Your Ultimate Guide To Great Sex During (And After) Menopause

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menopause and sexless marriage

Menopause is a term that can send fear and loathing throughout the lives of those who will experience it, and their partners. Some menstruating people are concerned it marks the end of their identity or their sex life.

True, menopause can lead to many changes in a person’s body, and lived experience, but it does not have to mark the end of great sex.

Does menopause lead to a sexless marriage or relationship?

No, not necessarily. There is no definitive age at which anyone stops being sexual, regardless of gender. Perimenopause or menopause may initiate a new chapter for sex, but that is to be expected.

Libido and sexuality are dynamic and expected to ebb and flow over the course of our lives, even for people who do not menstruate. When partners take time to learn about menopause, show care for each other as they cultivate a new normal, and stay proactive in their communication, their sex lives can stay vibrant and on their terms.

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What to Expect with Menopause

The majority of cisgender women and other menstruating folks begin menopause between the ages of 45-55, though some may start earlier and others later.

There are three distinct phases of menopause:


In this phase, the hormonal balance begins to change, and the body begins to produce less estrogen, progesterone, and testosterone. A menstruating person may notice less predictability with their menstrual cycle and some side effects of menopause begin to emerge.


Once the body has stopped producing as much estrogen and progesterone, the body goes into menopause and the menstrual cycle stops. This can last for a while, but once there has been no menstrual cycle for at least 12 months, postmenopause begins.


When someone enters postmenopause, following 12 months without a menstrual period, their ovaries are producing minimal levels of estrogen and progesterone and they can no longer become pregnant.

Menopause Symptoms

The side effects of menopause vary from person to person, but generally consist of some constellation of the following symptoms:

—Irregular periods

—Hot flashes


—Night sweats

—Insomnia and other sleep problems


—Weight gain

—Slowed metabolism

—Thinning hair

—Dry skin

—Loss of breast fullness

—Feeling bloated suddenly

—Gum related conditions and bleeding


—Mental health changes

—Mood fluctuations



—Difficulty concentrating

—Brain fog

—Sudden crying spells

—Memory lapses

—Sexual health changes

—Vaginal dryness

—Vaginal atrophy

—Decreased libido

It’s no wonder sex takes a back seat for many who go through menopause! If you or someone you know is going (or has gone) through menopause, take a moment to acknowledge how much you/they have endured. Maybe take two moments. It can be a lot.

In relationships, the experience of menopause can be a difficult phase of life for couples to weather. Like most life events, people don’t know much about it before they experience it.

A lack of comprehensive sex education sets the stage for people who endure menopause, and their partners, to feel ill-equipped, and to mistake the symptoms of menopause as indications of personality changes or relational strife. Misattributing symptoms for relational problems can actually lead to relational problems.

As sexual functioning changes, and libido takes a hit, shifts in physical intimacy can leave partners wondering if they are truly compatible or if their partner has lost interest in them. Sexual dysfunction can lead to compounded fears about whether sexual pleasure will ever be the same.

It may never be the same, but it may surprise you just how great sex after menopause can be. In fact, some cisgender postmenopausal women report having a higher sex drive than before.

RELATED: 6 Simple Ways To Rekindle The Spark & Passion If You Haven't Had Sex In A While

If you’ve found yourself in a sexless phase in your relationship, here are a few things you can do to revive your sexual energy:

1. Stock up on lubrication.

Vaginal dryness and atrophy can create friction and dryness that can make penetration painful. Play with different kinds of lubricants to help ease penetration.

You may also consider trying out sexual arousal serums, to increase sensation to the vulva during solo or partnered sex.

2. Think about sex more expansively.

People who have completed menopause are not broken; they’re evolving. Matching their physiological changes with sexual creativity can open a panacea of sexual pleasure options.

Sex is not just about penetration, so if penetration is painful, or not as interesting in the moment, focus on outercourse instead. Explore new avenues of erotica or fantasy, introduce some new toys into the mix, and create a co-created experience of whole-body pleasure. Sex is not just for genitals!

3. Communicate, communicate, communicate.

Talk with each other and practice active listening. Really, really listen. Before, during and after sex. Menopause can leave both partners confused, scared, facing concerns about aging, mortality, and changes in how they see themselves.

Keep the channels of communication open, discuss your needs openly and with compassion, and talk about what feels good during sex, what can reduce pain or discomfort, and what brings new or increased pleasure. You don’t have to have all the answers, and frankly, the answers may change with each sexual experience.

Communicate as if each sexual interaction is a new adventure, and it can become one.

4. Find the right professionals.

Even before menopause, sex can be a nuanced and complex experience. If it seems some support would offer a respite, start working with a team of professionals that specialize in sexual health and sexual mental health.

There are some medications and medical treatments that can help mitigate the symptoms of menopause, increase blood flow to the vagina for improved sexual sensations, and a certified sex therapist can help you process the complete mind, body, and relational experience of menopause.

Can a sexless relationship survive?

You do not have to settle for a sexless marriage or relationship if sex is a priority for you. However, a lack of sex is not necessarily a deal-breaker, nor does it signify the inevitable end of any relationship.

If a relationship ends due to sexual problems following menopause, it is likely there were other problems in the relationship, and menopause brought to the surface the couple’s inability to work through them.

Working with a couple’s therapist can help couples develop the skills they need to thrive together long-term. Nurturing a healthy relationship and navigating menopause is not easy, so remember to give yourself some space to be imperfect and permission to ask for support.

RELATED: How Do You Know When To Walk Away From A Sexless Marriage?

Dr. Kate Balestrieri is a Licensed Psychologist, Certified Sex Therapist, Certified Sex Addiction Therapist, PACT Therapist, and Founder of Modern Intimacy, a group practice in Los Angeles, Miami, NYC, Denver, and Chicago. Listen to her podcast, Modern Intimacy, and follow her on TikTok and Instagram.