn’t evolving and refining and as a woman you're struggling with desire, perimenopause will make it clear. Your body needs, maybe even demands authenticity; it becomes non-negotiable.
Therefore, in midlife, there is nowhere to hide, it's no longer possible to go through the motions and override what the body knows so clearly (the body always knows). Perimenopause is a truth teller.
Your desire hasn’t been stolen by midlife; instead you’ve lost the tolerance to keep having sex that doesn’t work for you.
The trouble is, so much of what we think of as 'normal' sex is outcome focused and porn informed - which isn't what tends to create desire for women. Let's call it goal-oriented sex.
Generally, in perimenopause, what becomes so important for us is the quality of the experience. That means slowing down, being present and intentional in each moment. Taking your time creates charge. We LOVE erotic charge. It creates emotional and erotic depth, and opens up levels of arousal and pleasure that goal-oriented sex simply cannot access. It’s a more feminine way of lovemaking - meandering and dwelling in sensation, savouring the experience.
Crucially, this benefits both of you—this isn’t shifting the centring of sexual pleasure from one partner to the other. Experience-oriented pleasure is expansive and pleasurable for both of you. So if it's a kiss, make it a truly stomach-flipping one. If it's stroking, make it super sensual. As I understand it, Tantra epitomises this.
Slowing down is so important. Not only is sensual touch slow, but also most women exist in caring, mothering, over-giving modes for so many hours of the day, and it takes time and space to switch into lover mode.
If you’re one of the many who is struggling with this, perimenopause doesn't signal the end of your sexual potential - there are endless accounts from older women about how liberating, enjoyable and free it can be, without the bother of periods, without the chance of pregnancy. You can expect fabulous sex in your 80's; it’s entirely possible. I invite you to consider it an opportunity to discover what truly expansive sex can actually be.
If this piece resonates with you, know that perimenopause is an opportunity. It can get better - so much better. Here’s how…
You can expect to have sex that fulfils and excites you. Slow, sensual, erotic and expansive sex - or sex that you love, doesn’t have to be a dream; it really is possible, even though it may feel somewhat hard to reach.
The ingredients to that shift include:
If vaginal changes like pain, thinness and dryness are an issue for you, speak to your doctor and consider vaginal oestrogen pessaries, which can make all the difference. And use a good lubricant (see below).
Build up your strength and capacity, for your own benefit of course but also because for the vast majority we will need to initiate the changes. It has to be - it comes down to our power having been suppressed (see patriarchal/capitalist context) so it’s up to us to take it back, and enjoy the satisfaction, self esteem, and power from having done that. But this may take effort and you have to have capacity for that. So:
Commit to time out; time alone to recharge and remember what being you feels like.
Jettison anything non essential that drains your energy—and delegate your chores.
See your friends and people who fill you up and make you laugh, i.e. find ways to play in other, non-sexual, ways.
Get help improving your sleep, digestion, recurring infections, and/or diet if physical symptoms are also draining you.
Make having some daily rest - even for 15 minutes - a non-negotiable. It sets a good standard for children, and works wonders for your strength. This isn’t lying on your bed and scrolling, messaging or watching anything. It’s listening to music or a guided meditation, doing yoga Nidra, or belly breathing. There is a surfeit of options online.
Exercise in a way you enjoy and which feels good, and try weight training. The increased muscle boosts testosterone, which in turn boosts drive and energy, it’s awesome to feel strong as a woman, and you’ll be looking after your metabolic and bone health too. If you’re not sure, search for a female-only gym or sessions— they feel much more welcoming than an open, unisex gym.
My personal favourite Craniosacral Therapy, and Traditional Chinese Medicine Acupuncture, two therapies that have helped so many of my clients to feel vital again.
Nurture your own desire, just for your own pleasure, nobody else. Read erotica, buy lingerie that you think is hot and you wear it for yourself. Have a daily orgasm practice to build that desire (make sure know yourself and what you like) —with lube. Indulge in fantasy, allow your imagination to run (nobody else will know).
Have an honest chat with your partner, clearly and kindly, frame it as needing to evolve as a couple now that your body is changing. Make it collaborative - this is now about apportioning blame - and take ownership where appropriate. In turn, listen to them.
Brush up on techniques, explore anything that intrigues or excites you - at your pace. Consider looking into Tantric sex, a slower form of lovemaking, that amplifies connection, arousal, and pleasure.
If you feel weight down and need help working through anything, especially shame, fear, trauma or blocks, get professional help. There are wonderful practitioners who can help.
Resources
Luckily there are resources to help you in the discovery, re-awakening process, and these are just some of them.
OMGYES is a platform dedicated to the study - and sharing about - female pleasure. It’s full of videos and animations about how to do…all sorts of things. You pay once and have access to the library for life.
A good lubricant is absolutely essential, not optional. Check out YES WB, which is clean and won’t disrupt the delicate vaginal pH or microbiome.
Come as You Are, by Dr Emily Nagoski, is a great and validating guide to female sex drive.
Want: Sexual Fantasies by Anonymous, collected by Gillian Anderson. This is a collection of sexual fantasies from women around the world, an exploration of how women feel about sex when they can be totally free and anonymous - compelling and great for firing up arousal.
The Heart of Tantric Sex, by Diana Richardson, is a brilliant and accessible introduction to tantric sex.
Non-Violent Communication, by Dr Marshall B Rosenberg, is an excellent book for learning how to communicate effectively.
For gorgeous underwear for sparking your flame Understatement Underwear, Fleur Du Mal, Cosabella, Bravissimo.
Sexy and Gorgeous Flower Essence for Self Confidence by Saskia’s Flower Essences is surprisingly effective for helping you feel sexy, shine and feel good about yourself.
For those who are really into manifestation, and consciousness, check out Leanne Rose, a somatic psychotherapist who also channels the Galayla Collective, who is a wonderful guide in this area, and who has inspired so much for me personally.