‍

Key Takeaways

‍

Is there a "normal" sexual frequency during menopause? Not at all! It depends on what works for you and your partner.

Why does libido change during perimenopause and menopause? Declining estrogen causes vaginal dryness, pain with intercourse and reduced sexual response.

‍What can help? Sexual health depends on multiple factors: solutions may include medical treatment, lubricants, pelvic floor therapy and relationship support.

‍The bottom line: You can definitely improve those unexpected changes in desire and sexual function with the right approach.

‍

‍

What Is a "Normal" Libido?

‍

When it comes to sexual frequency and other libido changes related to menopause, the answer isn't always what you'd expect. 

‍

Years ago, a woman came to my office frustrated. She told me her libido had dropped by half. To her, that meant she was having sex only half as often as before. 

‍

So we dug into it—discussing common menopause and perimenopause symptoms like vaginal dryness, pain with intercourse, and difficulty with orgasm. 

‍

We evaluated everything. Then I paused and asked: 

‍

"How many times per week are you actually having sex?" 

‍

She answered: "Seven times." 

‍

She and her partner were having sex 2 to 3 times a day, sometimes more on weekends. This had been their routine for years.

‍

Well damn! Now I had a whole new set of questions. 

‍

How do you find the time? 

‍

Is this insertional intercourse? 

‍

Are there snack breaks? 

‍

I mean, wow! Good for her!

‍

But this story raises an important question: when is sexual frequency too little or too much?

‍

The Real Answer: It Depends on You

‍

Here's the truth—and it's liberating: how much sex is "normal" comes down to one thing: does it bother you (and your partner)? 

‍

If a couple is having sex once every two weeks and both are satisfied and happy with this frequency, that's completely normal for them. If it's daily, fantastic—keep going. 

‍

But if there's been a change in sexual frequency that bothers you or strains your relationship, that's when we need to have a conversation.

‍

Sex and libido are complicated topics, deeply individualized for each person and partnership. This is especially true during perimenopause and menopause, when hormonal changes can significantly impact sexual desire, pleasure, and pain with intercourse.

‍

Why Sexual Changes Happen During Perimenopause and Menopause

‍

Perimenopause and menopause bring real physical changes that affect sexual health. 

‍

Declining estrogen levels can cause vaginal dryness, reduced blood flow to the genitals, thinning of vaginal tissues, and changes in sexual response. These factors often lead to pain with intercourse (dyspareunia), difficulty with orgasm, and decreased libido. 

‍

It's not in your head—it's biology!

‍

What Most People Get Wrong

‍

Patients often come looking for a quick fix. They want a pill, a cream, or a simple solution. But here's the reality: sexual function and libido are multifactorial. There's rarely just one cause or one cure.

‍

Sometimes fixing libido and sexual health is a team sport. You might need your partner, a sex therapist, pelvic floor physical therapy, your OB/GYN, and possibly a mental health therapist—all working together. This might sound overwhelming, but it means you have multiple avenues for support. 
‍

‍
And what about the other symptoms of perimenopause? You can’t sleep. You worry about your hair loss and that your partner may find you unattractive? You have a frozen shoulder, which hurts in certain positions. Your mood is constantly swinging! Some of these issues need to be addressed as they can definitely influence your libido.

‍

The First Step: Getting the Full Picture

‍

Our approach starts with understanding your specific situation. We assess:

‍

• Your baseline sexual frequency and what feels right for you
• Your expectations for your sexual relationship
• Changes you've noticed (especially related to perimenopause or menopause)
• Physical symptoms like vaginal dryness, pain with intercourse, or difficulty with orgasm
• Relationship dynamics and your partner's perspective
• Whether this is actually a problem—and for whom

‍

This last part matters. Sometimes a decrease in libido bothers the partner more than the person experiencing it. Understanding whose problem this is helps us create a realistic plan that works for your relationship.

‍

Setting Expectations and Getting to Work

‍

Let's be honest: sex is work. So is fixing sexual concerns. There needs to be realistic expectations and homework. Whether it's using lubricant for pain with intercourse, scheduling intimacy, doing pelvic floor exercises, adding medications, trying new sex toys, or addressing relationship issues, solutions require commitment.

‍

But here's what I know from years of working with patients navigating perimenopause, menopause, and sexual health challenges: this is solvable. It takes understanding, partnership (sometimes literally), and realistic expectations—but you can get back to a sexual life that feels good for you.

‍

So let's work together and fix this problem. Your sexual health and satisfaction matter, and you deserve support in addressing it.

‍

Book a 15-min FREE virtual consultation with us to see if we’re the right fit for your menopause care.

‍

And don’t forget to visit our Services page to explore our perimenopause and menopause care packages!

‍