By Dr Shahzadi Harper

After what could be years of being in a loving relationship, experiencing your bond crumbling due to hormonal changes seems unfair at best. And yet, as many of you will know, certain menopausal symptoms are often beyond our control – I’m talking about you, vaginal dryness.

A woman’s libido is a complicated thing, even before the hormonal meteorite of the menopause and perimenopause strikes. And now that research has proven that, contrary to previous belief, male and female libido is at least matched with some women reporting an increase as they get older, it is important to address issues that surround sexual well-being later in life and how that can in turn affect relationships.

“Grey divorce”, divorce among the over-forty-fives, is on the rise – whether this is due to infidelity, the children leaving home, or problems caused by menopausal change – what’s interesting is that over 60% of these were initiated by women. It’s figures like these that highlight the importance of reclaiming whatever territory we can when it comes to love, sex and happiness, be it to save the marriage, solve relationship issues, or pave the way to a better connection in the future.

Couplepause (my term) can be triggered by physical and mental factors and is often tied to the specific side-effects caused by the decrease in oestrogen production behind the menopause. Besides giving up caffeine and watching alcohol consumption – things that many of us do anyway – here are a few quick(ish) fixes  to help keep your relationship on track, for the men and the women.

  • Hot Flushes, caused by fluctuating hormone levels and their effect on the hypothalamus, which regulates temperature. The night time version manifests as night sweats can lead to sleepless nights. A good night’s sleep is the cornerstone to mental health and if one, or both of you are not sleeping properly, the how can you expect to feel happy? Forgive yourself for feeling tired and understand that you might need to take the day a little slower if you haven’t managed to sleep. It is also really important to regulate alcohol intake as this is proven to have an effect on hot flushes. Also, buy two single duvets. If you are constantly throwing the duvet off due to hot flushes, your partner won’t be able to sleep either and two insomniacs are certainly not better than one.
  • Vaginal Dryness, a massive libido-killer that is caused by reduced oestrogen production. This means a decrease in the mucus-producing cells that keep the vagina moist, lubricated and elastic. As a result, the vaginal lining can thin and the tissues become very dry, meaning sex, intimacy or even day to day life can becomes uncomfortable or painful for many women.  Take a little longer to get in the mood, perhaps try an intimate massage to initiate physical contact before using an organic, plant-based lubricant like the ones produced by the YES company. Products like these are kinder to intimate areas and don’t contain chemicals or hormones.
  • Weight Gain, it’s common to gain weight during the menopause for both women and men of the same age. This can lead to a loss of self-confidence, especially in the bedroom. Self-love is a great thing and comes in many forms. Recognising and acknowledging that your body is changing is healthy, but so is exercise. One study of 17,473 postmenopausal women found that those who lost at least 10 lbs (4.5 kg) of weight or 10% of their body weight over a year were more likely to eliminate hot flashes and night sweats. Why not go for a run or to the gym together? Exercise is a fantastic way to de-stress and can help improve sleep patterns, which in turn can help to manage weight better. Try to take a look at your plate: think more protein, less carbs to reduce that middle age spread.
  • Mood Swings, our old friend…except now they’re worse and last longer. Up to 70 percent of women describe irritability as their main emotional problem during the early stages of the menopausal transition and more seriously, 1 in 5 women report feeling depression and anxiety. The drop in oestrogen is thought to affect the way the body regulates serotonin and norepinephrine, two substances that have been linked to depression. Don’t be afraid to ask for help from your partner as well as your doctor, the menopause is a change for women emotionally and physically sure, that doesn’t mean men don’t have to change too and aren’t willing to for the woman they love. The menopause transition often has a ripple effect for the whole family; discuss your feelings, explain it’s not them. It’s OK to need a little more support and remember, sleep, exercise and meditation are your best ammunition against self-doubt.
  • Enjoy the Silence, taking some time to do just that can allow the body to relax, which, in turn can cut hot flushes and clear the mind of any lingering doubt, nastiness or resentment. Go for a walk and find a calm place to sit and reflect. Life seems less overwhelming that way.
  • Educate and Communicate, it’s come to light that women and men are seriously lacking in information surrounding the menopause, for a number of reasons, poor schooling and a kind of cultural embarrassment around the issues of sex and physical change in women to name a few. Reading and learning as much as you can about the menopause is a way to break down the taboos that surround the issue and liberate men and women from feeling embarrassed and alone when it comes to sex later in life.
  • One for the Guys, testosterone is on the decline from forty-five onwards which can lead to moodiness, feeling weaker, more tired and a decline in libido. All of these symptoms can impact self-confidence, especially when it comes to ‘feeling like a man’. Boosting testosterone in this situation is key. Taking exercise, especially doing squats, which bulks up the quads and glutes (the bum), is important when it comes to maintaining hormone levels, drive and strength.
  • And finally, HRT, pharmacological intervention in the menopause is an option to discuss with your doctor. The menopause transition can play havoc with your mind, body, self-esteem and sex life. There should be no shame in seeking hormone replacement therapy if these feelings become overwhelming, both for the men and the women. There are many different ways of taking HRT, including creams, tablets and skin patches and your GP can help you find out which method is best for you. Everyone is different and finding a personalised treatment plan to suit an individual’s needs is important. It’s important to take a holistic, empathetic approach to managing hormonal health.

Check out Rachel’s workshop on Natural Menopause. Click here to check out our courses page.

Dr Shahzadi Harper is a London-based GP. She is interested in optimizing women’s well-being and empowering them to look and feel their best. She looks after women of all backgrounds and ethnicities enabling them to make informed choices for their optimal health and longevity by balancing their hormones from turbulent teens through the menopause transition and beyond.  Dr Harper can be contacted on +44 7881364644 or emailed at She is also a brand ambassador for the YES Company, their products can be found here

Last Updated on February 2, 2023 by Editorial Staff

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