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Sex & Menopause

The world has been sending me messages that y'all are curious about sex and menopause and peri-menopause. I've received multiple emails about it, it came up in two recent classes, and Joan Price just dropped a good piece about sex and aging in Queer Majority.

Peri-Menopause and Loss of Desire

I received this inquiry after my #SexTalkTuesday event on Twitter. Some details have been obscured to protect the original writer's identity.

Dear Auntie:

Ref: Menopausal spouses.

I am 56 and retired. My wife is 54 and still works. We have been married almost 30 years. We have three adult children. One is currently living at home and the other two are out on thier own.

My wife's desire has decreased over the past year. She doesn't want to go the the doctor because she believes they will "just tell her to lose weight." She has started taking the following supplements: 

1. Super Collagen Super Collagen + C Supplement Tablet

2. Estroven Menopause Relief Weight Management Capsules

3. Vitamin D

4. Vitamin B2

5. Women's Libido Enhancer Supplement with Horny Goat Weed, Maca Root, DHEA - 30 

Our Christmas presents to each other were Planet Fitness memberships.  We make sure the other one goes.  On days we don’t get to the club, we take the dog around the neighborhood.

She has pretty much cut carbs out of her diet.  Since I’m the retired one, I usually cook dinner.  With both of us from Minnesota meals are very “meat, potatoes, and vegetables.” I’m trying to cook new things, healthier things.

I think we have all the physical things that we can do, taken care of.  Its the mental that frustrates me.  The lack of desire.  Outwardly, physically she seems to be good.  It’s what’s going on in her head that I can’t figure out.

Any help is good help.

Supplements and Vitamins

Thanks for reaching out.! There are a lot of things which can impact a person's libido in their 50s. Physical health is part of it. Mental health is part of it. Social and cultural institutions also impact desire.

I see you listed that she started taking a variety of supplements designed to increase libido and address weight concerns. Do you know what triggered this? Is it a desire to lose weight because she thinks it's "unhealthily"? Was there a loss of desire?

Vitamin D is generally safe and is a good supplement for women since it helps increase calcium absorption to prevent bone loss.

Collagen supplements can be helpful for some people. There is a lot of unknowns about their effectiveness and since they are supplements, there is no required testing to make sure they actually contain what they claim to contain. A recent study shows that short-term benefits using collagen for wound healing and increasing skin elasticity is promising, but more research is needed.

Collagen is in connective tissues and skin. Thinning skin can be a cause for concern as people age, as well as hair loss and nail strength. Topical treatments like lotions with hydrolonic or salicylic acids also improving texture and suppleness of skin. I live with schleroderma (thicking skin and other issues). I find lotions with uric acid very helpful in keeping skin soft and supple.

I'm also a huge fan of The Ordinary's squalane facial products. I found it did a lot to improve the texture and hydration of my face.

The libido enhancer has some helpful supplements. Maca root and DHEA have both been proven to improve sex drive in all genders. DHEA is a precursor to all sex hormones (testosterone, progesterone, estrogen). These hormones decrease significantly in the 50s so adding the supplement can be helpful. A bit of a warning. It can impact blood sugar levels, liver issues, and trigger mania in people with Bipolar disorder. If any of these is a concern, slowly titrate onto the dose and pay attention to how your body responds. DHEA can also have serious interactions with certain prescription medications. Be sure to check the list of medications which are contraindicated with DHEA.

Maca root has been shown to have slight positive increases in sexual desire for menopausal and perimenopausal women. There is a lot more study needed to see if this bears out over time with larger study populations.

B2 is generally a safe supplement and helps with energy levels for some folks.

As with all supplements, its a good idea to check with a health professional about their use.

Vaginal Lubrication and Thinning

If she is having difficulty with vaginal lubrication, there are several options. Lube is always a great addition. Even when self-lubrication isn't an issue, adding lubrication to sex can make things feel better for everyone. I recommend that most folks use it like white people use mayo- on everything and way more than you think is necessary!

I love Sliquid as a manufacturer. Their lubes are very hypoallergenic and safe for nearly everyone. They stay slick. AND... they don't stain sheets. There are lots of options for types of lubes offered here.

If she is experiencing vaginal thinning (sometimes called vaginal wall atrophy) which can cause pain during penetration, I suggest giving Quim a try. In includes CBD (the non-psychoactive ingredient in marijuana). It helps the vaginal muscles relax and reduces pain along with providing lubrication. I recommended it to my 72 yo mom and 65 yo aunt and they now swears by it.

Weight Loss Concerns

I notice that a lot of the supplements and life style changes are tied to the goal of weight loss. If her weight is a concern to her, it may be adding to feelings of being unsexy. As we age, our bodies change. Weight gain is common for folks in middle age. We are inundated with messages that we must be thin and young to be desirable. When we don't look like what we think we should we can feel shame, grief, embarrassment and other emotions which lead us to withdraw from intimacy.

If weight is contributing to her loss of intimacy, talk about it. If you can tell her how you see her, that you still desire her, and that you may even find the changing shape of her body sexy that can really help. It can be hard to talk about weight since it is a very fraught issue for many of us. But being open about what you have noticed about her desire to lose weight, loss of sexual desire and how you still really find her sexy can open a door to talking about those deep feelings.

Second, most of the messaging about weight and health has no medically supported research. The vast majority of "health problems" associated with weight gain can be explained by one of two things, 1) medical discrimination against fat patients, and 2) yo-yo dieting. Intentional weight loss with the nearly universal regaining of weight (95% of people who lose weight through dieting and exercise will regain it all or more within 5 years). It is this cycle of diet - weight loss- regaining weight due to your body adjusting to restricted calories/exercise that causes the most bodily harm. There is no disease which is exclusive to higher weight people.

The weight loss industry is a $73 BILLION (with a B) profit industry in the United States alone. They are spending billions to convince people that weight loss is necessary and existing in a higher weight body is unhealthily. If you want a good break down on medical studies and stats around weight and health, check out Ragan Chastian's Weight and Healthcare newsletter.

Its hard to feel sexy if you don't see people who look like you as sexy. Changing your social media to follow people who look like you (in their 50s, similar weight, other physical features) can help people feel more comfortable in their bodies. This in turn helps them want to engage in sex. I love following folks who celebrate being fat and middle aged because I feel better about myself! Check out my Instagram @FatChicksOnTop. I follow a ton of great folks on that site.

Loss of Spontaneous Desire

Sometimes loss of desire is a loss of spontaneous desire. We tend to think that sex needs to "just happen." Like you get inspired while watching TV and start making out. As we age as well as folks in long-term relationships tend to lose this spontaneous desire. When we start to carve out time for sex and masturbation, we find the old "spark." I know scheduling sex can sound awful! However, if you make a commitment that once a week you will take some time to be intimate, this can help grow intimacy again. Some nights may just be kissing and making out. Other times, try mutual masturbation. Sometimes it will be sex. Most folks in their 50s won't "be in the mood" when you start but 5-10 minutes in, people tend to be like "OMG! I'm glad we started this!"

Also, sex releases a whole bunch of brain chemicals which make us feel good. When these dissipate, we will want them again for a bit. The more you have sex or masturbate, the more your desire will grow and the more you will sex out sex or masturbation. Encouraging her to masturbate on her own will ultimately benefit both of you.

My favorite toy for most people with a vulva is the Fun Factory VIM wand. It is designed to fit a huge range of body types, is great for bigger bodies and disabled bodies, and has a nice rumble. I have 20+ wands people have sent me and this is the one I keep in my bedside drawer.

Also, consider reading Come as You Are by Dr. Emily Nagoski. Its a great (and science-based) explanation of desire, aging, and sex. Dr. Nagoski has a new book out, Come Together, which has wonderful reviews. I have yet to read this one, so I can't say for sure.

Final Thoughts

I hope some of those help. I am available for individual and couples coaching as well. Here is a link to my site and services:


Auntie Vice


Do you have a question, comment, or feedback? Feel free to email me at

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