Let's Talk About Sex – Intimacy, Desire and Your Changing Body During Menopause

A conversation that doesn't happen nearly enough: what can happen to your sex life in menopause? The whole topic of what we ‘thought’ intimacy to be can change. Wrapped up in this can be changes in feelings of desire, body image, physical discomfort and how all of this can bring about change in your intimate partner relationship.

If you've noticed changes in your sex life during menopause, whether it's less interest, more discomfort, or just a sense that something's shifted, then you are definitely not alone. And despite what the silence around this topic might suggest, it's not something you just have to accept and move on from. But is worth exploring, not only on a physical, but also on a relational level. Perhaps you’ve been compromising on standards when it comes to your body and sex…?

When Your Body Feels Different

Let's start with the physical changes, because they're very real and they do matter. Many women experience vaginal dryness, discomfort during sex, and changes in arousal during and after menopause (Domoney et al., 2013; Nappi et al., 2013). These symptoms are part of what's now medically called genitourinary syndrome of menopause (GSM), and they can range from mildly annoying to genuinely painful (Farrell, 2017; Simon et al., 2026).

These experiences aren't just "in your head," (as I often hear from women that they are told) and they're not signs that you're broken. They're physiological changes related to declining estrogen levels. One study found that vaginal discomfort affected not only women's sexual satisfaction but also their partners' experience of intimacy (Nappi et al., 2013). In other words, this is a couples' issue, not just a women's issue.

But physical changes are only part of the story. Research shows that women's sexual experiences during menopause are shaped by a complex mix of biological, psychological, and relational factors (Bulut et al., 2024; Alotaibi et al., 2025). Your body might feel different, but how you feel about your body, your relationship, and sex itself all play a role too.

What’s really interesting is that when oestrogen changes, not ALL women experience vaginal dryness. I am always curious as to how a woman has lived and how has her relationship with her body been in regards to having sex and being intimate? Often, there is much that can arise at the time of menopause that she has suppressed or ignored or disregarded – and the body has its way of speaking a little louder whilst the body becomes more transparent. An interesting and worthwhile consideration to ponder…

When Desire Shifts (or Disappears)

One of the most common, and least talked about, changes is a shift in sexual desire. Some women find their interest in sex decreases during menopause (Javadivala et al., 2018; Bachmann & Leiblum, 2004). Others find that while they're still interested in intimacy, the spontaneous desire they used to feel has been replaced by something more responsive - desire that emerges in the context of connection rather than out of the blue. A want for more quality in closeness with their partner, rather than the functional activity of sex on it’s own.

This shift can be confusing and even distressing, especially if you're used to feeling differently. One qualitative study found that women described their sexual motivations changing during the menopausal transition, with some feeling a loss of sexual identity (Javadivala et al., 2018). It's not uncommon to wonder, "Is this just who I am now?"

And then there's the partner dynamic. Research shows that when women experience sexual difficulties during menopause, it can affect their partners' satisfaction and sense of connection too (Khalesi et al., 2020). Some partners interpret decreased desire (in the way they are used to) as rejection or a sign that the relationship is in trouble, when really it's a physiological shift that has nothing to do with how much you love or value them.

Although it could be bringing the quality of connection into question – something for both to look at together.

The Intimacy Paradox

Here's something interesting that research has uncovered: while physical intimacy often becomes more challenging during menopause, many couples report that emotional intimacy becomes more important and, in some cases, more satisfying (Jannini et al., 2024). Women and their partners both tend to prioritise trust, mutual respect and emotional connection over purely physical aspects of intimacy as they age.

This doesn't mean physical intimacy doesn't matter, it absolutely does. But it does suggest that menopause can be an opportunity to redefine what intimacy means in your relationship. Some couples find that slowing down, focusing more on non-penetrative touch and communicating more openly about what feels good actually deepens their connection (Nappi et al., 2025).

The Silence That Makes It Worse

One of the biggest barriers to navigating sexual changes during menopause is the silence around it. Many women don't talk to their healthcare providers about sexual difficulties, and many providers don't ask (Calvin et al., 2025). Partners often don't know how to bring it up without sounding critical or making things worse (Liao et al., 2015).

This silence can leave women feeling isolated and ashamed, as if they're the only ones struggling. But research consistently shows that sexual changes during menopause are incredibly common (Bulut et al., 2024; Okeke et al., 2012). So you're not an outlier - you're experiencing something that millions of women go through.

What Can Help

The good news is that there are things that can make a real difference:

Talk to your healthcare provider. There are treatments available for vaginal dryness and discomfort, from lubricants and moisturisers to hormonal therapies. Don't suffer in silence because you think this is just "part of aging."

Communicate with your partner. Research shows that open communication about sexual changes is associated with better outcomes for both partners (Yang, 2023). Sometimes it's as simple as saying, "This doesn't feel comfortable right now. Can we try something different?"

Redefine intimacy together. Re-establish closeness and connectedness in your everyday – nurture this and let it build. Allow this closeness and everyday intimacy be your guide into new ways of being physically intimate.

Be gentle with yourself. Your body is going through a major transition. It's okay if it takes time to figure out what works now. And it’s also ok if you discover new standards for yourself and your body – this will be an adjustment for you and your partner.

A Gentle Reminder

Sexual changes during menopause don't mean your intimate life is over. It’s an opportunity to evolve, grow and check your standards. And while that evolution might feel uncomfortable at times, it can also be an opportunity to discover new ways of connecting with your partner and with your own body. Perhaps ways that are more honouring and more loving and more nurturing.

References

Alotaibi, S., Hinchliff, S., & Ali, P. (2025). A meta-ethnography of women's intimate and sexual experiences across the menopause continuum. International Journal of Women's Health, 17, 2465–2491. https://doi.org/10.2147/ijwh.s517807

Bachmann, G., & Leiblum, S. R. (2004). The impact of hormones on menopausal sexuality: A literature review. Menopause, 11(1), 120–130. https://doi.org/10.1097/01.GME.0000075502.60230.28

Bulut, H., Hinchliff, S., Ali, P., & Piercy, H. (2024). Women's experiences of intimate and sexual relationships during menopause: A qualitative synthesis. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.17436

Calvin, A. O., Cina, S., Byrskog, U., Erlandsson, K., & Borneskog, C. (2025). Women's experiences of their sexuality during their menopausal transition and the support offered to them by healthcare providers: A systematic review and metasynthesis. European Journal of Midwifery, 9, 1–13. https://doi.org/10.18332/ejm/209571

Domoney, C. L., Currie, H., Panay, N., Maamari, R., & Nappi, R. E. (2013). The CLOSER survey: Impact of postmenopausal vaginal discomfort on women and male partners in the UK. Menopause International, 19(2), 69–76. https://doi.org/10.1177/1754045313484139

Farrell, A. M. (2017). Genitourinary syndrome of menopause. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28697291

Jannini, E. A., Giraldi, A., Vignesh, S. O., & Hassan, T. (2024). Double pause: Understanding couple intimacy—A quantitative survey. The Journal of Sexual Medicine. https://doi.org/10.1093/jsxmed/qdae002.070

Javadivala, Z., Merghati-Khoei, E., Underwood, C., Mirghafourvand, M., & Allahverdipour, H. (2018). Sexual motivations during the menopausal transition among Iranian women: A qualitative inquiry. BMC Women's Health, 18(1), 191. https://doi.org/10.1186/S12905-018-0684-Z

Khalesi, Z. B., Jafarzadeh-Kenarsari, F., Mobarrez, Y. D., & Abedinzade, M. (2020). The impact of menopause on sexual function in women and their spouses. African Health Sciences, 20(4), 1979–1984. https://doi.org/10.4314/AHS.V20I4.56

Liao, L.-M., Lunn, S., & Baker, M. (2015). Midlife menopause: Male partners talking. Sexual and Relationship Therapy, 30(1), 167–180. https://doi.org/10.1080/14681994.2014.893290

Nappi, R. E., Kingsberg, S. A., Maamari, R., & Simon, J. A. (2013). The CLOSER survey: Implications of vaginal discomfort in postmenopausal women and in male partners. The Journal of Sexual Medicine. https://scispace.com/papers/original-research-women-s-sexual-health-the-closer-3sbfz3gxgc

Nappi, R. E., Tiranini, L., Martini, E., Martella, S., Barbagallo, F., & Cucinella, L. (2025). Bringing sex back into the relationship in midlife couples. Climacteric, 1–6. https://doi.org/10.1080/13697137.2025.2489460

Okeke, T. C., Ezenyeaku, C. C., Ikeako, L. C., & Agu, P. U. (2012). An overview of vulvovaginal atrophy-related sexual dysfunction in postmenopausal women. Journal of Basic and Clinical Reproductive Sciences, 1(1), 3–8. https://doi.org/10.4103/2278-960X.104288

Simon, J. A., Nappi, R. E., Chedraui, P., Clark, N., Gompel, A., Nasreen, H., Palacios, S., & Wolfman, W. (2026). Genitourinary syndrome of menopause: Recommendations from the Fifth International Consultation on Sexual Medicine. Sexual Medicine Reviews. https://doi.org/10.1093/sxmrev/qeaf055

Yang, Y. (2023). Understanding the role of open communication on couples' relationship and psychological well-being during menopause: An examination of the mediating effects of communal coping with an actor-partner interdependence model [Doctoral thesis]. https://doi.org/10.26153/tsw/45989