Reclaim Your Pleasure: 5 Common Sexual Health Issues in Midlife & Menopause (And How to Fix Them)

Let’s talk about something we don’t talk about enough: sex and menopause.

If you’re in midlife, you’ve likely noticed some major changes happening to your body—your hormones are shifting, your metabolism isn’t what it used to be, and even your sleep patterns have taken a hit. But one area that often gets pushed to the side (or whispered about in frustration) is sexual health.

Here’s the deal: Wanting a healthy, enjoyable sex life—whether with a partner or solo—is completely valid. And just because you’re in midlife doesn’t mean your pleasure has an expiration date! But menopause can bring some challenges that make intimacy feel like more of a struggle than a joy.

So, let’s break it down. Here are five common sexual health issues women face in midlife and menopause—plus real solutions to help you reclaim your confidence and pleasure.

1. Decreased Libido

It’s completely normal for your sex drive to fluctuate, but if you’re finding that your interest in intimacy has tanked and it’s bothering you, you’re not alone. Estrogen and testosterone levels drop during menopause, which can make arousal feel like an uphill battle. Add in stress, exhaustion, and hormone imbalances, and it’s no wonder sex feels like the last thing on your mind.

What helps: Start with stress management and sleep—because let’s be real, nothing kills the mood like being exhausted. Also, talk to your doctor about hormone therapy or supplements that support libido. And don’t underestimate the power of prioritizing self-care, pleasure, and open communication with your partner.

2. Vaginal Dryness

When estrogen levels decline, so does blood flow to the vaginal tissues, making it harder to stay naturally lubricated. The result? Sex that feels more like sandpaper than silk. Ouch.

What helps: Lubricants and vaginal moisturizers are your new best friends. Look for water-based or silicone-based lubes that are free from irritating additives. For a longer-term fix, talk to your doctor about vaginal estrogen creams or laser treatments designed to improve moisture and elasticity.

3. Vaginal Atrophy (aka When Dryness Gets Worse)

Vaginal atrophy is an extreme form of vaginal dryness where the vaginal walls become thin, inflamed, and extra sensitive, making intimacy (and even everyday activities) painful.

What helps: This is where treatment options like vaginal estrogen, DHEA suppositories, and pelvic floor therapy can make a big difference. And again—don’t suffer in silence! A menopause-literate doctor can help you find the right option for relief.

4. Urinary Tract Infections & Genitourinary Syndrome of Menopause (GSM)

Midlife and menopause can throw off your vaginal microbiome, leading to more frequent UTIs, irritation, and changes in vaginal pH. GSM is a broad term used to describe these shifts that affect not just the vagina, but also the bladder and urethra.

What helps: Hydration, probiotics, and vaginal estrogen can help restore balance. If you’re dealing with chronic UTIs, consider cranberry supplements and consult a doctor about preventive treatments.

5. Avoiding Closeness & Physical Intimacy

It’s not that you don’t love your partner—you just don’t want to be touched right now. Between hot flashes, night sweats, mood swings, and general discomfort, intimacy might feel like the last thing you’re up for.

What helps: First, give yourself grace. Midlife is a time of transition, and it’s okay to go through ups and downs. Communicate openly with your partner about how you’re feeling so they don’t mistake your distance for disinterest. If intimacy is something you want to enjoy more of, experiment with new forms of connection—sensual massage, non-sexual touch, or even scheduling intimacy when you feel your best.

Final Thoughts: Sexual Health is Health

If changes in your sexual health are affecting your confidence, relationships, or overall well-being, know this: You’re not alone, and you don’t have to “just deal with it.”

There are solutions—whether that’s adjusting your lifestyle, exploring treatment options, or simply shifting the way you think about pleasure in midlife. And remember, a satisfying sex life is not a thing of the past—it’s yours to redefine in whatever way feels best for you.

Want more support? 

• Check out my blog on Sex and Menopause: How to Communicate with Your Partner if you are struggling with starting that conversation. 
• Dive deeper into Sex and Perimenopause in my 7 week course Thriving in Midlife: How to Navigate Perimenopause and Beyond.  
• If your partner is curious about what's going on, share my blog on What All Men Need to Know About Menopause

 Let’s keep the conversation going—because midlife should be about thriving, not just surviving!