Menopause and sex: WTF is going on?

VIP special. What has happened to my libido and sex life at perimenopause?

Hello lovely VIP subscribers! Thank you so much for supporting my work; I can’t tell you ho much I appreciate it. 

I thought I’d jump straight into the Important Stuff with this edition of exclusive content for you. It’s the question everyone wonders about but no-one wants to ask (at least in public): What has happened to my sex life? 

As you’ll know if you’ve read my book, I have a whole chapter on this in This Changes Everything. That’s because for women this is a very complicated issue. And unlike (usually) for men, there’s no simple solution. 

I recently listened to a podcast about the invention of Viagra which had me feeling, I must say, a bit envious. That’s because the experts quoted there said that for men, erectile dysfunction is most often a biological issue; one that can be solved with that now-famous little blue pill. All men have to do to sort it, is see their GP or even just wander into a pharmacy for a consultation, pay as little as $40 and wham, bam, liftoff. 

As you may be aware, attempts to come up with an equivalent pill for women have been, well, pretty average. That’s not surprising really, since low desire and sexual dysfunction for women is not simply biological. We’re talking about not just desire here, but also not getting the pleasure we used to get;  fewer or less intense orgasms; taking longer to get aroused, etc.  

For women this can feel like a huge loss. And it’s about many factors all tangled up together. As I wrote in the book: 

We all know that women’s desire is affected by far more than just what happens with our partner when we hit the sheets. No offence to the males in our lives, but unlike them, what it takes for a woman to get off is far more complicated than it is for a man. Men tend to follow a pretty straightforward track from arousal to orgasm, and – erectile dysfunction aside – there’s not much that can throw that off course. For women, of course, there are many, many things that can derail the desire train, no matter whether we’re 25 or 65. 

Low desire is incredibly common at perimenopause. It’s the most common sexual problem in women at midlife, according to a 2017 Australian study, which found a staggering 69% of its 2000 respondents (aged 40-65) reporting low desire. Forty percent of women also reported sexually-related personal distress. In my own survey, 52% of women said they’d had a loss of libido. 

What can we do about it? 
Again, frustratingly, the research on women’s desire lags far behind where we’d like it to be. No surprises there. But it’s still bloody frustrating. Here’s what endocrinologist Anna Fenton told me: