Editor’s Note: I originally published this post years ago during a completely different season of life, sharing what I thought was a foolproof “30-Day Sex Challenge.” Since then, my body, my health, and my journey have evolved immensely. I’m updating this space today because willpower or scheduled activity isn’t the fix for midlife intimacy challenges—understanding our changing biology is. Read on for the real, raw clinical truth about what happens to our bodies over 40, and the actual tools that bring permanent repair.
Ladies, it’s time we had a talk. Not THE talk, but you’ll definitely need to have had THAT talk before we have THIS talk. It’s a subject that gets joked about, glamorized, and sensationalized, but it’s rarely treated with the sincere power it’s capable of. I’m talking about sex. More specifically, it’s time we had a talk about how much sex you and your significant other are having. A little too personal? Trust me, I agree, and if this wasn’t a subject I felt extremely passionate about, I wouldn’t bring it up.
⏱️ TL;DR: Reclaiming Midlife Intimacy
If you only have 30 seconds, here is how to understand the physical changes affecting your libido over 40 and move from feeling frustrated to finding permanent repair:
- It’s Biology, Not Connection: A drop in libido after 40 isn’t relationship fatigue; it is a physiological response to shifting estrogen and cortisol levels.
- The Clinical Culprit (GSM): Dropping estrogen naturally causes Genitourinary Syndrome of Menopause (GSM), leading to tissue thinning, intense pain during intercourse, and recurring UTIs. It cannot be “willpowered” away.
- The Intimacy Toolkit: Real relief comes from clinical and physical support—including localized vaginal estrogen to restore tissue moisture, pure coconut or water-based lubricants, and silicone dilators for nervous system recovery.
- Vulnerable Communication: Healing the “intimacy gap” begins with radical honesty about what your body is experiencing, removing pressure, and creating a safe space for cooperative connection.
In the original post, I noted that after a 30 day sex challenge, what really changed was creating a dedicated chunk of time, every single day, completely focused on each other. Despite the good, the bad, and the ugly of the day, despite busy schedules and hurt feelings, we knew that nightly we were going to have the opportunity to put everything aside and just focus on us. This is especially true if you’ve never prioritized time quite like that before.
BUT what happens when we hit our 40s, 50s, and beyond? Our libido can decline—and that change is not from a lack of desire or because you no longer want to be close to your partner. It’s not midlife relationship fatigue, and it is certainly not a sign that your relationship is failing.
It simply means there are physiological changes happening in your body that can make sex feel uncomfortable, painful, and maybe even completely exhausting.
When I first wrote about the 30-Day Sex Challenge, I was in a completely different season of life. While my journey has taken many turns since then, one truth remains: Intimacy is one of the most powerful tools we have for our own healing and health. Whether you are in a long-term partnership or navigating a new chapter, reclaiming your connection to intimacy is a vital part of becoming the CEO of your own health.
To help break down what is actually happening to our bodies, I sat down for a raw, two-part conversation on Heidi’s Lane with the incredible Dr. Radhika Sharma. If you are struggling with this right now, please pause and give these episodes a listen:
Tune In: Behind the Sex & Libido Curtains from my podcast:
Deep-dive conversations with leading women’s health experts to help you master your hormones.
Breaking the Shame Barrier (The Psychological Load)
If you’re feeling any unwanted shifts in your libido, or if your body just doesn’t “feel” like it has in the past when it comes to intimacy, please know that you are not alone. I’ve been there too.
This shift happened for me a couple of years ago, and I was like, “What the heck is actually happening?” It was the hardest, most embarrassing sexual thing for me to go through. It was incredibly difficult for me to even admit out loud that I was experiencing vaginal dryness—having to use lubricant for the first time!—and having physical pain during sex.
I wondered, like maybe you have too: Is this a shame thing?
So many culturally- and religiously-based thoughts were filtering through my heart, and they felt heavy. All of this actually pushed me into an anxious, depressed spiral that made me feel like I was doomed. I thought I was going crazy—the depression, the anxiety, and the fears were so very real, and they affected every single area of my life.
And I kept thinking, “Why didn’t anyone tell me about this?”
Historically, women have been scared to talk about the libido and hormonal shifts that naturally occur as we age—even with their trusted OB/GYNs. We’ve been afraid to be vulnerable and ask for help.
🚀 Get the Support You Deserve:
Grab my Perimenopause Guide—it is an absolute must-have resource for navigating this transition with confidence!
Dr. Radhika Sharma is an OB/GYN, certified wellness coach, and co-host of the Double Scrub podcast. We went deep into what’s going on with our bodies as we age (especially “down there”) so that we can better understand the physiology and stop viewing these natural occurrences through a lens of brokenness.
When it comes to the shame we feel, Dr. Sharma attributes it to the specific biological season we’re in: We’re often done having babies, our periods are gone (or mostly gone), our estrogen is down, and it can mistakenly feel like our sex lives are supposed to be done too. In fact, the morning we recorded our first episode, she shared that she had literally just seen three women in her clinic who were experiencing exactly what I went through, and they all thought they were going crazy, too.
Hiding what’s going on from your partner can create a massive “intimacy gap” in a relationship. The first step toward healing those gaps isn’t physical connection; it’s radical, vulnerable honesty about what your body is experiencing. And your body is going through a lot, my friends.
Conquering the Sahara Desert (The Clinical Reality of GSM)
If you’re feeling like the Sahara Desert when it comes to intimacy, you’re experiencing more than just basic dryness. This clinical condition is called Genitourinary Syndrome of Menopause (GSM).
Here is exactly what is happening under the hood:
↓ Estrogen Levels ──> Vaginal Tissue Becomes Thin, Dry, & Hyper-Sensitive ──> Irritation & Pain
As your estrogen levels drop, your vaginal tissue naturally loses its elasticity and moisture. GSM can result in:
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Recurring UTIs and more frequent urination
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Bacterial and pH imbalances
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Reduced arousal and difficulty achieving orgasm
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Intense pain during intercourse (specifically pain with penetration)
There’s a secondary biological battle going on here, too. As estrogen levels drop, cortisol (your stress hormone) can rise, increasing overall body stress and inflammation. At the same time, lower estrogen decreases the production of oxytocin—the hormone responsible for sexual arousal, bonding, and emotional connection. Because oxytocin naturally acts as a buffer to lower cortisol, this hormone flip creates a literal biological storm in your body!
Related Reading: Learn how Food Noise is linked to shifting hormones during perimenopause.
GSM is not something you can “willpower” your way out of. If intimacy hurts, the logical defense mechanism is to avoid it entirely. But avoidance is not the long-term repair we need.
The Midlife Intimacy Toolkit
Concrete medical and physical solutions to help repair your libido over 40.
1. Vaginal Estrogen
The ultimate game-changer. It reverses tissue thinning, alleviates painful intercourse, and restores deep moisture safely and locally.
2. Pure & Simple Lubes
Stick to organic coconut oil or water-based options. Avoid scented, ultra-processed products that disrupt your natural pH.
3. Tissue Recovery
Silicone dilators and temporary lidocaine gently help re-expand narrow tissues and calm the nervous system for pain-free sex.
While what you’re experiencing can be incredibly frustrating, Dr. Sharma shared some incredible, concrete medical and physical solutions to help repair your libido after 40:
1. Vaginal Estrogen (The Game Changer)
If you’re not familiar with vaginal estrogen, think of it like a baby aspirin for heart health, or Viagra for your lady parts. When it comes to improving your sex drive and comfort in your relationship, vaginal estrogen is queen. It helps reverse tissue thinning, alleviates painful intercourse, and directly restores deep moisture.
Note: Some women might experience a temporary yeast infection or strange discharge when first beginning vaginal estrogen. This is simply your body’s way of returning to a healthy, normal pH level. If this happens to you, stay the course—don’t give up!
The Medical Data: If you worry that topical, localized estrogen might cause breast cancer, the resounding clinical data finds that this information is false. Because it acts locally rather than systemically, it is even considered safe for many breast cancer survivors (always consult your personal physician).
2. Pure & Simple Lubrication
Another immediate solution for perimenopause-related intimacy issues is quality lubrication.
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What’s Best: Stick with organic coconut oil or high-quality, pure water-based lubricants (like classic KY).
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What to Avoid: Steer clear of almond oil and fancy, heavily scented, ultra-processed drugstore lubricants. Both of these can destroy the delicate vaginal microbiome and trigger painful infections.
3. Nervous System Recovery (Dilators & Lidocaine)
If you’re returning to intimacy after a long period of abstinence or pain, your vaginal muscles can involuntarily constrict and narrow, making intercourse even more painful. Please remember: You are not broken. You are fixable.
Using medical-grade silicone dilators—gradually moving up sizes at your own pace—can slowly and gently help to re-expand the tissue, making sex comfortable again. Temporary over-the-counter lidocaine gel is another excellent option to help desensitize the area and ensure intercourse is pain-free as you heal.
Bonus Tip: Improving your pelvic floor health is another foundational way to repair these issues. Learn more about pelvic floor health here.
The 30-Day Connection Re-Boot (For Both Partners)
As we navigate intimacy in our 40s and beyond, let’s collectively change the playbook:
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Shift the Focus: Let’s stop blaming the psychological dynamics of “low desire” in a relationship and start acknowledging the fluctuating hormones that are actually causing the physical roadblocks.
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Lighten the Cognitive Load: Remember that low sex drive is deeply tied to daily overwhelm, physical exhaustion, and mental fatigue—all of which are exacerbated by perimenopause.
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Create a Safe Space: Let’s view intimacy as a space for cooperative connection, where there is mutual vulnerability and open communication about physical comfort and emotional needs—without blame, pressure, or fear.
Ladies, please do not suffer in silence. You are not alone, and it is completely okay to pivot your strategy as your body evolves. Give yourself permission to be the true CEO of your own health.
Xo,
154 Responses
Wow. Just wow. This is eye opening. I’ve lost 100lbs and my libido has tanked. We found I have a chronic condition that affects ot along with being fatigued constantly. I have a wonderful but demanding career that has be traveling several times a year on top of that. I’ve worked hard for it. My marriage has suffered from these greatly. My husband says he feels unwanted. And to him sex = love. We have been struggling for over a year now. My personal victories has turned my marriage into a bad place instead of a sanctuary. I think I’ll try this, whether I feel like having sex or not. Doing what we’ve been doing isn’t working. It’s time to step out of the comfort zone and push to make it better. Thank you for sharing and inspiring. Love both you and Chris!
I?ve been married fifteen years and the last two have been without physical intimacy. I tell him it?s because I had bilateral Adhesive Capsulitis for three years and a hysterectomy prior to that, but truly, I?m just not interested. We sleep in separately because he has a sleep disorder that causes him to act out in his sleep (which means I don?t get much rest if we sleep together), and if we are intimate, I feel like I am there just to satisfy him. No cuddling, no caressing, etc. We live like roommates and it?s slowly killing my spirit.
I?m too young (early 50?s) to feel so dead inside. I honestly don?t think that having sex in a twin size bed for 30 days is going to save my marriage!
Your Friend – I really hope you try (because you won?t know unless you try, right?). Sometimes it takes something out of our comfort zone to bring people together and remember why you fell in love in the first place 🙂
Why not try it? It couldn?t hurt bd what if it helps?
Hey dear.
I wish Heidi can answer you.. meanwhile your comment touched me deeply.
As i understood from heidi’s article… This challenge is more than THAT it’s about the intimacy, the commitment and the “We time”… So why you don’t give it a try.
I’m only 29… And believe me I had moments like that… And it has nothing doing about my hubby… It’s just that i felt always tired… And this moment felt like another chore for me.. (that certainly wasn?t)…
We, women, think a lot… About everything.. And this doesnt help.
My husband told me many times to just stop thinking… Live the moment… I tried… But that not easy stuff..
Maybe you should give this challenge a try whithout thinking… And besides it… (which is more important in my eyes… And heidi told about laughing and everything… I guess because they were having some talks…) for me communication is everything…
Good luck
I?m willing to give the challenge a shot, but feeling loved and cherished when you?re left alone within ten minutes of having sex isn?t satisfying to me. It makes me feel used and cheap. I realize that?s my problem and I need to deal with it; perhaps I can make that part of the challenge. ?
FWIW, my hubby is a man of few words and isn?t one to say what?s on his mind freely. I have to drag things about work, for instance, out of him.
Read him Heidi?s story and then read him yours. Let him read all of the comments. He probably thinks that you two are the only ones going through this! He?ll know and you are not alone!
I?m pregnant with our second child, and my husband and I are constantly fighting. His biggest issue? He?s upset that when we first started dating we had sex almost every day (multiple times a day,) now we are lucky to have sex twice a month. When I found out baby number two is on the way, I?ve lost all desire to be intimate. I?d love to do this challenge but …, (always seems to be my answer) my issues with him are deeper.. financial and basic trust. I recommended that we go to a counselor…
Thanks for sharing your story, because I did think you had the perfect relationship. This gives me hope!
Jane, I understand completely. I have the same issues with my husband, basic trusts and finance. We have sex maybe once a month and I literally have no desire to be intimate. I don?t need to cuddle and like space truthfully. When we are intimate though we are a lot closer and seem to argue less. We have the relationship where, outside looking in, we should have no issues but we have talked divorce and agree we are not happy with how things have been. I would love to try this challenge but I can see myself getting tired and just not in the mood. Maybe I am the problem then? But it is worth the try for my relationship, so…
My husband and I are three months in to our marriage with a 9 month old child. (We have been together for 5 years total however.) Things have been very rough between us and I think this could be an absolute game changer. I shall update my comment after we?ve tried out this idea. Probably need to bring up the idea to my husband first of course. Lol.
Thank you for sharing ?
Every year my husband travels for 1 month ( a work obligation). Over the years you would think it would get easier… but it doesn?t.
I find I become angry and resentful…. vs understanding ( He doesn?t want to leave us at all !)
So, with building stress, lots of emotions and trips to the marriage counselor ( something that should be REQUIRED once you get married – it?s so amazing !)
We get back on track about 3-4 weeks after he comes home.
Now, your challenge just might be what we need when he gets back !
After 20 years…. some things DO become easier while others… more difficult.
Challenge accepted!?
I love your honesty. It’s part of the reason why I feel like I can relate to everything you say. People tend to portray their lifes as perfect on social media, because god forbid, we could ever have a bad day.
I truly believe that sex is an essential part of a loving relationship: because otherwise, you eventually turn into roommates who like living together. However, nobody talks about it, just like you said. But I am so glad you did!
This is crazy, yesterday my husband and I were sitting in our car talking about divorce i even called to make an appointment with a lawyer. We do love each other but theres been broken trust not of the cheating kind but nevertheless ,trust has been broken . I opened up my Instagram and I saw this beautiful picture of you guys and im willing to give this a try . Hopefully it works
I completely agree with this. We?ve been married for 13 years and I do believe being open about sex and taking that time regularly to focus simply on one another is vital. People don?t like to discuss the subject but without sex you bevome great friends and roomates rather than intimate lovers. Love the article xxx
You guys are an inspiration. Heidi I respect and amire you so much for winning in many fights I have been having for many years. My anorexia and PTSD have ruined, and continue to ruin my life and my marriage. My husband has watched me almost die in hospital and live without me for nearly a year while I regained the weight. I often read your articles and think it is possible! I too run my own business and know the stress but also freedom that brings. Although it will be difficult I am going to try your challenge I hope it works we have been through so much and I am at the top of my weight tolerance I don’t think we could survive that cycle again (I just need to hit the gym) I miss my best friend
Thank you for putting yourself out there
The thought of this terrifies me. For the past 17 years together with my husband, I have slowly shut down and closed myself off emotionally and physically. I have told myself that I am protecting myself and my heart because I have been, and continue to be, hurt so deeply by him. We have sex, but for me it’s strictly done out of necessity, not love and connectivity (he knows this) I have told him over and over that when he is being critical and mean, SEX or any intimacy is the LAST thing I want. BUT for him, sex and deeper intimacy with me is what he needs and desires and he gets more and more critical and mean when he feels “shut out” and neglected…..It’s a vicious circle and dance we go round and round…over and over……for years and years! It actually happened again last night…(even on Valentines day) I’m writing this because I need some accountability! I have begged God to help me love my husband the way he needs to be loved and to be the wife and mother that He created me to be! I KNOW for a fact that the Lord had me restless tonight for a reason….I stumbled on this in the middle of the night for a reason! Thank you! Thank you for posting something so dear to your heart in order to encourage others! God bless your family and your marriage ?
Brenda, I am so sorry that your husband has been critical and mean. I don’t think men fully realize the impact that their careless words can have on our hearts. I completely agree with you that sex or any intimacy is the LAST thing on my mind when he’s been awful. I really hope things improve for you.
You guys are an inspiration and I love how honest you are. I?m not married or even in a relationship but gives me hope that there are people out there that are happy.