Menopause and Sex: Expectations and how to entice your intimacy back to life

Vanessa Tarfon

1 Apr 2024 – 4 min read

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If you thought menopause was an old woman’s problem you’d never experience then think again. This denial and the secretive conversations about menopause have left everyone unprepared for midlife health. And I mean everyone, including women transitioning through menopause and their partners. 


Even less is spoken about menopause and sexual health so it’s time to break the taboo.

When does menopause start?

Women can start the menopause transition at any age but it is most common to start in your mid-40s. The average age in industrialised countries is 47.5 years old and in Australia, the mean age for menopause is 51.3 years old.


The drop in oestradiol (oestrogen) is responsible for many of the symptoms below. Testosterone starts reducing from your mid-20s so it doesn’t cause a sudden decline in your sexual health.

Menopause symptoms that affect sexual health

Not all women experience the same symptoms or severity of symptoms which makes your transition and treatment individual. Given that sexuality is individual, your sexual health and functioning will be affected differently.


Psychological symptoms

  • Mood swings
  • Anger
  • Low libido/difficulty reaching orgasm
  • Identity crisis “feeling old”
  • Fogginess


These symptoms negatively impact overall confidence and self-image, sexual desire and relationship connection.


Physical/somatic symptoms

  • Pelvic floor weakness
  • Incontinence
  • Prolapse
  • Vaginal dryness
  • Vagina and vulva tissue thinning and loss of fatty tissue
  • Vaginal canal shortening
  • Hot flushes
  • Night sweats
  • Sleeping disorders
  • Muscle and joint pain
  • Sore breasts 
  • Abdominal weight gain


These symptoms negatively impact body image, overall sense of wellbeing, and sexual functioning such as lubrication causing sexual pain and discomfort.

69% of menopausal women experience sexual problems around the world.

These symptoms can reduce sexual desire, increase arousal issues and difficulty to orgasm and cause painful sex.


Menopause symptoms are not the only reason for sexuality changes during this time. In this phase of life, women face life changes and psychosocial factors that negatively impact their sex lives.

Menopause impacts on relationships

  1. Sexual activity decline – predominantly sexual activity frequency reduces. When it remains the same, often this is because the woman feels obliged to continue having sex but doesn’t desire sex. An ingrained sense of giving their partner what they “need” and prioritising male sexual pleasure.
  2. Sexual satisfaction decreases – due to stress response activation and pain, sex becomes a chore that women bear through reducing their pleasure. 
  3. Communication issues – people lack the vocabulary to talk about sexual concerns with current or new partners. Sexual problems go in conjunction with communication decline. This is hard for single women who are experiencing menopause but want to shift a new relationship into a sexual relationship and face inadequacy fears like “Do I remember what to do?”
  4. Relationship disconnection and commitment concerns – people drift apart navigating their hobbies, interests and needs alone. Resentment increases from anger and disappointment at their partner or current situation. If left unresolved it can lead to a decline in relationship commitment.

3 easy steps to navigate your sex life through menopause

Stay active

The International Menopause Society recommends 150 minutes of physical activity weekly through menopause. There are strong links between physical activity and reduced sexual problems. Staying active will support your mental, physical and sexual health through the release of endorphins. There is also a link between orgasm frequency and sexual activity frequency. 

More physical activity = more sexual activity = increased pleasure.

Body image work

Positive self-messaging and sensual self-massages are important ways to accept your body and ensure your nerves continue to activate to pleasurable touch. If you don’t like yourself and want to touch yourself, it’s hard to be vulnerable in front of someone else. Contact me directly for more instructions.


If you’re in a relationship, don’t think you are the only one affected by age. Men also experience age-related sexual health changes. For example, increasing erectile dysfunction, reduction in morning erections and lower libido. 

You and your partner must communicate about your sexual health because a decline in your sex life could likely be because you are BOTH experiencing changes and feeling embarrassed.

If you’re in a new relationship or dating, contact me today for the best way to access your inner sensual tiger and comfortably open up to new partners.


Menopause, sex and ageing education is limited, but this phase of life doesn’t need to be as daunting as it seems! It can be the best sexual time of your life! Contact me to receive more information on maintaining a healthy and exciting sex life now and into the future.

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Vanessa Tarfon

Sex Therapist, owner of Authentic Awareness

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