By Sophora Health Editorial Team  ·  Medically reviewed  ·  Published July 2026  ·  Last reviewed July 2026

Menopause, Marriage and the Sex You’re No Longer Having

You still love them. You may still want the marriage. But somewhere along the way, sex disappeared.

Maybe desire stopped showing up.

Maybe sex became uncomfortable, so you started avoiding the moments that might lead to it.

Maybe you are exhausted. You have slept badly for months. Your body feels different. Your patience is shorter. You have spent the entire day being needed by everyone, and by bedtime the last thing you want is one more person wanting something from you.

So you go to bed a little later.

You turn over a little earlier.

And suddenly your phone becomes absolutely fascinating at 11:47 p.m.

Meanwhile, something is happening between you.

Your partner may think you no longer want them. You may be wondering why you cannot make yourself want what you used to want. One of you feels rejected. The other feels pressured. Sometimes both of you feel lonely.

And neither of you quite knows how to talk about it without someone ending up hurt.

If you are asking, “What happened to us?”

That may be the real question underneath your Google search.

You probably did not wake up one morning, announce that your marriage was now sexless, update the household spreadsheet and carry on with breakfast.

It usually happens more slowly.

Sex becomes less frequent.

Then initiating it feels awkward.

Then not having sex becomes normal.

Then one day you realise you cannot remember the last time you did.

Perhaps you miss it.

Perhaps your partner misses it more than you do.

Perhaps you miss the closeness but not the sex itself.

Or perhaps, if you are completely truthful with yourself, you feel relieved that sex has stopped.

These are different experiences. They need different answers.

First, this may not be one problem

Sexual desire is not an on-and-off switch controlled by one hormone. Biology matters, but so do sleep, stress, health, medication, emotional connection, body image, relationship history and whether sex actually feels good to you.

During the menopause transition, oestrogen levels change and eventually fall. For some women, this contributes to vaginal dryness and changes in the tissues around the vagina and urinary system. Sex can become uncomfortable or painful. Hormonal and other midlife changes may also affect sexual desire, although the relationship between hormones and desire is not simple.

Then there is sleep.

If you are waking several times a night hot, sweaty and irritated that another human being has somehow managed to sleep peacefully beside you through the entire event, romance may not be your first thought the following evening.

That is biology meeting real life.

And real life matters.

A 2024 synthesis of qualitative research on menopause and intimate relationships found that women’s sexual experiences during menopause are shaped by multiple factors, including changes in desire, physical symptoms, communication, concern about a partner’s satisfaction and the cultural meaning attached to menopause and sexuality.

More recent qualitative research has reached a similar conclusion: sexuality during the menopause transition is influenced by both biological and psychosocial factors, including the quality of the relationship itself.

So if you are living in a menopause sexless marriage, there may be several things happening at once.

Your body may have changed.

Your energy may have changed.

Your desire may have changed.

Your relationship may have changed.

And sometimes the answer is an inconveniently human combination of all four.

Sometimes you want sex. You just don’t want sex that hurts.

For some women, desire did not disappear first.

Comfort did.

As oestrogen levels fall, the tissues in and around the vagina can become drier, thinner and more sensitive. Doctors group these changes under the term genitourinary syndrome of menopause, or GSM.

In plain English, you may notice dryness, burning, irritation, urinary problems or pain during sex.

And once sex hurts, something very sensible can happen.

You stop wanting to do the thing that hurts.

Your body is not being difficult. It has learned what to expect.

Then a physical problem can become a relationship problem.

Your partner experiences avoidance as rejection.

You experience their attempts to start sex as pressure.

Neither person may realise that discomfort was where the whole cycle began.

If sex hurts, the answer is not to become better at tolerating painful sex. The pain is the thing to address first.

Lubricants can help reduce friction during sex. Vaginal moisturisers are designed for more regular use to help with ongoing dryness. Depending on your symptoms and medical history, a healthcare professional may also discuss treatments such as local vaginal oestrogen or other medical options.

If you have persistent pain, bleeding during or after sex, ongoing burning or urinary symptoms, speak with a healthcare professional rather than assuming menopause is the only possible cause.

Sometimes you simply don’t want sex

There may be no pain.

No dramatic argument.

No secret affair.

No mysterious stranger from your past arriving in episode six.

You simply do not think about sex very much anymore.

You may still love affection. You may want a hug. You may want someone beside you on the sofa. You may enjoy holding hands, kissing or sleeping next to your partner.

You just do not particularly want sex.

Menopause may be part of that picture. But desire is affected by much more than hormones.

Sleep matters.

Mood matters.

Stress matters.

Medication can matter.

Your physical health matters.

How you feel about yourself matters.

And what is happening between you and the person wanting to have sex with you matters enormously.

Then there is midlife itself.

Work. Children. Ageing parents. Money. Caring responsibilities. Household jobs. Health worries. The mental list that appears in your head at precisely the moment someone is trying to be romantic.

Sometimes the mystery is not why desire disappeared.

The mystery is where it was supposed to find room.

And sometimes it really is the marriage

Menopause does not happen inside a relationship vacuum.

If resentment was already there, menopause may not have created it.

If you have spent years feeling unseen or carrying most of the practical and emotional work of family life, changing your hormone levels cannot automatically repair that.

If sex has become something you provide rather than something you enjoy together, the question may not be, “How do I increase my libido?”

It may be, “Why don’t I want this anymore?”

There is an important difference between:

• I want to want sex again.
• I want sex, but it has become uncomfortable.
• I miss feeling close to my partner.
• I like affection, but I don’t want every cuddle to become an invitation to sex.
• My partner wants sex and I wish I wanted it too.
• I don’t want sex, and I am comfortable with that.
• I don’t want sex with this person.

From the other side of the bed, these can all look like the same thing.

They are not.

And they do not have the same solution.

The honest evidence picture

The strongest evidence tells us that sexual wellbeing during menopause is both biological and personal. Menopause-related physical changes can affect comfort and sexual function, but a woman’s experience of sex is also shaped by her health, relationship, culture, circumstances and her own feelings about sexuality.

Modern medicine can treat many physical symptoms. Vaginal dryness and menopause-related discomfort, for example, have recognised treatment options. Other menopause symptoms that affect sleep and wellbeing may also be treatable.

But medicine cannot prescribe emotional closeness.

It cannot medicate away years of resentment.

And no blood test can tell you whether you still want the relationship you are in.

This is why good menopause care needs both biology and context.

The International Menopause Society’s current evidence-based recommendations include sexual wellbeing and genitourinary syndrome as important parts of women’s midlife health. The World Health Organization also notes that sexual wellbeing during menopause is overlooked in many countries and that vaginal dryness and pain during sex can go untreated.

That matters because women cannot ask for treatment they have never been told exists.

The global picture: menopause does not happen in one kind of marriage

There is no single cultural experience of menopause, marriage or sex.

Research across the world shows that women’s experiences are shaped not only by physical symptoms but also by family roles, religion, community expectations, access to healthcare and whether talking about sex is considered acceptable at all.

In qualitative research from Zimbabwe and South Africa, women described menopause in different ways. Some experienced uncertainty and loss, while others welcomed it as freedom from menstruation and childbirth or as a transition towards becoming a respected elder.

Research involving women from Asian and Black ethnic backgrounds has also shown that menopause can carry spiritual, moral and generational meaning. Some women understand this stage through family knowledge, faith, ancestral traditions or cultural ideas about ageing alongside, or sometimes instead of, a purely medical explanation.

Among migrant and refugee women from backgrounds including Afghanistan, India, Iraq, Somalia, South Sudan, Sri Lanka and South America living in Australia and Canada, research has found that women’s experiences of menopause are shaped by cultural expectations, migration and different understandings of women’s bodies and ageing.

Studies in Australia have similarly found that religion, migration, family relationships and traditional approaches to health can influence how some women understand menopause and seek help.

Research from Latin America also reminds us that even women grouped under the same broad regional label can have very different symptom experiences. Studies involving Quechua women in Peru and Zenú women in Colombia found substantial differences between the two groups.

And a 2025 review drawing together qualitative studies from countries including Lebanon, Iran, Sweden, Chile, Spain, the UK, Ireland, Thailand, Singapore, Australia, the United States, China, Malaysia and Taiwan found highly individual experiences of sexuality during menopause, shaped by relationship dynamics, sexual autonomy and personal views of menopause.

The lesson is not that women from one ethnicity experience menopause one way and women from another experience it differently.

The lesson is almost the opposite.

Your biology matters. Your culture matters. Your relationship matters. Your personal history matters. And none of those things should be used to make assumptions about you.

What about spirituality?

For some women, menopause is entirely physical.

For others, it carries a deeper meaning.

It may mark the end of fertility, a change in identity, a new relationship with ageing, or a point at which long-standing questions about marriage and self become harder to ignore.

Research into women’s lived experiences shows that some women interpret menopause through faith, spirituality, ancestral knowledge or cultural traditions. These perspectives are meaningful parts of women’s experiences, but they are not substitutes for medical evidence when a physical symptom needs diagnosis or treatment.

You can pray and see your doctor.

You can value ancestral wisdom and use modern medicine.

You can understand your body biologically while also asking what this stage of life means to you.

These things do not have to compete.

Your hormones may explain part of what changed. They do not get to write the entire story of your marriage.

Someone important to you needs this too.

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Before you try to fix your libido, ask yourself this

If nobody else was disappointed, what would you want?

Would you want sex to feel comfortable again?

Would you want your desire back?

Would you want more affection without feeling that every kiss has somewhere else to be?

Would you like to rebuild intimacy slowly?

Would you like your partner to understand what has changed in your body?

Would you like help with dryness or pain?

Would you like the two of you to finally talk about things that started long before menopause?

Or are you beginning to realise that the absence of sex is telling you something about your relationship?

You do not need the complete answer today.

But knowing which question is yours changes what you do next.

What to do next

If you want sex, but it hurts

Start with the physical problem. You do not need to push through pain to protect your marriage.

Try an appropriate lubricant for sex and consider a vaginal moisturiser for ongoing dryness. If symptoms continue, speak with a healthcare professional about possible genitourinary syndrome of menopause and the treatments available to you.

If you have lost desire and you miss it

Look at the whole picture. Consider your sleep, stress, mood, medications, physical health, comfort during sex and relationship.

If low desire is persistent and bothers you, discuss it with a menopause-informed healthcare professional. Treatment depends on what is contributing to the problem. For some women, addressing other menopause symptoms helps. In appropriately assessed postmenopausal women with persistent low sexual desire that causes distress, testosterone may sometimes be considered under medical guidance.

If you want affection but not sex

Say that clearly.

Touch can remain touch.

A kiss can simply be a kiss.

A cuddle does not need a five-year strategic plan for where it is heading.

For some couples, removing the expectation that affection must always lead to sex makes physical closeness feel possible again.

If you feel pressured to have sex

Your partner’s disappointment does not create an obligation for you to have sex.

Consent matters in a marriage, including a marriage of many years.

If saying no leads to threats, intimidation, punishment or fear, this is not simply a menopause or libido problem. Consider speaking privately with a healthcare professional or an appropriate support service where you live.

If you have stopped connecting altogether

Start the conversation somewhere other than the bedroom.

Preferably not at 11:47 p.m. when one person is hopeful and the other has just remembered an urgent need to reorganise the bedside drawer.

Try:

“I know something has changed between us. I don’t want this conversation to be about blame. I want us to understand what has happened and what we both want now.”

If every attempt to talk ends in blame, silence or conflict, a qualified couples counsellor or sex therapist may help you talk about the relationship alongside the physical changes of menopause.

If you are not sure you want the relationship anymore

Give that question its own space.

Menopause can coincide with a time when women reassess many parts of life. But difficult feelings about a marriage should not automatically be blamed on hormones.

You can have menopause symptoms and relationship problems.

Both can be true.

And treating one does not automatically solve the other.

When to raise it with your doctor

Speak with a healthcare professional if you have persistent vaginal dryness, burning, irritation, urinary symptoms, repeated urinary infections, pain during sex, bleeding during or after sex, or a significant change in sexual desire that concerns or distresses you.

Ask specifically about menopause-related vaginal and urinary changes if these symptoms sound familiar. They are common, but common does not mean you simply have to live with them.

If you have had breast cancer or another hormone-sensitive cancer, discuss treatment choices with the healthcare professionals involved in your care. Your individual history matters when deciding which options are appropriate.

Questions you are probably asking

Can menopause cause a sexless marriage?

It can contribute to one, but menopause is rarely the only explanation. Changes in sexual desire, vaginal dryness, painful sex, poor sleep and other menopause symptoms can affect intimacy. Stress, medication, health problems and relationship difficulties can also play a part.

Is low sex drive normal during menopause?

Changes in sexual desire can happen during menopause, but not every woman experiences them. Some women have less desire, some notice little change, and some experience greater sexual freedom or interest. If your loss of desire bothers you, it is worth exploring possible physical, emotional and relationship causes.

Can a marriage survive without sex?

There is no medically correct amount of sex for a marriage. The important question is whether both people are comfortable with the relationship as it is. A marriage with little or no sex may work well when both partners genuinely agree. Difficulty often arises when one person is content and the other feels rejected, pressured or lonely.

Can intimacy return after menopause?

Yes, for many couples it can. What helps depends on what changed. Treating physical discomfort, improving sleep, addressing menopause symptoms, reducing pressure around sex and talking openly about what each person wants may all help. Sometimes intimacy returns in a different form from the one the couple had earlier in life.

What if I don’t want my libido back?

You do not have to want more sex simply because someone else thinks you should. Low desire becomes a medical concern particularly when it causes distress to you. Your own experience and wishes matter when deciding whether you want help or treatment.

Someone important to you needs this too.

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You do not have to begin by asking how to make yourself want sex again. Begin with a better question: What do I miss? What hurts? What do I want? Then start there.

References & Evidence Base

International Menopause Society. Recommendations and Key Messages on Women’s Midlife Health and Menopause. Current international evidence-based recommendations covering menopause care, genitourinary syndrome of menopause and sexual wellbeing.

World Health Organization. Menopause. Global guidance recognising that sexual wellbeing in menopause is frequently overlooked and that vaginal dryness and pain during sex may go untreated.

Women’s Experiences of Intimate and Sexual Relationships During Menopause: A Qualitative Synthesis. Journal of Clinical Nursing, 2024. Synthesis of 18 qualitative studies examining menopause, sexuality, intimate relationships and cultural context.

Women’s Experiences of Sexuality During Menopausal Transition. European Journal of Obstetrics & Gynecology and Reproductive Biology X, 2026. Qualitative research examining biological, psychological and relationship influences on sexuality.

Women’s Experiences of Their Sexuality During Their Menopausal Transition and the Support Offered by Healthcare Providers. Systematic review and meta-synthesis, 2025. Evidence drawn from 21 qualitative studies across diverse cultural settings.

Understanding Experiences and Views of the Menopause in Zimbabwe and South Africa. Climacteric, 2025. Qualitative research examining diverse social and cultural experiences of menopause in Southern Africa.

Embodied Transitions: Cultural Framings of Menopause Among Minority Ethnic Women. Journal of Women & Aging, 2026. Qualitative research exploring cultural, spiritual and generational meanings of menopause among Chinese and Black women.

‘Age of Despair’, or ‘When Life Starts’: Migrant and Refugee Women Negotiate Constructions of Menopause. Culture, Health & Sexuality. Research involving women from Afghanistan, India, Iraq, Somalia, South Sudan, Sri Lanka and South American backgrounds living in Australia and Canada.

Cultural Issues in Menopause. Menopause. Qualitative research among Macedonian women in Australia examining the influence of migration, religion, family relationships and cultural understandings of menopause.

Severe Menopausal Symptoms in Mid-Aged Latin American Women. Climacteric. Research involving Quechua women in Peru and Zenú women in Colombia, illustrating differences in reported menopause experiences between populations.

Last reviewed: July 2026  ·  Review due: September 2026  ·  Not therapy. Not medical advice. For your own use and understanding only.  ·  mysophora.com