Ask a Cleveland Sex Therapist: Menopause Has Killed My Sex Drive, But I Crave Intimacy. Help! – Cleveland Scene

Welcome to Ask a Cleveland Sex Therapist. Want to ask Matt a question that could be tackled in a future column? Click here. Now, onto this week’s topic.

I am a 55-year-old woman who is going through menopause and also has a chronic illness. My capacity to be sexual is on the low end of the energy I am able to give. I do not date or have any sex partners, but I crave intimacy and to be touched. My sexual self has over the last 15 years slowly faded and gone away. What suggestions do you have? I have tried HRT and had very bad results, so I stopped.

-Anonymous 

Hey Anonymous! As a cis-male who will never have to experience the impacts of menopause, I want to start by acknowledging the openness and honesty of what you shared. You are navigating not just one, but two major life transitions: menopause and chronic illness. Either one on its own can significantly shift how we inhabit our bodies and relate to our sexual selves. Together, they can create a perfect storm of exhaustion, discomfort, and grief. What I hear in your question is not a lack of desire for connection, but a lack of capacity. That makes sense with what you are experiencing and it’s also incredibly common. Many women and people with uteruses experience their sexual energy dimming in midlife, not because it’s gone forever, but because it’s been waiting for a different kind of attention. Today, I want to share what this evolution can look like. 

When menopause arrives, hormonal shifts can impact everything from vaginal lubrication and elasticity to sleep quality, mood regulation, and energy levels. Add chronic illness to the mix, and you’re often dealing with pain, fatigue, or medication side effects that can make sex feel like another task or something to avoid altogether. Before I go any further, a great resource to check out would be What Fresh Hell is This by Heather Corrina. This book changed how I work with clients who are experiencing menopause and it’s not only informative, but also pretty funny. You’ve already tried HRT and found it didn’t work for you, which I want to emphasize is a perfectly valid and important boundary to set. There’s often cultural messaging that if menopause affects your sexuality, you must “fix” it medically. While hormone therapy can be helpful for some, it’s not the only option, and sometimes, it’s just not worth the trade-offs for your particular body. Your body has told you what works and what doesn’t and listening to that is very important.

The piece that stands out most in your letter is your craving for intimacy and touch. That feeling of wanting connection can feel so powerful and all-consuming. This makes sense as skin-to-skin contact releases oxytocin, lowers cortisol levels, and has profound impacts on mood and nervous system regulation. In our culture, unfortunately, we often tie intimacy and touch exclusively to partnered sex. This narrow lens leaves many people, especially single folks, feeling starved for touch when sex isn’t accessible or desirable in the ways it used to be. I often tell my clients that because of this, we need to start expanding our definitions of intimacy. It is also helpful to note for everyone reading this that your sexuality is not static, it is dynamic, and its evolution can be something to celebrate.

While yes, sexual touch can feel great, what if we looked at non-demand touch? Non-demand touch is contact with another human that does not lead to sex. This could be massages (professional or with trusted friends), cuddling groups, restorative yoga with hands-on assists, or bodywork modalities like Reiki or therapeutic touch. Non-demand touch, however you explore it, can allow your body to experience safe, nourishing touch without the pressure to perform sexually. My partner and I pretzel all the time on our couch and when we have gone sometime without doing it, I can feel my body longing for it.

Beyond receiving touch, I think it is important to look at creating a secure attachment again with your body. Not with the goal of reigniting your libido, but to cultivate a sense of aliveness. One of the cruel tricks of menopause and chronic illness is that they can make us feel like strangers in our own skin. I know when I experience even the slightest injury, I feel disconnected from myself. Practices like sensual self-massage, bathing slowly with fragrant oils, dancing lightly to music you love, or exploring non-goal-oriented self-pleasure can all help rekindle your erotic self in a way that honors your current energy levels. This doesn’t have to mean penetrative sex or orgasms. It can simply mean touching your body with curiosity and kindness again. Here is a great article to check out for more information on self-pleasure. Think of it less like “revving the engine” and more like “keeping the pilot light on.” A few minutes of daily or weekly connection has the potential of slowly shifting your relationship with your sexuality.

As I wrap up, I also want to touch on the grief that you may be experiencing. When someone says, “My sexual self has faded away over the last 15 years,” I hear a story of loss behind that. Menopause is not the death of sexuality, but it often requires us to rewrite the story we’ve told ourselves about what our sexuality is “supposed” to look like. That rewriting takes time, and sometimes it involves mourning the version of ourselves that could have spontaneous, vigorous sex without a second thought. That mourning doesn’t mean your sexual self is gone; it means you’re acknowledging the truth of change. That evolution can be incredibly rich once we stop holding ourselves to old scripts. I often describe sexuality as an orb that lives within us that brightens and dims depending on what is impacting us. Although it may feel dim right now, we can brighten it again. Our sexuality is always evolving if we tune into it. Remember, intimacy is not limited to partnered sex. It can be cultivated in many ways with many different people. This is a new chapter in your life, and I hope it can be one filled with grace, acceptance, and adventure.

Matt Lachman is a Licensed Professional Clinical Counselor and Supervisor, AASECT Certified Sex Therapist, and owner of Cleveland Sex Therapy, located in the heart of Gordon Square. Since opening Cleveland Sex Therapy in 2019, Matt has been dedicated to promoting sex positivity and inclusivity in his work with individuals, couples, and polyamorous relationships. When he’s not helping clients navigate their sexual and relational journeys, you can find him enjoying a cold brew at Gypsy Beans, sipping a cocktail at Luxe, or relaxing on his couch watching reruns of Happy Endings. Ask a question of your own here.

Disclaimer: The advice provided in this column is intended for generalinformational purposes only and should not be considered a substitute for professional therapy or mental health treatment. Each individual’s situation is unique, and the insights offered here may not address the complexities of your specific circumstances. If you’re experiencing challenges related to your mental health, relationships, or sexuality, I strongly encourage you to reach out to a licensed therapist or mental health professional for personalized support. You’re not alone—help is available.

Subscribe to Cleveland Scene newsletters.

Follow us: Apple News | Google News | NewsBreak | Reddit | Instagram | Facebook | Twitter | Or sign up for our RSS Feed

Related