Not a Sexual Dead-End: Sexologist Dr. Jess Talks Pleasure in Mid-Life

Our relationship with sex is in constant flux, evolving as we gain sexual experience and discover our innate sexual identities and desires. Sexuality is an eternal unfolding—one with no wrong or right answers, just ones that are unique to you. 

Perimenopause, in particular, can usher in a new phase of sexual exploration or, alternatively, a wave of symptoms that make sex the last thing on your mind. 

“If you’re dealing with exhaustion, mood swings, hot flashes, sleeplessness, pain in the uterine and pelvic area, that’s going to affect your desire for sex,” says Dr. Jess. 

But that’s not to say perimenopause is a sexual dead end. Rather, according to Dr. Jess, it can be an opportunity to reflect on your sexual values and cultivate your ideal sex life. 

While perimenopause symptoms—including a sudden lack of sexual desire—can be challenging, they’re road bumps in a more expansive journey towards mid-life and a renewed sense of sexual freedom, whether that looks like discovering new erogenous zones or deciding sex is indefinitely off the menu. 

With expert insights from Dr. Jess, we’re exploring the possibilities for pleasure in perimenopause. 

What’s Going on With My Sex Drive?

So, you’re hot, moody, and exhausted. It’s not exactly a mystery that sex isn’t at the top of your to-do list. At the same time, it may be alarming to feel less in touch with your sexual side than usual—and you’re certainly not alone on that front. 

“What we see is that oftentimes desire decreases or disappears altogether,” says Dr. Jess. “I hear from people that they’ve always enjoyed sex, had desire, and for it to just disappear into thin air feels so overwhelming.”

Other symptoms, like flash periods or vaginal dryness, can also curb your desire to do anything penetrative. Your mood and sense of self, too, can feel precarious during this transition. 

But the important thing to remember is just that: it’s a transition. Once you’ve identified your symptoms, according to Dr. Jess, you can seek a number of different treatments and solutions—from pelvic physiotherapy to lubrication. 

Once pain or discomfort is mediated, you may find there’s more space to reimagine sexual desire.

Wait, There Are Different Kinds of Sexual Desire?

Desire can take many forms. It can feel like a red-hot flicker, a carnal urge. Or, it can feel like a gentle flame, one that needs to be fanned and tended with care. It can also be up-down, and everything in between. 

“At various points [in] our lives, we experience desire differently,” says Dr. Jess. “It’s not as though everybody who hits perimenopause experiences a loss of spontaneous desire, but it’s not uncommon.” 

What she’s referring to is the distinction between spontaneous desire and reactive desire. Though for most, the decrease in spontaneous desire usually occurs before perimenopause, especially for those in long term relationships. 

Though desire is more of a spectrum than a dichotomy, the distinction between spontaneous and reactive desire can be helpful in cultivating an active sex life. 

“When we talk about spontaneous desire, we’re referring to desire that just happens,” according to Dr. Jess. “When we talk about responsive desire, we’re talking about desire that doesn’t just pop up on its own—you do something to get aroused first, then desire follows.”

Reactive desire can mean asking your partner to do that thing you like, or reaching for a toy to see if that inner flame ignites. 

Why Is it Important to Cultivate Sexual Values?

When Dr. Jess uses the term sexual values, she’s referring to what sex means to you. Sex is multi-dimensional and encompasses the physical, emotional, relational, spiritual, and beyond. 

Whether in perimenopause or not, for Dr. Jess this is a standard starting point with clients.

“When we talk through your sexual values, [you might be] fine with the fact that you don’t have sexual interest right now,” she says. “Or, you might be like, sex is a huge part of my life and I want to find a new way to experience pleasure—and there are many new ways to experience pleasure.”

Dr. Jess also points to misconceptions surrounding the necessity for sexual desire. “If you have no desire for sex and you feel fine about having no desire for sex, that’s also cool,” she says. 

She also recommends tuning into what comes to mind when you think of pleasure more generally. Orgasms are great, but what else brings you pleasure? It could be food, dance, wine, or your favorite indulgences. 

Your relationship to sex is for you to define. “When it comes to sex itself,” says Dr. Jess, “I think [perimenopause] is an opportunity to really tune into what sex means to you. 

How Can I Access Support? 

As with any life-impacting transition, support is key. “Look specifically at what symptoms you’re experiencing and consider what your options are,” says Dr. Jess. 

If you’re experiencing night sweats and insomnia, that’s an opportunity to check in with your healthcare provider. If you’re dealing with pelvic pain, dryness, or painful penetration (even with lots of lube) you may want to check-in with a pelvic floor physiotherapist. 

“If your healthcare provider is dismissive and isn’t treating you as a patient who’s dealing with perimenopause, then you might want to look for another option,” she says. Advocate for yourself and never shy away from getting a second opinion. 

She also calls attention to the importance of emotional support from partners. “I think it’s really important that our partners, regardless of gender, but specifically men, step up,” she says. “If you’re going to be in a relationship with someone whose identity is different [from] yours—so, in this case, perhaps gender identity— you have to do some work to understand how they move through the world.”

Everyone seems to have a baseline understanding of the significance of puberty, per se, yet the magnitude of menopause often remains obscured from the mainstream. “I think we need to see all the transitions in life,” says Dr. Jess. Which means: “we just need to talk about it.” 

The more we talk openly about perimenopause, get curious about its challenges and rewards, and shed the shame, the less people will suffer in silence. 

“There’s a shedding of shame, a shedding of responsibility,” says Dr. Jess. “I just think it’s so cathartic.”

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We hope you found this post informative—but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. 

We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.