What Can You Do?
If you’re someone who’s already been having a satisfying sex life, you probably already do most of the things that are usually suggested when it comes to sex and menopause and that are connected with having or continuing to have a satisfying sexual life during and after perimenopause, like open and honest communication, making pleasure—very much including your own—a priority, healthy partnerships and wholly consensual interactions, and sexual exploration. If you’re someone with disabilities, who has or has had sexual partners with disabilities, or who is otherwise already used to adjusting to physical, emotional, and other changes in sex and sexuality, in making and asking for accommodations as needed or wanted, same goes for you: you’ve probably already got most of this down.
If you haven’t had a very satisfying sex life up until now, and your sexuality and sex life aren’t already pretty adaptable when it comes to rolling with the physical and emotional changes and changing needs of yourself and your partners, I can almost guarantee that if you do many of the things I’m going to suggest here, then you may well have menopause to thank for potentially radically improving how you feel about and in your own sexuality and your sexual life by the time it’s over— and maybe even before that. No kidding.
First, there are a couple things that can help with most, if not all, of what’s changed or changing.
Identify, Acknowledge, and Deal with Fears
Despite what erotic thrillers would have you believe, fear and anxiety don’t usually make sex more fun. Especially when fear and anxiety are about sex.
Our sexual fears can easily become self-fulfilling prophecies. If we lean into fear that our bodies won’t respond sexually anymore, that we won’t orgasm, or that we’ll feel pain, all of those outcomes become more likely. Just like with pain, fear can create a negative feedback loop our bodies and minds respond to.
A lot of these fears are based in the sexual frameworks and beliefs of our cultures, our relationships, or our own minds and sexualities that were always busted; they may just have been or seemed less impassable before than they might once things start shifting with menopause or once you know some of the change that’s probably coming. So, in order to deal with some of our fears, we might first have to deal with some of—maybe even all of— our beliefs about them.
Like Patti LaBelle, You Might Need to Get Yourself a New Attitude
The sex and sexuality frameworks many of us learned growing up are exceptionally limited, all the more so for the menopausal and postmenopausal. The limitations of those frameworks we might run up against the most, and find the most inflexible, are primarily about ableism, ageism, and heteronormativity. Developing an awareness of those limits and how they affect you and doing what you can to kick them to the curb or change them can help a lot. That might look like recognizing and letting go of the idea that desire has to be frequent or fervent or that being able to have sex means being able to have certain kinds of sex only certain ways or that there’s one way sexy looks—and it doesn’t look over forty.
Queering things up goes a long way, whatever your sexual orientation or identity. I mean centering sex on pleasure, joy, freedom, experimentation, and exploration, not reproduction, obligation, or rigid gender or sex roles. I mean sex that’s about all kinds of pleasure and the whole of our bodies and selves, not just genitals, intercourse, or physical sex, and that cares about mutuality (when there’s more than just you), intimacy, and connection.
With and after menopause, hetero-normative sex and sexuality can become anything from boring or difficult to downright painful and oppressive. Those “rules” weren’t really written with anyone but cisgender men in mind and doom them to substandard sex and relationships too.
You also might need to change how you think about and create your sex life through a disability lens. Even if you don’t need to, you’ll likely benefit from it.
In accessible sex and sexuality frameworks, ever-changing bodies and states of health, wants, needs, adjustments, accommodations, and even radical changes are a given and are just considered realities of being human. That’s not the sexual praxis most of us learned, unfortunately. But if sex and our sexualities are to actually be about us, they have to allow for and be accepting of all of those things, because our bodies and our needs are always changing.
Even for those who meet and can continue to meet almost every other standard, you simply can’t remain young: it’s impossible. As a frequent side effect, you also won’t remain able in all the ways you may have been when you were younger. You will age out of youth-based privilege if you haven’t already, and your body will age with you, often bringing changes to your abilities.
Ageist beliefs about sex are not friends to our sexual lives or identities. If we believe that people postmenopause or in menopausal transition don’t want sex, we are priming our pump to go that way (which might be helpful for you if that’s a direction you want but counter to your wants if it’s not). If we believe an orientation or other sexual shift can’t be real or positive but must instead be some kind of meaningless midlife crisis, your belief may cause you to miss the boat on positive change. If we believe that no one who isn’t young is sexually desirable . . . well, you see where this is going.
What else can help?
– Ya Basics—reducing and managing stress, improving your sleep, getting movement in, staying hydrated, quitting smoking, and getting social support—can all help with sex and sexuality.
– Estrogen therapy, particularly local estrogen, can usually help with genital issues, and testosterone therapy is often prescribed for desire/arousal issues, including if systemic estrogen therapy isn’t helping with it, which it sometimes will.
– If genitourinary symptoms (like vulvovaginal dryness or pain or bladder issues) are going on and creating sexual issues, managing those can help.
– Mental health and mood can have a big impact on sex and sexuality. For info on managing those, see page 129. Know it’s always okay to take a break from sex and sexuality if and when you need to, whether that’s about mental health or anything else: sometimes the thing that helps your sex life most may be to put it on pause while you take care of other parts of yourself. If sex feels like an obligation in any way, changing that will absolutely help with your sex life and how you feel about it. I promise.
– You might look into sex therapy, counseling, and/or relationship counseling. Some sex workers also specialize in working with sexual life passages.
– Bodywork and other ways of experiencing touch that is non-sexual or not specifically sexual can help.
– You might try something new: that can be a new partner, adding partners, or a different kind of relationship, new toys or kinds of sex you haven’t tried before, trying sex in new contexts, taking on different roles, or including different emotional dynamics in your sex life than you have before.
– If you’re having vasomotor impacts and are just too darn hot to be physically close to someone else, but you still want to be sexual, mutual masturbation is one way to be sexual together without wanting to yell for the other person to get their painfully warm body away from you.
– If you’re having sexual issues and don’t even want to be engaging in sex (or a particular kind of it), rather than trying to change your body or make yourself adapt, this may be the perfect time to change your sexual life so you’re only ever doing what you want to do and not doing what you don’t. If you don’t want to engage in any kind of sex at all, it is always okay to take sex out of your life, temporarily or permanently.
Plan sex and make real time for it:
If there’s something unsexy about planning, then I’m going to need someone to explain to me why I get so excited when I have a date. Any prep “in case of sex” is planning sex. So if you haven’t been planning because you’ve got a negative mindset about it, try that on. It’s just a date. Just give it a shot. That plan can be for masturbation or sex with partners, or you can make one standing date for each. Schedule what masturbation visionary and feminist educator Betty Dodson calls “erotic recess” and treat it like recess, not like a community-service assignment.
If, when it’s time for recess, you’re not feeling it, that’s always okay: do something else that’s nice for yourself or your relationship with that time. One of the changes that seems common with aging is for the lines to get really blurry when it comes to pleasure, intimacy, and sex: whether or not something is expressly sexual matters less than if it—whatever it is—is enjoyable.
Lube, lube, lube, lube, lube, lube, lube: In the event you’re not already a lube superfan, and shame has gotten in your way of using a slippery vat of lubey goodness, hear this: Lube is not a bummer or something to be embarrassed about. Lube is gravy on potatoes, pomade on a pompadour, or warm, melty syrup on pancakes, for crying out loud. Lube is a glorious thing that can make a potentially already good thing anywhere from a little better to downright magical. When George Harrison was posthumously inducted into the Rock & Roll Hall of Fame in 2004, Tom Petty, Jeff Lynne, Marc Mann, Steve Win-wood, and George’s son Dhani were already doing a gorgeous version of “My Guitar Gently Weeps.” Then Prince slithered out and lit the whole thing up with a guitar solo a thousand times more delicious and amazing than you even expected it to be, and you already expected it to be pretty incredible, because Prince, okay? Lube is that guitar solo.
Reprinted with permission from What Fresh Hell Is This? Perimenopause, Menopause, Other Indignities, and You (Hachette Go), available from Amazon or Bookshop.
