One of the biggest, and most difficult, topics to unpack on the journey is the role of intimacy in a relationship. Overall, any relationship, when adding in all the complexities of menopause … It’s no surprise that many women find it almost impossible to navigate the difficulties of an intimate relationship during the menopause, and afterwards.

Menopause myths busted

1. Women lose interest in sex – some may, many don’t, some find their sex drive actually increases. There is no rule that says a woman won’t want to have sex during or after the menopause.
2. Sex is always painful after the menopause – many women find that the loss of oestrogen can lead to vaginal dryness and discomfort, which in turn makes it more likely that they will experience irritation or damage to the vaginal lining. However, this isn’t inevitable. Some women find lubricants are all they need, whilst others discover that local hormone replacement therapy (HRT) treatment replaces the vaginal oestrogen, making sex fun again. And local HRT (pessary, cream or tablet) doesn’t carry the same risks as general HRT, so it’s a much more appropriate option for many women.
3. It’s normal to go off sex at a certain age – sexuality, and sexual behaviour, wax and wane as we go through life. We probably won’t be having the same sex in our sixties that we had in our twenties, but we’re not wearing the same clothes or driving the same cars either! Developing a loving physical relationship where you and your partner can explore what sex means to you today is key, not just to great sex, but also to being comfortable in your own skin and happy together.

Sex and intimacy – a plaited thread

It’s vital to understand that many women have been fed another dangerous myth, which is that you ‘shouldn’t lead a man on’ and it’s ‘not fair to start something if you can’t finish it’. This can lead to many heterosexual women rejecting any form of intimacy because they are worried that they may upset their partner. Nothing could be less true. Physical, emotional and sexual intimacy are three different things that cross over and interweave and during the menopause most women, and their partners, need more intimacy, not less, to support them as they walk through a demanding period of their lives.

• Physical intimacy can be a simple as stroking a pet, hugging a friend or having a massage.
• Emotional intimacy is the act of sharing information about life, how you’re feeling and what’s going on or even just telling a joke and laughing together.
• Sexual intimacy may, or may not, include penetrative sex but definitely does include meaningful touch, physical pleasure and – often but not always – orgasm.

These three forms of intimacy weave together, and the ability to move from one form of intimacy to the other is a hallmark of a healthy, mature relationship. While we may often be tired, not happy with the way our bodies look or perform, and troubled by other symptoms of the menopause, we’re not machines that can turn our reactions on or off – and nor are our partners.

The key to finding the right balance of sex and intimacy is to communicate clearly, have realistic expectations, engage with your support network (the HRT forum is full of support and ideas) and explore new ways of expressing your affection that might help you, and your partner, both feel confident about yourselves, your bodies and your relationship.