Sexual Health for Women over 40

Sexual Health for Women Over 40: What You Need to Know

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Women over forty years old are at a stage of their lives that features a great deal of change. In particular, those experiencing menopause will notice that their bodies undergo many physical changes. However, there is nothing to fear about “middle age” when it comes to your sex life.

In fact, the belief that women are past their sexual prime in middle age is becoming quickly outdated as society has come to understand that your 40s are a time to explore new aspects of your sexuality. This is true even as you approach and move through menopause. Your 40s may be the perfect time to reflect on all you have learned thus far, embrace your feelings as an accomplished woman, and concentrate on overcoming challenges you may be facing in your relationship and your sexual health. Here’s how.

A Time for Surprisingly Positive Change

Whether you’re in the midst of menopause or awaiting its beginning, life in your 40s may actually include the best sex of your life. Exploring new ideas in sexuality, allowing yourself the permission and motivation to try new things, and growing in confidence in yourself are just some of the incredible advantages of sexuality at this stage in life.

The same can be true for couples just as it can for individual women. As couples move through their 40s, they may begin to have a stronger awareness of themselves as sexual beings and may experience a desire to explore the playful side of intercourse and physical pleasure. As people (especially women) age, they can also lean into the ability to form deeper emotional bonds, which can contribute to more meaningful and passionate sex.

Although sexual desire and episodes of sexual intimacy can wax and wane, this is also completely natural. For women in their 40s who are in long-term relationships, there are bound to be lulls from time to time, and this is not typically attributed to age.

Long-term couples may unwittingly become lax about the routines around sex that served them in their younger years, such as going out on dates, dressing up for sex, flirting with their partner and exploring sex play with toys and accessories. In this way, the comfort couples experience after they have spent years together can actually lead to a decrease in communication about sexual needs and desires. Fortunately, the 40s are a prime time for a couple to look for opportunities to reconnect and explore their needs together.

What Sexual Changes Happen in Women at 40?

Although every body is different, 40+ women’s bodies eventually undergo certain physical changes that contribute to shifts in their sexual health. Some of these changes are further spurred on by a woman’s experiences in life and her sense of self-worth. For example, an increase in confidence and comfort with her own body coupled with hormonal changes can work together to impact a woman’s ability to achieve orgasm more quickly and easily. Women may even find that their orgasmic experience is enhanced by their lifted inhibitions as they discover a second phase of their sex life.

Let’s explore two of the most significant contributors to these changes: hormonal and mental shifts.

Hormonal Shifts in Your 40s

As women approach and move through menopause, typically in their 40s, hormonal shifts are one of the most impactful changes they’ll experience. Fluctuating estrogen levels and increasingly irregular periods can actually cause the vaginal walls to thin and become more easily irritated. In addition, these tissues are more likely to bleed and tear due to the increased dryness that occurs naturally with age.

That means one key to having comfortable and pleasurable sex in your 40s is to invest in some quality lube. Make sure you do a little research to find one that contains all-natural ingredients that are compatible with your intimate areas. You may even consider trying out several different types to find out what works for you, including some newer CBD-infused lubricants with added botanical aphrodisiacs to enhance the entire sensory experience.

The thinning of vaginal tissues also carries an increased risk of exposure to STDs. If you are having intercourse with multiple partners, keep in mind that your vaginal environment is more susceptible to infection due to your body’s hormonal changes. Even if you aren’t concerned about getting pregnant, use condoms with any new partner to protect yourself from unwanted pathogens. If you are using any kind of lubrication in conjunction with a condom, make sure it isn’t an oil-based one, as this can degrade the material of the condom.

Mental Shifts in Your 40s

As women age, their mental limitations may decrease as they shift their focus away from what others think of them. This can mean women choose to drop some of their inhibitions as they search for satisfaction in other areas of life, including sex. Acquiring a greater sense of flexibility about sex itself is one of the most rewarding benefits of reaching 40. Even as physical limitations may increase with age, a reduced preoccupation with body image or pleasing your partner will increase your own sexual satisfaction as you let go of previous fears and worries and enjoy the physical sensations themselves.

Fantasies and erotic dreams are also not uncommon for women in their 40s or those experiencing menopause. These fantasies and dreams may include experiences you haven’t yet had in real life, such as having sex with someone of the same sex, having sex with someone in an unusual location, or having sex with more than one partner at the same time. As your hormones cause physical changes, these shifts can affect your conscious and unconscious mind. Leaning into these fantasies with a supportive partner can lead to increased sexual pleasure and satisfaction and help you grow in confidence about expressing your sexual preferences and deepest desires.

The natural aging process, coupled with the lingering emotional impact of the COVID-19 pandemic, has had an effect on both men and women. Older adults, in general, are seeking an increased connection with their significant other, especially after the pandemic. For most, this includes both quality time and romance.

Reflecting on the importance of relationships and connections in your life is a valuable way to honor the changes you are going through during menopause and embrace your sexuality. Telling your partner you love them, celebrating special occasions such as birthdays and anniversaries, taking vacations, giving and receiving gifts, and simply setting time aside to be with one another are essential to mental health and keeping romance alive with your partner. Doing so can help you feel more comfortable exploring or settling into your sexuality together.

All About Menopause in Your 40s

Menopause Symptoms

Of course, one phenomenon looms over any discussion of sexual health in your 40s: menopause. There are three stages of menopause: perimenopause, menopause, and post-menopause. In everyday terms, these refer to three stages that describe when changes begin, when your menstrual cycle stops, and your new normal after the changes are complete.

Here’s a look at what happens during each stage:

Perimenopause: The First Stage

Perimenopause, or premenopause, is when symptoms of menopause begin to appear. This is a stage that occurs quite a few years before actual menopause – as many as eight years prior. When you enter perimenopause, you’ll probably start to notice some early menopause symptoms, like changes to your period or mood shifts. These changes happen because your body’s estrogen and progesterone levels are starting to naturally decline. Your body will gradually adapt to these changes, just as it did when you started puberty.

Menopause: The End of Your Menstrual Cycle

At this point, your periods stop completely. This phase lasts for one year, because once you’ve gone 12 consecutive months without a period, you enter post-menopause. It also signals the end of your body’s ability to become pregnant.

Although the average age for menopause is about 51, many women experience menopause in their 40s. Genetics plays a role in the timing of your menopause, so talking to family members who have gone through it may be helpful. Similarly, medical factors can influence the timing of menopause; autoimmune disorders, radiation therapy, chemotherapy, and ovary removal can also impact its onset.


Post-menopause simply means “after menopause,” and you reach this point when it’s been 12 months since your last period. You will be in this stage for the rest of your life, as you are no longer able to become pregnant. This is due to the end of ovulation, although your ovaries will continue to produce low levels of the hormones progesterone and estrogen.

After your last menstrual cycle, you may still experience symptoms of menopause for anywhere from 2-7 years. At this time, symptoms will most likely become milder as they eventually taper off completely.

Keep in mind that women in the post-menopause stage are at a higher risk for certain health conditions. Heart disease and postmenopausal osteoporosis may be risk factors, so speak to your doctor about a plan to prevent or manage these conditions in the event they occur.

How Can I Improve My Sexual Health at 40?

As mentioned, sex drive does decrease naturally with age in both men and women. However, women are more likely to experience a decline in desire, especially as they enter their late 40s and early 50s. Of course, this effect varies by individual. There are some women who experience an increase in their sex drive, especially if they are experiencing other life changes such as children leaving home, freedom from worrying about pregnancy, and an increase in confidence due to life experiences and success.

However, it’s important to note that menopause brings physical effects to women’s bodies, such as falling estrogen levels. Reduced estrogen typically contributes to vaginal dryness, hot flashes, night sweats, and other uncomfortable sensations. These physical symptoms can lead to a shift in sex drive and sexual sensation. Moreover, the age-related decrease in testosterone can also lead to a reduction in desire in women.

Some women may undergo menopause suddenly due to other health-related events, such as chemotherapy or ovary removal, which then causes an immediate drop in both estrogen and testosterone. This often reduces desire as the body works to cope with its new normal.

Although some women do not feel a great impact on their sex life during menopause, others may be troubled by their decrease in sexual thoughts. If this is the case and you are feeling frustrated, or as though your relationship with your partner is suffering, you may be experiencing something called “hypoactive sexual desire disorder.” Speak to a medical professional about your concerns regarding any component of your sexual health.

If you are wondering how to keep the spark alive in your 40s and throughout menopause, read on for some helpful ideas.

But First, What Exactly is Sex Drive?

Sex Drive Components

Your sex drive is divided into three major components:

  • Drive – This is the biological component that manifests as sexual thoughts and fantasies, erotic attraction to others, the seeking out of sexual activity, and genital tingling or sensitivity. Sex drive varies widely from woman to woman and from day to day based on an individual’s daily activities, stress, and overall health.
  • Beliefs, Values, and Expectations About Sex – Your natural drive may be influenced by your personal attitudes toward sex. These attitudes are shaped by culture, religion, family, friends, and media consumption. A positive attitude toward sex will increase your desire for both sexual encounters and sensations.
  • Motivation – This is your willingness to behave sexually at a given time and with a given partner. Motivation is complex because it is influenced by emotion and interpersonal factors. For many women, a caring relationship is often a necessary component to experiencing sexual desire.

Igniting Your Sex Drive

Even when coupled with menopause, increased age does not mean less sex. Sex in your 40s and beyond is all about acceptance and adaptation. Here are a few tips.

Consider and Explore

Take into consideration what it means for you to give and receive affection in the bedroom. If you feel that you are limited physically in ways you weren’t in your 20s, for example, explore how you can experience sexual pleasure at this new stage of your life. This can take shape in many forms, from making time in your calendar for sex or date nights, to exploring new toys, clothing and accessories, and to opening up to your partner about your desires, curiosities, fantasies, and needs.

Reframe Your Thinking

Consider your 40s as a powerful peak in your life instead of the end of the road. There are many ways physical intimacy can grow, just as you have, in other forms of self-care like exercise and healthy eating. Although hormone levels may be declining, both men and women can opt to explore what makes them feel aroused and sexually satisfied. Understanding that an increase in stimulation during sex, or a more focused engagement in pleasuring a certain part of your body, may assist in maximizing your sexual arousal.

Shift Your Focus

On the other hand, the focus can shift from physical sensations to other pleasurable experiences, such as connecting with your partner. Take the time to slow down, focus on what you like, and let go of the sense of urgency that may have followed you from earlier in your life. Sex isn’t fast food, after all; it can be a multi-course meal complete with new tastes, sensations, and surprises.

Adjust Your Physical Well-Being

Another crucial consideration is your physical well-being and activity level. Regular aerobic exercise and strength training can relieve stress, improve your body image, and boost your libido. Exercise also produces endorphins, which lift your mood naturally and can help you feel energized and ready to engage with your partner on a personal and physical level.

Schedule a Consultation

Schedule your Consultation Today

Whether you are experiencing symptoms of menopause in your 40s or you feel you need to address your sexual well-being, reach out to schedule an appointment with a trusted gynecologist. Together, you can explore ways to maintain or improve your sexual health according to the unique hormone changes and life events you’ve experienced. For more information about sexual health after 40 and during menopause, contact Arizona Gynecology Consultants to schedule an appointment.

About Kristina Calligan, FNP

Kristina Calligan is a sub-specialty nurse practitioner in Women’s Health. A native to Arizona she obtained her Bachelor of Science in nursing in 2006 at Grand Canyon University in Glendale, Arizona. Never one to stop striving and achieving all that she could, she completed two master degrees in Nursing Science and Business Administration in 2012. Ms. Calligan joined Arizona Gynecology Consultants in 2009. Prior to working at Arizona Gynecology Consultants, she worked as a nurse in labor and delivery at several local hospitals and a research coordinator in women’s health care. Read More About Kristina Calligan, FNP