Menopause and Intimacy. Navigating Desire Changes with Psychosexual Therapy

Introduction

Menopause is a natural life stage, but it can bring changes to libido, arousal, and comfort during sex. For many women, this shift can feel confusing or distressing, sometimes leading to a sense of lost intimacy with their partner.

Psychosexual therapy offers support for navigating these changes, helping women and couples adjust, communicate, and maintain fulfilling intimate relationships during and after menopause.

How Menopause Affects Sexuality

1. Physical Changes

• Vaginal dryness or discomfort during intercourse
• Changes in arousal and orgasm response
• Hot flushes, night sweats and fatigue reducing desire

2. Emotional and Psychological Factors

• Body image concerns
• Reduced confidence or self-esteem
• Anxiety, low mood or irritability linked to hormonal shifts

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3. Relationship Impact

When intimacy changes, couples may feel distant. Partners often misinterpret low libido as rejection, creating tension or avoidance.

The Role of Psychosexual Therapy

1. Understanding Menopause and Desire

Therapists provide education about how hormonal shifts affect sexuality, normalising the experience and reducing shame.

2. Addressing Pain and Discomfort

Therapy explores both psychological strategies and practical options (e.g. lubricants, medical referrals) to reduce discomfort during sex.

3. Rebuilding Intimacy Beyond Intercourse

Sensate focus exercises and intimacy-building practices encourage couples to connect without pressure, rekindling closeness and pleasure.

4. Enhancing Communication

Psychosexual counselling gives couples a safe space to discuss changes in libido, expectations, and emotional needs.

5.Pelvic Floor Fitness Exercises

Boost blood flow to the vagina and surrounding tissues, helping with lubrication and sensitivity.

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Menopause, Identity and Sexual Confidence

For many women, menopause is not only about biology but also identity. Therapy helps reframe this life stage as an opportunity for growth and deeper connection rather than loss.

Online and In-Person Therapy Support

Many women find online psychosexual therapy accessible during busy or difficult times, while in-person sessions may offer more personalised support. Both formats are effective in addressing menopause-related intimacy concerns.

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Conclusion:

Menopause can bring challenges, but it does not mean the end of sexual intimacy. With the support of psychosexual therapy, women and couples can address changes openly, restore confidence, and find new ways to enjoy closeness and pleasure.

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