Sex in Midlife: Getting Back Into It

Maybe you’ve done all the “unsexy” things we talked about in the last installment. You’ve stocked the nightstand with lube. You’re treating the vaginal dryness or pain during sex. You’ve even tried scheduling intimacy instead of waiting for spontaneous desire to strike.

But there’s another part of getting your sex life back that’s harder to put on a to-do list: actually wanting to be intimate again.

Maybe you miss feeling close to your partner, but lately you find yourself hoping they fall asleep before you get into bed. Maybe the second a kiss starts to feel like it could lead to sex, your body tenses. Or maybe sex has hurt enough times that you’ve started avoiding physical affection altogether out of fear it will lead to penetration.

According to Alloy’s own survey data, 37.1% of women ages 35 to 59 say changes in desire sometimes bother them, while 23.8% say they actively do. Another 28.6% say they’ve made peace with those changes. Finally, 9.5% of respondents say their lack of desire is a relief.

That disconnect can be confusing, especially if you still love your partner, find them attractive, and miss having sex with them. But missing that connection and feeling physically or emotionally ready for sex aren’t always synonymous.

"One of the most confusing parts of midlife is thinking, 'I still love you, I'm still attracted to you, so why don't I want sex?'" says Dr. Kate Schuh White, a board-certified menopause and sexual medicine specialist. "Emotional connection and sexual desire overlap, but they are not the same system."

As we covered in the first part of this series, declining estrogen can change your vaginal and vulvar tissues, blood flow, genital sensation, and orgasm. In the second, we tackled some of the admittedly unsexy but effective ways to work with those changes and make sex feel better.

But comfortable sex and connected sex aren’t always the same thing. This final installment tackles that missing piece: how to reconnect when your body, desire, relationship, or life has changed.

You May Need to Focus on Connection Before Desire

You and your partner may experience intimacy differently. For many men, physical intimacy can be one of the ways they get to emotional closeness. For many women, particularly in long-term relationships, feeling emotionally close, relaxed, and safe may help create the ideal conditions for physical desire.

Keep in mind that this isn’t a universal rule for either gender. But it may help explain why one partner is thinking, If we had sex, we’d feel closer, while the other is thinking, I need to feel closer before I want sex.

There’s also something called responsive desire. Unlike spontaneous desire, where you feel horny seemingly out of nowhere, responsive desire can develop after intimacy has already started. For instance, you might feel excited to be intimate after talking with your partner, cuddling on the couch, or kissing for a while.

In fact, researchers have suggested that this responsive pattern can be an important part of women’s sexual response, particularly in long-term relationships.

So instead of making the goal “I need to want sex more,” start smaller. Think: When do you feel closest to your partner? What helps you transition out of work, caregiver, or parent mode? What kinds of physical affection feel good when there’s no expectation that they have to lead anywhere?

Your Sex Drive Isn’t Your Identity

When your sexual response changes, it can kick off a surprisingly deep identity crisis in some people. Think about it: If sex used to feel easy or you used to crave it without putting much thought into it, suddenly losing that familiarity can leave you wondering: What happened to me?

And it’s okay if your libido does feel like an important part of who you are. Maybe you’ve always considered yourself a sexual person, and losing that desire feels like you’re losing a piece of yourself. That feeling is valid, but a change in desire doesn’t make you any less sexual or attractive, nor does it mean you’re somehow failing at your relationship.

Hormonal shifts, painful sex, sleep disruption, stress, medications, health conditions, and changes in your relationship can all affect sexual desire. Your body may also require more time or a different kind of stimulation to become physically aroused than it did 10 or 20 years ago.

And remember that desire, arousal, and orgasm aren’t interchangeable. You can mentally want sex as your body is slow to become aroused. You can become physically aroused without initially craving sex. You can also experience changes in all three at once.

Alloy’s survey data revealed that 47.8% of women reported low or no desire during perimenopause or after menopause, making it the most commonly reported barrier to sex, ahead of factors such as vaginal dryness, body image, and difficulty reaching orgasm.

Midlife Has a Lot Competing With Sex

Midlife can be a uniquely crowded stage of life. You might be caring for an aging parent while still supporting your own children. Maybe one of those adult children has moved back home, and suddenly you and your partner have a lot less privacy.

You could be recovering from surgery, managing a chronic health condition, or taking a medication that affects your libido or sexual response. Even chronic sleep deprivation can make curling up with your pillow more appealing than having sex.

Your relationships can change, too. For example, maybe you’re dating after a divorce or becoming physically intimate with someone new after losing a longtime partner. Being naked with another person again may be both exhilarating and intimidating, as it calls for you to be vulnerable about your body and sexual response.

“Arousal and orgasm require focus, not high alert,” Dr. White says. “When estrogen falls and dopamine signaling shifts, it can be harder to quiet an anxious or distracted brain, and that follows you into the bedroom. You cannot orgasm while your brain is scanning the room for the next problem to solve.

All of these circumstances can affect intimacy. Ask yourself, what is making intimacy harder for me right now? You may find that the answer is physical, emotional, or both. 

Have the Conversation You’ve Been Avoiding

When you start pulling away physically, your partner may notice without understanding why. This may cause them to spiral unexpectedly, wondering whether you’re still into them. 

At the same time, you might be thinking, “I love you, but I’m exhausted!” Or, “I want to be close to you, but I’m worried our cuddling will turn into sex, and that hurts me right now.”

When nobody says those things out loud, both people are left guessing. In some cases, resentment can build.

This conversation doesn’t need to start with how often you should be having sex. In fact, taking frequency off the table may make it easier to talk about what’s actually happening.

Consider starting this dialogue by saying: “I love you and miss feeling close to you, but my body is going through some real physical changes right now that make sex uncomfortable. I want us to figure out how to navigate this together.”

Or maybe even: “It’s not that I don’t want to be intimate with you. My body has completely different needs now when it comes to sex. Can we slow things down and focus on our connection first?”

And if sex has become painful or pressure-filled, you can take the expected outcome away altogether without sacrificing affection. You might say something like: “I want us to get back to a place where intimacy feels good for both of us. Can we take sex off the table for a little while and just focus on touch?”

That last approach can be especially helpful if you’ve started associating physical affection with an obligation to have sex. If every kiss, back rub, or cuddle feels like the opening act to intercourse, you may eventually start avoiding those things, too.

Getting Back Into It May Mean Getting Help

Emotional connection matters, but so does a physical or medical issue that needs to be treated.

If your vaginal tissues constantly feel dry or irritated, you’re having trouble becoming physically aroused, or your desire has changed in a way that bothers you, these are all valid reasons to talk to your doctor.

That may mean treating genitourinary syndrome of menopause (GSM), so penetration stops hurting. It could mean exploring whether a medication is affecting your libido. Maybe you need more direct clitoral stimulation or support for physical arousal. Or perhaps desire itself is the symptom you want help addressing.

There isn’t one prescription for “getting your sex life back” because there isn’t one reason people lose it in the first place.

Remember the biology behind changes in your orgasm, sensation, blood flow, and vaginal tissue health? How about the practical stuff that followed, such as using vaginal estrogen when appropriate, reaching for lube before sex hurts, making time for intimacy, and telling your partner what your body needs?

Estradiol Vaginal Cream

$119.97

3-month supply

Effective relief for vaginal dryness, itching, burning and the prevention of frequent UTIs.

Start Now

Now comes the part you can’t necessarily solve with a tube of lube or an appointment on your calendar: reconnecting. That might mean treating pain. It might mean giving your body a longer runway to become aroused. It could mean rediscovering nonsexual touch with someone you’ve loved for decades or figuring out what intimacy looks like with someone completely new.

The bottom line is this: You don’t have to force yourself back into the sex life you used to have. And, importantly, you can build a new sex life that fits the body, relationship, and life you have now.

Frequently Asked Questions

Why do I love my partner but still lack a desire for sex?

Emotional connection and sexual desire rely on separate systems in the body. Declining estrogen, stress, sleep disruption, and midlife responsibilities can lessen physical desire even when you love your partner and find them attractive. In long-term relationships, desire often becomes responsive rather than spontaneous, meaning it develops after intimacy begins—such as through talking, cuddling, or kissing—rather than striking out of nowhere.

How can I stop avoiding affection if I am worried it will lead to painful sex?

Open communication with your partner is key, including taking sex off the table entirely for a while so physical touch does not feel like an obligation. Removing the expectation that affection must lead to penetration allows you to enjoy nonsexual physical touch without fear or pressure. You can explain to your partner that your body is navigating physical changes and ask to slow down to focus on connection first.

When should I speak with a doctor about midlife changes in my sex life?

You should consult a doctor if changes in your desire bother you, if sex is uncomfortable or painful, or if you experience constant vaginal dryness, irritation, or difficulty becoming physically aroused. A medical provider can evaluate whether treatments for conditions like genitourinary syndrome of menopause (GSM) are appropriate, check if current medications are impacting your libido, or provide options to support desire and physical arousal.

References

Davis, S. R., Baber, R., Panay, N., et al. (2019). Global Consensus Position Statement on the use of Testosterone Therapy for Women. Maturitas, 128, 89–93. https://doi.org/10.1016/j.maturitas.2019.07.001Cited by: 622

Salvatore, S., Ruffolo, A. F., Phillips, C., et al. (2023). Vaginal laser therapy for GSM/VVA: where we stand now – a review by the EUGA Working Group on Laser. Climacteric, 26(4), 336–352. https://doi.org/10.1080/13697137.2023.2225766Cited by: 42

Shifren, J. L., Monz, B. U., Russo, P. A., et al. (2008). Sexual Problems and Distress in United States Women. Obstetrics & Gynecology, 112(5), 970–978. https://doi.org/10.1097/aog.0b013e3181898cdbCited by: 1916