Why Midlife May Be a Woman’s Sexual Prime

July 29, 2025

A middle aged couple together on their bed

Midlife and beyond can feel like a time of renewed sexual freedom. “There are many reasons that menopause can improve sexual satisfaction,” says Rachel Pope, MD, an OB/GYN at University Hospitals.

“The lack of periods and no more concerns about pregnancy can be liberating and reduce stress around intimacy,” she says. “Some women experience increased libido simply for these reasons, but libido can also increase with menopause changes in general.”

Midlife Changes and Challenges

It’s a time of empowerment that brings greater confidence and self-awareness. “Many women feel like they know themselves. They know what they want and they don't settle for less than that,” says Dr. Pope. “They may also have more time to spend on themselves than before.”

Some of the changes to the body that come with aging during perimenopause and menopause can put a damper on sex. The good news is a variety of treatment options exist if women reach out for help:

Genitourinary syndrome of menopause (GSM): “Many women will experience vaginal dryness or urinary tract infections (UTIs) for the first time,” says Dr. Pope. “These are treatable symptoms. Vaginal estrogen is safe for most women as long as there is no uterine bleeding. It’s a relatively easy medication to use that will improve moisture and sensation.” There are also other hormonal and nonhormonal treatments that may help relieve GSM symptoms.
Low libido: Another common symptom is the loss of sex drive. “Many women experience decreased desire in midlife,” says Dr. Pope. “There are effective hormonal and nonhormonal treatments for this, too. If your health care provider does not offer these treatments, ask to be referred to a sex medicine specialist.” A specialist can also help identify psychological factors that could be contributing to low sexual desire and refer you to specialized counseling.
Difficulty achieving orgasms: “Orgasms can become muted or more challenging to reach after menopause,” says Dr. Pope. If this is a symptom you experience, she suggests scheduling an appointment and a physical exam with a sex medicine specialist. “There are some physical changes that can occur throughout a woman's life that can decrease sensitivity to the clitoris, which can be evaluated and treated.”

4 Tips for More Sexual Satisfaction

Whether or not you’re having partner sex, taking some time for solo exploration can be beneficial. “In addition to helping you learn what feels good, orgasms release endorphins and are good for your health,” says Dr. Pope. They can help relieve pain and stress, strengthen pelvic floor muscles, help with heart health, and improve mood and sleep.

Get to know your midlife body better. “Take the time to focus on your body and learn what feels good on your own,” says Dr. Pope. This may include exploring different kinds of stimulation, including with a vibrator and in other ways, that can help build arousal and enhance orgasms.
Don’t ignore your clitoris. Dr. Pope emphasizes that 80 percent of women reach orgasm through clitoral stimulation. “It’s not how the movies tend to show it with the main focus on vaginal penetration,” she says.
Practice healthy lifestyle habits. Other ways to increase sexual satisfaction include maintaining a physically active, healthy lifestyle; a balanced diet; and getting your annual exams. Health conditions like diabetes and hypertension affect the blood vessels and nerves, which can affect the genitals as well. It’s best to prevent them, if possible, or work with your healthcare team to manage them.
Take care of your mental and emotional well-being. Getting enough sleep; managing stress and anxiety; socializing; engaging in activities you enjoy; and making time to relax can all help boost your mood. When you feel good, it can contribute to greater sexual pleasure.

Improving Midlife Sex With a Partner

If you’re in a relationship that isn’t satisfying you sexually, don’t lose hope. There are things you can do to get your sex life back on track.

“Both women and men might experience changes that negatively affect their sexual experience,” says Dr. Pope. “Up to 50 percent of women will notice vaginal dryness and pain with penetrative intercourse and many men will experience erectile dysfunction.”

It’s important for partners to share what they’re going through. “Communication is key,” says Dr. Pope. “Talking to your partner about your sexual health should be like talking about any other aspect of your health.” Having open conversations helps decrease stigma and normalizes any issues that may come up. It’s also an opportunity for you to show your support for one another.

If you have trouble discussing the subject with your partner, or if they’re unwilling to talk about it, Dr. Pope suggests seeking help from a sexual medicine expert who can diagnose the situation and make it easier for the two of you to address it and get the treatment and support you need.

Looking Ahead

Many people enjoy a satisfying sex life well beyond their childbearing years. “Something that sets humans apart from other mammals is that sex is not always about reproduction,” says Dr. Pope. “These organs are there and functioning, you can still use them!”

She has many octogenarian patients, and even a couple of 90-something-year-old patients, who are sexually active and happy, she says. “The intimacy that my patients find with each other strengthens their relationships and bonds.”

But she also points out that it’s common to experience more physical problems with age that can impact sexual well-being. If sex is no longer a part of your life, or it's not an important part anymore, that’s okay too. It’s nothing to feel bad about, says Dr. Pope. “I just want people to know that it can be an active part of most people’s lives if they want it to be, and that treatments and support are available.”