Perimenopause – The Effects On Your Sex Life

Perimenopause can cause physical and emotional side effects that interfere with a healthy sex life. This happens in the years before periods stop and is characterised by hot flashes and other symptoms. Menopause begins when the menstrual cycle has stopped for at least a year.

While every woman’s experience is different, an estimated 17- 45 percent of Perimenopausal women say sex can be painful. Luckily, there are options to help treat the most common complications. In this piece, I am looking at perimenopause effects and some helpful treatments.


Physical Effects

During perimenopause, the hormones that bring about fertility and pregnancy decrease, including the hormone estrogen. This results changes in the blood vessels and tissues of the vagina and vulva, making the organs more susceptible to damage.

Most sexual complications at this stage, stem from vulvovaginal atrophy, a condition manifested by severe dryness, a loss of elasticity, and thickness of the vulva and vaginal tissues. The physical changes here can vary from woman to woman and usually cause some emotional side effects as well.

At this stage tissues of the vagina and vulva receive less estrogen. As a result, these tend to thin, lose their folds, and dry out. Thinner tissues are more easily broken, bruised, and irritated. Here, the woman becomes scared of intercourse; which can put stress on her relationship with her partner and even put her in a state of depression. The tissues also receive less lubrication, which intensifies the friction they are exposed to during intercourse, so increasing the risk of damage.

Other Physical Symptoms May Include:

Decrease in vaginal tone or loss of stretch in the vaginal wall

Pain, bleeding or burning during sex

A feeling of tightness during intercourse

Decreased libido or sexual drive

Difficulty becoming or staying aroused

Repeated urinary tract infections

Some women also experience atrophic vaginitis, which causes inflammation of the vaginal tissues. Again, atrophic vaginitis stems from reduced estrogen levels and can cause pain, swelling, itching and burning.

Not all women see the same physical changes during perimenopause, and the severity of symptoms can vary. It is recommended that women see their doctor if symptoms begin to affect their daily life or diminish the quality of life.

Emotional Effects

The physical symptoms of perimenopause can cause emotional side effects too. Changing hormone levels can interfere with sleep and mood, causing tiredness, anxiety, irritability, and depression. Decreased sex drive or inability to enjoy sex can also lead to loss of self-esteem and intimacy.

What perimenopause represents can also cause emotional problems. These side effects are just as debilitating as physical effects, especially when it comes to sex. During times of stress or sadness, people often lose interest in activities that would otherwise bring them pleasure. In this respect, pain and discomfort can make it difficult to enjoy sex.

Many of the physical changes that occur with aging can also intensify the emotional symptoms of perimenopause. If sexual arousal or sensitivity is also affected, some women will shy away from sexual activity altogether, which can worsen symptoms.

The Most Common Emotional Side Effects May Include:

Anxiety, nervousness, or uncertainty


Lack of concentration and motivation


Depression or sadness

Sense of loss or regret

Loss of sexual desire or interest

Loss of self-confidence

Loss of intimacy

Feelings of worthless or helplessness.

Results of one survey found that, 70 percent of Perimenopausal women who experienced pain during sex said the problem also caused tensions with their partner; and in their relationship.

Not all women experience negative emotional symptoms linked to perimenopause. Some women gain additional wisdom, confidence, and ability to speak for themselves. Those who do experience negative symptoms should talk to a doctor or a counsellor, if they interfere with healthy sexual activity or everyday life.

Reducing Sexual Complications

The sexual complications of perimenopause may be helped by maintaining an active sex life. Staying sexually active is one of the easiest ways to lessen the sexual complications of this condition.

The physical and emotional side effects of perimenopause cause many women to reduce or refrain from sexual activity. However, the vagina needs consistent use to remain healthy, especially during this life transitioning phase. Regular sexual stimulation helps promote blood flow to the vagina.

Over-the-counter products and behavioural changes are often the first recommended treatments. In worse cases, a doctor may prescribe hormone therapies to help reduce severe vaginal dryness or hormonal creams to apply to the tissues.


Tips and Treatments For Sexual Side Effects:

Regulating or reducing stress through exercise and therapies

Engaging in regular sexual activity

Vaginal lubricants applied before intercourse

Using lukewarm versus hot water for cleansing

Vaginal moisturisers applied regularly and before intercourse

Avoiding detergents, soaps, oils, or washes that can cause vaginal dryness

Increasing foreplay or activities that promote sexual arousal

Engaging in couple bonding or strengthening activities

Talking to a therapist or counselor

Finding ways to rekindle passion or repair partner relations

Trying new or varied sexual activities

Treating vaginal irritation, infections, and inflammation

Keeping hydrated

Avoiding materials that irritate the skin

Treating Sexual Complications

Approximately 55 percent of women do not seek medical treatment for Perimenopausal symptoms.

For some women, however, these symptoms are powerful and persistent, so medical treatment is advised. Doctors may prescribe medications or creams that are composed of estrogen, progesterone, or both.

Individual treatment plans depend on a variety of factors, including additional health complications. Women who have undergone a hysterectomy will not require extra progesterone.


Although many herbs and spices are praised as cure-alls for menopause symptoms, care must be taken in the selection made; as your body is at a crucial point in the “change of life” process. Other lifestyle and non-communicable illnesses, such as diabetes, heart disease and hypertension may surface. Therefore care must be taken in the selection of and suggestion of herbal treatments. You may also consume the foods that are derived from some of those herbs and spices; in recommended servings. For example ginger and turmeric are easy to use and consume in healthy additions to your meals, juices and shakes.


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