Can’t Orgasm During Perimenopause or Menopause? Why and What Actually Helps
Vanessa Tarfon
1 Jun 2025 – 4 min read
That Frustration When You Just Can’t Get There…
Argh, that feeling when you’re climbing the orgasm mountain, doing “all the right things,” maybe even enjoying the moment…but the peak? Flatline. If you’ve ever felt like orgasm is something just out of reach, especially in perimenopause or menopause, you are so not alone. And more importantly, you’re not broken.
This isn’t just in your head. It’s a real and common experience with real solutions.
What Is Anorgasmia?
Anorgasmia is an umbrella term referring to persistent difficulty or inability to reach orgasm despite adequate stimulation and arousal. It can show up suddenly in midlife or be a lifelong experience. While many women are told “you just need to relax” or “you’ll grow out of it,” the truth is far more layered, especially during hormonal transitions like perimenopause and menopause.
Orgasm Is More Than a Button to Push
Let’s begin here: orgasm is not a performance goal or proof you’re “good at sex.” It’s a physiological, emotional, and psychological experience. Sometimes it’s all three, and sometimes it’s just one. When orgasm stops happening or has never happened, it’s not about “trying harder.” It’s a signal.
When the Body Sends the Signal
Your body may be speaking through:
- Hormonal changes in perimenopause or menopause, impacting blood flow, nerve sensitivity, and lubrication.
- Side effects from medications like antidepressants, which can blunt sexual sensation.
- Health conditions such as diabetes, multiple sclerosis, or pelvic floor dysfunction, which can interfere with orgasmic response.
Many women report weaker orgasms after 40, a sudden drop in sensitivity, or the sense that orgasm just disappeared, and yet these physical changes are often ignored or dismissed.
When the Relationship Sends the Signal
If you feel emotionally disconnected from your partner, resentful, or unable to fully relax, your nervous system won’t feel safe enough to access deep pleasure. Your body is doing what it’s wired to do: protect you. Not surrender.
If you’re stuck in people-pleasing, performing, or “just getting it over with,” climax may stay out of reach, not because you’re broken, but because your body is prioritising safety over sensation.
When the Past Blocks the Present
Sexual shame, trauma, and early messages around sex (“Don’t do it or you’ll get pregnant!” or “Good girls don’t touch themselves”) leave deep imprints. Possibly affecting your nervous system and inability to accept pleasurable sensations at all.
If you weren’t taught that pleasure is for you, or never had space to explore what truly turns you on, it makes perfect sense that your body might still be holding back.
The Myth of the “Normal” Orgasm
There is no one way to orgasm, and no one “right” way it should feel. Some women climax through clitoral stimulation, others need internal touch, emotional safety, fantasy, movement or a mix of it all. Sometimes it’s a short, sharp release. Other times, it’s slow waves across the body.
Midlife orgasms often evolve. And that’s not a flaw, it’s an opportunity for reconnection.
Tools for Healing and Reclaiming Pleasure
If orgasm feels unreachable or different now that you’re in perimenopause or menopause, here’s where I often begin with the women I support:
1. Get Curious About Your Context
Instead of hyper-focusing on your technique, ask:
“What’s happening in my life, mind, and body when I’m trying to feel pleasure?”
Are you anxious? Exhausted? Disconnected from your partner or yourself? Your context matters more than your technique. Especially in midlife, when sex often becomes emotionally and hormonally complex.
2. Ditch the Goal
Instead of aiming for climax, let pleasure be your compass. What would a “3 out of 10” feel like on the orgasm scale? Gentle warmth? A slight flutter? Pleasure builds when there’s less pressure.
3. Reconnect with Solo Pleasure
Self-pleasure gives you space to explore without performance. Try:
- External stimulation without a vibrator
- Deep breathing and sensual touch
- Simply placing your hand on your vulva and noticing sensation
It’s not about chasing orgasm. It’s about inviting sensation back on your own terms.
4. Seek Support
Working with a Sex Therapist can help you explore shame, build safety in your nervous system, and reconnect with your desires gently, and with compassion. You do not have to figure this out alone.
5. Talk to your Doctor (Bring Data!)
If you’re on medications, navigating menopause, or have chronic conditions, speak to a menopause-literate GP. Ask about:
- Hormonal options (like vaginal oestrogen or testosterone)
- Pelvic floor therapy
- Sexual side effects from medications
- Referrals to allied health professionals
When pleasure feels muted, it might be a signal your midlife body needs different support.
You Deserve More Than a “Functional” Sex Life
Orgasm isn’t the only measure of good sex, but pleasure is your birth right. Even if it’s been years. Even if you’ve never climaxed. Even if menopause changed everything.
You’re allowed to feel fully alive in your body and it’s never too late to begin again.
Orgasm and Menopause FAQ
Why can’t I orgasm during perimenopause?
Oestrogen and testosterone decline can reduce blood flow and nerve sensitivity, along with genitourinary changes, making orgasm more difficult. Stress, sleep changes, and emotional shifts also affect desire and arousal. It’s common but it is all treatable.
Is it normal to have weaker orgasms after 40 or after menopause?
Yes. Many women experience shorter, less intense orgasms or trouble climaxing at all. That doesn’t mean your pleasure is over, just that your body may need different kinds of touch, connection, or support. This is the time to take control of your sexual liberation!
Can hormone therapy help with orgasm problems?
In some cases, yes. Hormone therapies like vaginal oestrogen or testosterone (Androfeme) can improve arousal, lubrication, and sensitivity. Always speak to a healthcare provider who understands midlife sexual wellness.
Vanessa Tarfon
Sex Therapist, owner of Authentic Awareness
Related Posts
A gentle, shame-free guide for women exploring their bodies and pleasure for the first time or in a long time, especially after 35.
Revealing how your body image impacts your sex life and strategies to change your sexual self-confidence to revive your sexuality.
You always thought of it as an “old woman’s issue” and now you are menopausal. What to expect and how to support your sex life through menopause