How Menopause Affects Her Sexuality (and How You Can Help)

Menopause may be a challenge for your wife—but there are things you can do to help.

Chris Taylor

It isn’t only a myth that menopause wreaks havoc on a woman’s sexuality—which is why quite a few husbands have asked us to talk about menopause here.

Even when a husband has a good idea what will happen in menopause, watching it happen to his wife can be confusing and sometimes frustrating.

For his wife, it can be just as confusing.

I was pretty well informed about menopause and was very much in tune with changes in my body. Even so, menopause threw me for a loop.

As a sex-positive wife, I somehow expected that I would just sail through the challenges of menopause without having my sexual interest or response changed at all. Boy howdy, was I wrong.

If your wife is approaching menopause or is already there, read on to learn about why her sexuality might take a hit—and what you can do to help her.

The Basics

Let’s look at some essential facts about menopause.

A woman in menopause (also referred to as post-menopausal) has had no menstrual period for 12 consecutive months. However, many symptoms and challenges begin several years before actual menopause. This time is referred to as perimenopause.

Women typically reach natural menopause in their 40s or 50s, with the average age of 51. Women who have had their ovaries removed may experience surgical menopause much earlier. A woman whose ovaries have been removed is likely to experience the physical changes that accompany menopause.

Although menopause comes with common symptoms, they won’t look the same for every woman. Some women have only six months of problems, whereas others suffer for more than a decade. The average is one to two years.

Her New Body

During menopause, women experience a decline in estrogen and testosterone. Estrogen affects the parts of her anatomy that manage sexual response, and testosterone affects her general interest in sex.

Your wife’s body is experiencing changes that make her body seem like a stranger to her and that can make sex difficult.

My own body neither looks nor feels like it did before menopause. It doesn’t function quite the same either.

Vulvovaginal Atrophy

As hormone levels drop, the vagina becomes less stretchy, the vaginal wall thins, her genitals swell with arousal more slowly, her vulva becomes less sensitive, and her vagina produces less natural lubrication.

Here’s why these things matter:

  • Sex becomes uncomfortable or even painful.
  • She takes longer to be sexually aroused. (This is analogous to a man who needs more stimulation as he ages.)
  • Orgasm may take longer or be more difficult to achieve.
  • The kinds of touch that have worked for most of your marriage no longer work as effectively.
  • She may experience an increase in bladder leakage, which can make her self-conscious or frustrated by her body.

The body she has known for so many years is suddenly different. She may avoid sex in order to avoid pain, or she may want to do more “just for you” sex since it takes her so long to experience arousal and she doesn’t know if all that extra time will even make a difference.

Even if sex isn’t painful and orgasm is still relatively easy, sex may feel a little different than it did before menopause.

How You Can Help
  • Encourage her to see a doctor. Although she may be comfortable with the obstetrician who delivered her babies, she may find it more helpful to see a doctor who specializes in menopause.
  • Use an artificial lubricant for sex. Try some different ones until you find one that works well.
  • Encourage her to talk to her doctor about vaginal estrogen. Many women who cannot take hormone replacement therapy that affects their entire system may still be able to use vaginal estrogen.
  • Take the time she needs to be aroused and reach orgasm. This extra time is an investment in your relationship and helps your wife know that you think she is worth the extra effort.
  • Be willing to try new kinds of touch to arouse her.
  • Ask your wife if she has experienced pain or discomfort during sex.
  • If sex is uncomfortable, incorporate “other-course” rather than just intercourse into your sex life. Become more adept at oral and manual stimulation. Place a penis sleeve between her thighs to have some of the intimacy of intercourse without the discomfort for her.

Hot Flashes and Night Sweats

A hot flash is a sudden feeling of heat that spreads through the check, neck, and face. Some women experience a rapid heartbeat, sudden severe sweating, and a red flushed appearance. A hot flash may be preceded by feelings of electric shock.

Night sweats are severe hot flashes that happen during the night. Women often sweat through their night clothes and bedding.

Hot flashes and night sweats can be extremely uncomfortable, making it difficult to tolerate any physical contact. Additionally, frequent night sweats deprive a woman of the sleep she needs to feel rested and energetic the next day.

My husband used to joke that I should go lie down on the sidewalk in winter to let my hot flashes melt away the snow. Although that wouldn’t have worked too well, I did often go stand in several inches of snow just to cool myself down during a hot flash.

How You Can Help

Be patient and kind when she is having hot flashes or night sweats. As frustrating as it may be for you to have her throwing the covers off and on all night long, it is even more frustrating for her. Offer to get her a cool compress for her neck or forehead.

Body Image

The hormonal changes of menopause have an impact on metabolism. Women may experience a sudden weight gain, or they may gain weight in a different place on their body. Their skin begins to become more dry and less supple. Women may be come more self-conscious or feel like they look old for the first time.

I haven’t struggled with body image nearly as much as many women, but I have to tell you that when I look in the mirror, I am all too aware of what wrinkles or sags in a way it didn’t used to.

How You Can Help

Remind her often how beautiful she is to you. Let her know how glad you are that she is the one with whom you are growing older.

Other Health Problems

For women who experience natural menopause (that is, without having their ovaries removed), menopause happens at a time of life when other health problems are coming along.

Arthritis, autoimmune disorders, heart problems, diabetes, and more can affect a woman’s energy for sex or her ability to use sex positions that she has enjoyed in the past.

How You Can Help

Encourage your wife to see a doctor about other health issues that arise. Help her pursue treatment, and join her in lifestyle changes her doctor recommends as part of her treatment.

Mood Swings

Fluctuating hormones disrupt some of the brain’s processes that manage mood, so if your wife has experienced menopausal mood swings, that’s pretty normal. She may be more sensitive than usual, which can mean that she more easily becomes upset.

Between vulvovaginal atrophy, hot flashes/night sweats, body image, health struggles, and mood swings, is it any wonder that sex may be both more difficult and less rewarding than it used to be for your wife?

How You Can Help

Mood swings are difficult. Your wife’s mood can set the mood for your whole home and family.

All I can suggest is that you view this as a wonderful opportunity for you to live out 1 Corinthians 13: 4-7.

Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres.

Be patient with your wife’s mood swings and remember that she has to live with them even more than you do. Don’t be easily angered. Keep no record of wrongs. Persevere.

Her New Self

It isn’t only the hormones of menopause that can throw a wrench into your sex life. The challenges of midlife can get in the way too.

Your wife’s midlife is a time of redefining herself and her relationships.

The loss of fertility can be quite distressing for many women—even if they never wanted to have children. Menopause closes and locks the door on possibility. For a woman who wanted to have children but didn’t, menopause can lead to a deep grief about her body.

Menopause often comes around the same time as kids are launching into their adult lives. Losing her role as an active mother in her kids’ daily lives can bring a loss of purpose.

Although an empty nest can create a wonderful opportunity for your wife to reconnect with you, she may still feel uncertain about how to navigate your relationship without your children.

She may also be taking on a new role with her parents (or yours). Elder care brings a whole new set of challenges, and it redefines her relationship with parents, siblings, and more.

Women learn early to mark time and be aware of the rhythms of life. They plan life around their periods, or they use different phases of their cycle to remember the past month. (E.g., “I remember which day we went to the dentist because I started having cramps while I was writing the check.”)

The loss of periods erases a significant rhythm of life that your wife has experienced for decades. Some women find this disquieting.

Your wife’s mental and emotional energy may be trying to make sense of who she is now, and that can make it difficult for her to think about sex.

How You Can Help
  • Be intentional about nurturing your nonsexual intimacy.
  • Ask your wife to share what she is thinking and feeling during this season of life.

Although much of what your wife experiences with menopause is about her, you can make a positive difference in helping her navigate through this time.

More important, walking alongside her during the challenges of menopause can strengthen your spiritual and emotional intimacy in a unique way.

I can’t change the fact that my sexual response has been affected by menopause. However, the fact that my husband has been patient, loving, and kind throughout the journey has made me want to work even harder on the sexual aspect of our marriage.

Other Resources

Menopause may be a challenge for your wife—but there are things you can do to help.

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