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
I’m a sex therapist south of Denver, and want to thank you for sharing. I speak with individuals and couples about this pretty much all day, every day. Now, most couples cannot do the 30 day challenge. Too many wounds, and honestly, sex is sometimes the only thing a woman can keep for herself inside a marriage where she is hurting. A lot of men’s love language is physical touch. However, sex can happen MANY ways, and does not mean intercourse-sex necessarily. Orgasm and intercourse should not be the focus or goal of sex. The goal should be connection and pleasure. Emotional safety and eroticism. On your period? Mutual masturbation can be so fun! Pissed as hell at each other? Agree with one another that the argument topic is still there, but you are committed to connecting with each other through intimacy/sex. Baths, massages, role play, naked cuddling, are all ways to have sex. Most people tell me I’m crazy, but focusing on intercourse sex all the time isnt realistic. Medications, illness, pain for women (which isnt talked about enough at all) can keep intercourse from happening the way we want it to. Sex shouldn’t really be seen ever as “bad”. Sure, maybe it didnt happen the way/feel the way “YOU wanted it to”. Most sex just stops in the middle if it isnt “good or great”. Bur if couples would giggle and say, let’s try something else, intimacy deepens, sex continues, and you dont feel cut off. Rejection is huge when it comes to sex. It’s really amazing you and Chris could recreate your own couples sexual style. One of my favorite parts of my job is helping couples redefine their sexuality with each other. 🙂
This!! ??? Thank you so much for your answer ?
That’s exactly how I feel about this. Thank you!
If your wife is fat and old… And yoh dont find her attractive. All these things you mentioned would be pointless
I was actually looking up some articles about this yesterday… my husband and I have been together for just shy of 16 years… I was just 16 when we met… we have had many problems over the years but nothing that ever would pull us apart… until the last few years. I have watched my marriage crumble… sex is a big issue in our marriage… I am going to commit to this because I do believe it could be the saving grace… right now the only other options are to continue to hate each other or get a divorce… which neither of those are appealing. Thank you for sharing this story… you and Chris are a big reason I am perusing my goal to become a personal trainer!!
Challenge accepted! Day 1 complete ?
I found a book about this at my local library and it honestly helped my husband. It was kinda fun finding ways to sneak around our children so we can have us time. It truly works. Thank you for your inspiration!
My husband and I were in the same boat, with three kids and running three businesses. We would get 1 date night a year. It just wasn?t enough. We own our own businesses, so we started taking a ?stay at home date day? while all three kids are in school, each week. That changed everything. It isn?t every day, which would be al ost impossible for us with Special Needs kiddos, but we dedicate time to each other, and to us! Definitely works!
I have been in a relationship for 5 yrs and I still love this man as I did the day our relationship began. I still get excited to see him after a day of work or if either of us are away for a day or 2. But I have realized from his words and his actions that he does not have those feelings that made him come to me 5 yrs ago and tell me he wants to be in a relationship. He loves me but has fallen out of love with me. In the beginning we would make love every day and most days multiple times, now maybe once a week. I would love to try this challenge to bring the man I fell in love back to me but I truly believe he would not. He is trying to push me away, out of his life, so do I even still try?
Wouldn’t hurt to try. Worst thing that can happen is that he confirms what you’re thinking about his feelings and doesn’t want to participate. But, at least then you would KNOW. And once/week is still actually more often than a lot of marriages, so I bet there’s still hope for you both.
Your comment about loving but not being in love rings true with me. We?ve been married nearly 41 years. My husband had prostate cancer and is now impudent. Haven?t had sex in several years. ?Other? means is all we have. My problem is I get no intimacy. If I ask for his help, he will but there is no skin to skin contact and when I kiss him it?s no different than kissing my dad. I feel like a roommate. ? I do love him but zero passion.
Jan I’m so sorry to hear that. Amazing you’ve been married for 41 years! We are coming up on our 6th year of marriage. My husband is a naturopath and I work at the best chiropractic office there is. Have you guys tried anything like that? Just curious because after we started seeing a chiropractor years ago, our sex life improved a ton! Also, because of the cancer is that what the docs said would happen? I only ask bc I’ve done and had things happen that docs told me would never happen. Would love to help with suggesting alternative methods for you both so you can get your intimacy and marriage back to an incredible place.
Hey, I know toys are something taboo to a lot of people but it might help. If he has a sex drive but is just unable to perform the act, he might be open to a strap on of some kind?
Thank you so much for sharing this! My husband and I need to do this. We?ve been together 11 years and starting about 9 years ago we began having difficulty with sex. He just didn?t want it. Over the years he?s been tested (hormones), we?ve gone to multiple therapists, we?ve talked about it & argued about it (becaus it hurts my soul), but nothing changes. We?ve tried to figure out what the problem is, but I guess he las no libido. We?re in our 30?s and have a 4 year old. He refused to have sex with me while I was pregnant, kept saying it would hurt the baby but it just hurt me. We?ve gone though periods where we?ve had sex 2-3 times in a year. I long so deeply for the intimacy! Not just the sex, but the closeness and the cuddling, etc. I lately feel like I?ve almost accepted this is what our life is, friends/roommates. I?ve told him all the above multiple times, we?ve discussed this topic a million times. He?s not a very cuddly person and I am big time, I need it to feel
loved, I always have and will. He knows that, he try?s to show affection sometimes but then it fades again and I always have to ask/beg for it. I?ve thought of s million reasons why he might have this problem, and all have lead us nowhere. It?s not hormones, it?s not infidelity…I?ve wondered if it?s because I?ve gained a lot of weight partially because of some health issues & medications, but this problem started when I was in the best shape of my life so I know it?s not only that. I?ve recentlh been thing of trying to find a sex therapist, because this is an aweful way to live. But, I?m soooo thankful I read what you shared. I want to do this! It sounds scary, overwhelming and imposssible, but worth it if it helps our marriage. My only question is, what about if i?m on my cycle? Can we skip that week? TMI? Thank you again! I really really needed to hear this! Wish me luck bringing this up to him tonight.
Read Heather DeKeyser?s comment. I think it will help you. XO
I?m always the practical one. What about during your period? Mine are so dang heavy it would truly be unpleasant and uncomfortable ?
I was wondering that too
I was thinking the exact same thing!
How about in the shower? Keeps cleanup easier.
Read Heather DeKeyes comment. I think it will help you! XO
I?ve actually found having sex during my heavy period reduces my pain, cramps and slowed down the flow. I have multiple gyn issues and my husband notices a difference too. It?s worth a try.
Thank you for being vulnerable and sharing! You changed my marriage today!!
Well it?s been over a year without intimacy between my wife and I of soon to be 20yrs. We barely even kiss anymore and the only times we say ?love you? is in text msgs. We argue like we hate each other. It saddens me every time and it?s usually over the silliest stupidest things. She was my best friend and we were inseparable even our children used to say ?gross? when we?d kiss in the kitchen or wherever. Now almost strangers living together. I?m so glad this worked for you Heidi. I?m gonna try and ask her to give this a shot. Lord knows what we are barley hanging onto now doesn?t have much time left.