Sex, desire and sexual health in midlife: a topic often whispered, but rarely discussed openly. NSS dives deep with Dr. Cuterus to bring you honest, science-backed answers about sexual drive, hormones, medication impacts, and rekindling intimacy in your 40s, 50s, and beyond. There’s no expiration date on feeling good!
Boris Johnson Got Us Thinking…
When former UK Prime Minister Boris Johnson (60) and his wife Carrie (37) welcomed their third child in 2023, it wasn’t just another celebrity baby update—it sparked a conversation here at NSS.
At 60, Johnson was becoming a parent again. And naturally, we started wondering: Child birth aside, how does our sex life change in midlife. Does desire fade with age? Is it normal to still feel aroused, or not? Should we expect to have pleasure and fun with sex in our 40s and 50s, or even after that?
These are questions many of us wrestle with silently. Social norms, discomfort, or simply not knowing who to ask, often lead us to bottle them up.
So, we decided to open up the bottle and let our questions unleash. And we had just the right person to answer them–none other than the brilliant Dr. Tanaya Narendra (aka Dr. Cuterus). Known on- and offline as the sex-positive, body-positive, and yes, age-positive, Dr Cuterus gives us real, science-backed answers on what happens to sexual health in your 40s, 50s, and beyond.
1. Is there an expiration to feeling aroused? Is this different for men and women?
There is absolutely no expiration date on feeling aroused. Many people maintain an active sexual life well into their later years. As long as there are no associated pain points, nothing prevents individuals from enjoying a fulfilling sex life or engaging in self-pleasure. And it’s the same for men and women. A lot goes into feeling aroused, and this includes physiological as well as emotional and mental reasons. A lot of people are also more self-assured and experimental when they are older and have more experience. So desire can be created and satisfied in different ways later in age.
2. A lot is being said these days about menopause. Does it (or andropause) impact your sexual drive?
Yes, menopause can impact sexual drive, primarily due to hormonal changes that lead to several related issues, not all of which are directly sexual. One common effect is vaginal and vulvar dryness, caused by a decline in estrogen and progesterone levels over time. Estrogen acts like a natural vaginal moisturizer, and its reduction can alter genital tissue. For example, some women experience thinning or loss of the labia, the outer vaginal folds, and in severe cases, extreme dryness can cause the vagina to narrow or feel like it’s closing.
On the other hand, post-menopause, many women experience less anxiety about pregnancy and greater body confidence, which younger women may lack. This psychological shift can enhance sexual drive, as increased self-assurance often boosts desire.
Similarly, for men, andropause involves a reduction in testosterone, which can decrease sexual desire and lead to difficulties with erections. To mitigate these effects, it’s important to get adequate sunlight, exercise regularly, and maintain a healthy body weight.
3. Midlife is a time when a lot of us get started on medications for, say, hypertension, heart conditions, diabetes, etc. Can certain medications impact sexual drive? If yes, what’s the workaround for it?
Yes, many medications can affect sexual drive and the ability to engage in sexual activity. For instance, individuals on antidepressants often face challenges with arousal and, if aroused, may struggle to achieve orgasm, a condition known as anorgasmia. These medications can suppress or block the pathways responsible for orgasm, which may lead to dissatisfaction despite enjoying sex. In such cases, reframing how one perceives sex and pleasure can be helpful. Since sex is inherently enjoyable, focusing on alternative ways to experience pleasure is key.
Similarly, some beta-blockers, commonly prescribed for high blood pressure, can reduce sex drive and impair the ability to orgasm. Diabetes also alters the hormonal balance, impacting not only arousal but also sexual performance and orgasm. Any metabolic or medical condition can influence these mechanisms. To counter these effects, we encourage people to maintain an active sex life, even as they age, to keep the body’s systems functioning and prevent them from “rusting.”
4. Just like regular medical checkups, is there a time or type of medical check to be done for sexual wellbeing in midlife?
I strongly recommend that women get a pap smear every three to five years, depending on their age. This simple and effective diagnostic test can detect early changes in the cervix, such as inflammatory, infectious, or cancerous conditions. Additionally, regular full-body checkups are beneficial for maintaining overall health, including sexual well-being.
5. When should one seek medical intervention for issues about sexual health and well-being?
If you experience any persistent issue that feels unusual or unfamiliar, it’s wise to consult a medical practitioner for help. This could include problems like lack of arousal, vaginal dryness, difficulty with erections, or other concerns related to sexual health and well-being.
6. Some women in their midlife say that they experience long and intense arousals in their 40s – is this true, and if so, is there a scientific reason for this?
Yes, this can indeed happen. Women have a baseline level of testosterone in their bodies, which is typically overshadowed by higher levels of estrogen and progesterone. As women approach menopause, hormonal shifts reduce estrogen and progesterone levels, allowing the baseline testosterone to become more prominent. This can lead to heightened and more intense arousal. Additionally, this phase often brings increased confidence, fewer body image concerns, and a stronger sense of body ownership, further enhancing sexual experiences.
7. Can the empty nest syndrome impact arousal in a certain way? How can couples bring their sex life back on track in this time?
Responses to empty nest syndrome vary widely. Some couples embrace this phase, seizing the opportunity to pursue a more active sex life. Others may internalise the sadness of their children leaving, which can affect their arousal and intimacy. How couples navigate this period is a deeply personal choice.
To bring their sex life back on track, couples can focus on open communication to express their feelings and desires, rediscover shared interests, and prioritise quality time together. Exploring new ways to connect, such as trying new activities or scheduling intimate moments, can help rekindle passion. If challenges persist, consulting a therapist or sexual wellness specialist can provide tailored strategies to enhance intimacy.
To sum up:
- There is no cap to when you can feel aroused.
- A healthy sex life depends on how healthy you are physically and mentally.
- Embrace the changes that age brings, both positive and not-so-positive.
- Focus on what gives you pleasure, even if it is new and different ways.
Signing off in true Dr Cuterus style: Byeeee!
1 Comment
It makes a lot of sense. Appreciate the lead. Here’s to more love making !