Menopause, Perimenopause, and Sexual Wellness: What Changes, What Doesn’t

For something half the population goes through, menopause doesn’t get talked about nearly enough, especially when it comes to sex. We hear about hot flushes and night sweats, but what about libido? Vaginal dryness? That quiet shift in how intimacy feels, or doesn’t?

If you're in the thick of perimenopause, already postmenopausal, or just starting to notice changes you can't quite explain, you’re not imagining it. But here’s the truth: menopause can affect your sexual wellbeing, yes, but it doesn’t mean desire disappears, or that good sex becomes a thing of the past.

So, What Exactly Is Perimenopause?

Perimenopause is the transitional phase leading up to menopause. It often begins in your 40s (sometimes earlier) and can last several years. Hormones, especially oestrogen and progesterone, start to fluctuate, sometimes wildly. Periods become irregular. Symptoms like mood swings, fatigue, and brain fog might appear.

Menopause itself is defined as going 12 months without a period. After that, you’re considered postmenopausal. But here’s the part often glossed over: this hormonal rollercoaster can change the way your body responds to sex.

Also Read: Perimenopause Symptoms: What’s Normal, What’s Not, and When to Seek Help

What Might Change, and Why

1. Vaginal Dryness and Discomfort

With less oestrogen, vaginal tissues become thinner and less lubricated. That can make sex feel uncomfortable, or painful.This is one of the most common changes, and there are solutions. From simple water-based lubes to oestrogen creams and vaginal moisturisers, comfort is absolutely possible again. You just may need to try something new.

2. A Shift in Libido

Some people feel their desire fade like background music. Others feel a surge, relief from pregnancy worries, less stress about contraception, more freedom in their bodies.

What’s common is change, not one direction. If you feel disconnected from desire, you're not alone, and it doesn’t have to stay that way. Mental health, sleep, relationship dynamics, and body confidence all play a role.

3. Changes in Orgasm or Arousal

Orgasms might take longer. Arousal may not feel as immediate. That doesn’t mean sex stops being pleasurable, it just might require more buildup, different kinds of touch, or a slower 

What Doesn’t Change (Unless You Let It)

Here’s what menopause doesn’t take away:

• Your right to pleasure

• Your capacity for intimacy and connection

• Your sexual identity—whatever it may be

• Your ability to explore, experiment, and enjoy your body

Too many people assume menopause is the end of their sexual life. It isn’t. In fact, for some, it’s a new chapter, less about performance, more about real connection. Less pressure, more presence.

Emotional and Mental Shifts Matter Too

Let’s not ignore the emotional layer. Body image may take a hit. Energy might be low. You may not feel sexy in the way you used to, but that doesn’t mean you’re not.

Sometimes, the most powerful shift isn’t hormonal, it’s psychological: reframing sex as something you get to do, not something you should do. That small shift often opens the door to rediscovering what pleasure means now.

Also Read: The Beauty Shift: How Menopause Transforms Your Hair, Skin, and Nails (and What You Can Do About it)

Tools That Can Help

 

• Lubricants & vaginal moisturisers – game-changers for dryness and comfort

• Topical oestrogen or hormone therapy – talk to a GP or menopause specialist

• Pelvic floor exercises or therapy – especially if you’ve had children or experience pain

• Sex therapy or relationship counselling – for when emotional or communication barriers show up

• Solo exploration – yes, masturbation is a wellness tool; it helps blood flow, connection, and confidence

There’s no shame in needing help. You wouldn’t power through a broken ankle without support. Why do that with your sex life?

You Haven’t "Aged Out" of Sexual Wellness

If your sexual self feels quieter, more complicated, or even unfamiliar right now, you're not alone. But you're also not at the end of anything.

Pleasure doesn’t have an expiry date. It evolves. It adapts. It becomes more nuanced, often more meaningful. Sometimes it softens, sometimes it deepens. 

You deserve care that takes your whole self into account, your body, your identity, your relationships, and your changing needs.