When a woman experiences menopause her body does not respond as it once did. The effects of menopause are complex. The hormones are affected, for instance lowering oestrogen levels which reduce vaginal lubrication). It marks the end of fertility; it can lead to depression and there are societal attitudes that may reinforce older women to take less interest in sex, particularly if not in a relationship.

However, hormones aside, the key factors for maintaining a healthy sex life for the over 45 aged woman are more in the quality of the relationship and her mental health, rather than the physiological factors. Women tend to become less distressed about changes in their sexual responsiveness as they age than men do, and for many women, being in a relationship, and the quality of the relationship are as or more important than their sexual pleasure and orgasm. For many women though, they do want to maintain an active sex life and can be frustrated by a potential male attitude of –“if I can’t perform as I did in my twenties I will avoid sex altogether”.

Sex has physiological, psychological and sociological components. As aging occurs, each component impacts on the relationship and there is a need to refine and reinforce those aspects which are positive and can be worked on, both individually and as a couple. Each partner has a responsibility for their own sexuality, their arousal and orgasm. If the partners are not communicating about their desires, their emotions and their physical requirements, there is a strong chance that sex will drop off the agenda, at least as a topic of open conversation. (It is noted by a leading sex therapist that less than 10 sexual encounters a year denotes a non-sexual marriage. It is also considered that in the USA one out of five marriages is non-sexual. B. McCarthy 2004).

For those women who have chosen not to be ‘pleasure focussed’ sexually, and it is causing friction in the relationship, the old adage “just do it” can be useful. Sometimes, by accepting the caress of a lover, by considering erotica, by communicating honestly, may just start the warming up process that might lead to wonderful pleasure. Letting go of self-consciousness and moving into a rhythm of sexual activity can bring a number of advantages, including the burning of calories, better sleep patterns, lower blood pressure and increased lifespan.

Growing older can be challenging, and looking back on those carefree days when sexual arousal might have been easy can be distressing. Let’s face it; it will never be the same again. So rather than look backwards, construct a future where there is greater intimacy. Create scenarios for yourself and your lover so that when things do not work in terms of penile penetration, there are erotic ways to achieve mutual pleasure – the use of masturbation, or oral techniques to achieve joint satisfaction; or find sensual means of allowing time out in order to reconnect at some later date.