Menopause and Sex

You may know about hot flushes and poor sleep, but menopause’s impact on your sexual self, your desire, your body, your intimacy, often comes unexpectedly. When it does, it can feel extremely isolating, as though something fundamental has shifted without your permission.

You are not imagining it. And you are not alone.

The hormonal changes of perimenopause and menopause, primarily the decline in oestrogen and testosterone, can affect sexual wellbeing in ways that are both physical and deeply personal. Vaginal dryness and tissue changes can make sex uncomfortable or painful. Desire can feel muted or absent. Arousal may take longer, feel different, or seem elusive, which can be confusing if you don't understand what's driving it. For some people, orgasm changes too — in intensity, in ease, or in the way the body responds. These are not failures of femininity or signs that your sexuality has left the building. They are physiological realities, and they deserve to be named honestly not quietly endured.

But menopause is never purely physical. It arrives, often uninvited, alongside a whole constellation of other experiences. Shifts in body image. Questions about identity, ageing, and visibility. Changes in how you relate to yourself as a sexual being. If you are in a relationship, your partner may be navigating their own uncertainties about how to respond, what you need, or whether to reach out, risking discomfort. The relational ripple effects are real, and they matter just as much as what's happening in the body.

There is also a cultural silence around all this that does genuine harm. Menopause and sexuality are rarely discussed in the same breath, and when they are, the narrative is too often one of loss, as though desire has an expiry date and the best you can hope for is to grieve it gracefully. That is simply not true. Many people find that with the right support, understanding, and sometimes medical intervention, their sexual lives in and beyond menopause are rich, pleasurable, and deeply connected. But getting there requires information, honesty, and space to work out what you want - not what you think you should still want, or what you've been told to expect.

At Lou Goodwin Therapy, I work with people navigating the sexual and relational landscape of menopause with warmth, clinical expertise, and zero judgment. In therapy, you can expect to gain a clearer understanding of the changes you're experiencing, find practical strategies to increase comfort and pleasure, and strengthen your communication with your partner. We collaborate to rebuild confidence, address any emotional or relational challenges, and tailor support, whether therapeutic, relational, or medical, to help you find joy, pleasure, and connection again. Sometimes that means rebuilding communication with a partner. Sometimes it means reconnecting with your own body on your own terms. Often, it means simply having a conversation that nobody else has been willing to have with you.

Your sexuality does not have an expiry date. If menopause is affecting your sexual wellbeing, you deserve proper support - not a pat on the head and a prescription for lubricant.

Get in touch today to book a session