Sex during perimenopause changes for everyone. We dive into the often-silent topic of midlife intimacy with sex therapist Nisha McKenzie, who helps us understand why our desire shifts and what we can do about it.
• Changes in libido are normal and common during perimenopause
• Estrogen decline affects vaginal tissue, causing dryness, pain, and thinning
• Vaginal estrogen treatment can help with physical symptoms without systemic effects
• Communication is more important than hormones for maintaining intimacy
• Non-demand touch helps maintain connection without pressure for sex
• Building a "third relationship island" instead of one partner always accommodating the other
• Testosterone therapy can help with libido for some women, but won't fix relationship issues
• Our society fails to teach healthy sexual communication, especially for women
• Pain during sex is not normal and should be addressed, not tolerated
• Sexual desire doesn't end after menopause - many women experience increased freedom
Join us in The Pause Diaries Facebook group - a private space where almost 700 women share stories and support each other through perimenopause and beyond.
Loved this conversation? Let’s keep it going.
Join our private Facebook group, The Pause Diaries, where we dive deeper into all things perimenopause and menopause—without judgment, just real talk.
If this episode inspired you, share it with a friend or colleague. And don’t forget to subscribe, rate, and review The Pause Podcast—your support helps us bring more expert voices to the table.
Got a story, symptom, or question? Send it my way at by posting it our Facebook Group The Pause Diaries that supports the podcast.
I just might feature it in an upcoming episode!
Until next time, stay curious, stay empowered, and never hit pause on your wellbeing.
