You may find that you want to have sex but struggle to enjoy it in the moment due to physical pain or discomfort. On the flip side, you may feel you don’t desire sex in the way you once did but enjoy it when you do have it.

It’s important not to underestimate the impact hormonal symptoms can have on the way you may feel about yourself. If you are struggling with low mood because of your hormone health, it can impact how confident you feel about your body. This in turn can influence your desire to be intimate with a partner.
So, if problem PMS means you are struggling to sleep, or fibroids are causing heavy bleeding, it’s not surprising you may not feel you have the capacity to engage with sex. If this resonates with you, keep scrolling. We are going to get into how hormones can impact the way your body responds to sex and give you some pleasure producing tips that could help get you back to feeling good about sex, be that with yourself or someone else!

What do we mean by 'sex'?

Most people assume when we use the word ‘sex’ we are describing penis vagina intercourse. There are many different ways to have sex though, and not all of them involve penetration! It’s important to recognize this, as vaginal intercourse (where something enters the vagina) can prove uncomfortable for lots of us. This could be because of physical symptoms such as dryness or pain, or because of psychological factors.

When we use sex as a shorthand to mean penetration, we miss out many different people’s experiences and in doing so, can dismiss other ways of having sex or position them as ‘less than’. An alternative way to think about sex and the ways in which we have sex, is to consider simply what feels good for you when it comes to having different intimate areas of your body touched. Maybe nothing has entered your vagina – it doesn’t mean you haven’t had sex!

Changing our thinking in this way can help us to feel more empowered in the relationship we have with ourselves sexually. Afterall, you can have a happy and healthy sex life, regardless of whether someone is lucky enough to join you.

Can hormones impact my sex life?

There are many different hormones that help to fuel both our desire and physical response to sex. The hormones testosterone and estrogen are particularly important.

While you may have always thought of testosterone as a ‘male hormone’ it’s actually very important in maintaining a number of bodily functions and responses in women too. This is particularly the case when it comes to sex. Testosterone is the helpful hormone that has a lot to say when it comes to getting you in the mood. Love having sex in the morning? Well, this could be because testosterone levels are seen to peak between the hours of 7am and 10am. Not super convenient for a 9 to 5 we admit, but if you work from home why not try to lean into that natural testosterone treat!

The hormone estrogen is responsible for helping your vulva and vagina to stay well moisturized and lubricated when you have sex or feel aroused. At different points in our lives (such as during perimenopause and menopause) your estrogen will be in shorter supply and as a result you may experience symptoms that impact your physical response to sex. Even if your desire to have sex is still there, you may find you experience dryness both inside and around your vagina, as well as skin irritation and changes on your vulva. You may also find that your vaginal muscles and surrounding tissue weakens too.

When it comes to sex, I'm always in my head

The relationship between body and mind is complicated and this is certainly true for sex. The connection between your desire and your physical response is impacted by multiple factors, which can make figuring out what the ‘issue’ is more challenging. For example, being in pain when you have sex can impact your desire. You may find you come to dread sex because of a pre-emptive fear it will be uncomfortable. That fear can in turn lead to a physical response in which you feel tense, nervous, or anxious which will impact how your body responds to stimulation.

Equally, if you have experienced any kind of trauma related to your body or sex, this can have a huge impact on how you respond physically in intimate moments. Trauma doesn’t have to be relational either. You may have experienced a particularly invasive medical intervention or have complex internalized shame surrounding the idea of having or enjoying sex. Whatever the reason, it’s important to remind yourself that what you are experiencing isn’t abnormal or strange. In fact, it’s safe to say the person that has no sexual hang-ups is likely the abnormal one!

If you feel that your sex life is being impacted by emotional or psychological factors you would like to address, you may want to consider speaking to a therapist about the way that you feel. Sometimes speaking to others can help us to spot certain things we hadn’t considered.

In the meantime, try and think about the following:

  • Take your time: many of us can feel pressured to ‘perform’ sexually in certain moments. This can lead to a vicious cycle in which we end up feeling stressed and overwhelmed. Try and remember that having sex (with yourself or a partner) is meant to be fun! If the experience isn’t feeling good for you, it’s OK to take a break, or stop completely and come back to sex another time.
  • Communicate: although it can be overwhelming to talk to a partner about how you are feeling, everyone appreciates feeling like they’re ‘in the know’. If there is something you don’t like, or there are things you feel your partner should know before you have sex, try to communicate this to them. These conversations can be daunting, but actually may bring you closer together. Check out our pieces on intentional intimacy for more ideas on how to get closer with communication.
  • Step back: if you are experiencing something specific that is impacting your sex life, try to take a step back and really think about what may be going on. For example, if you find yourself tensing up when you are about to have sex, try and be honest with yourself about why this may be. Is there a trigger you can identify? Do you think the reason may be psychological or physical?
  • Explore: many of us can become complacent when it comes to exploring our sexual likes and dislikes. However, just as our bodies and minds change over time, so do our responses to sex. Perhaps you no longer find penetrative sex as satisfying in the same way? That’s OK, as we have explained, there are many different ways to have sex and it can be great fun to explore some different options. If you’re struggling to feel inspired, check out our piece on creating your very own sex menu.

While it’s easier said than done, try to remind yourself that sex is complicated for everyone. Any emotions you are experiencing about your sexual situations are valid and probably way more common than you may think.

Communicating your needs

Part of leading a fulfilling sex life involves communicating your sexual dos and don’ts to a partner. As mentioned, your needs may change over time and it’s important to be aware of this. So, whether you are dating someone new, or in a long-term relationship, it’s important to try to talk to your partner about your changing sexual needs.

Talking to a partner about what you are experiencing both physically and emotionally is a good place to start. Try opening up about any physical discomfort you are experiencing during sex, any feelings you may be having about your body or self-image and any other general feelings connected to sex you think are important to communicate. For example, if you feel like having poor self-image is making the idea of sex less appealing to you, talk to your partner about this and try to find some solutions together to help you feel more confident in intimate moments.

While it’s important to let your partner know what you’re struggling with, it’s also a good idea to tell them what you like too! Is there a particular position or sex act you prefer, let them know. Prioritizing pleasure will make the experience more enjoyable for both of you.

Talking to a partner encourages intimacy and can help to bring you closer together. If you are struggling to start a conversation however, or feel you could do with some support, you may want to consider talking to a sex and relationships therapist together. Many couples find that having another person in the room can help to make these conversations more manageable and ensure that conversation stays productive and on track. A therapist may also raise points you hadn’t considered yourselves.

Prioritizing pleasure

What makes sex pleasurable varies from person to person. Your pleasure could be stimulated by physical factors, emotional intimacy, or even the location where you are having sex!

The most important thing is that any sex you are having should be enjoyable and fun!

Although we may know this in theory, many women report feeling stressed during sex, because of pressures placed upon them to orgasm.
Try and think about the following when having sex:

  1. Remove any ‘obligation’ you are experiencing. Try to relax in the moment and banish any worries that you need to achieve anything. This can actually be freeing!
  2. If you are struggling to enjoy sex because of physical pain or discomfort, try to make sure you are having sex in ways that feel comfortable for you. You could try to adopt different physical positions or use pillows to help support yourself.
  3. If penetrative sex is causing you pain, try and think about other ways to have sex that you find more enjoyable (such as oral sex or mutual touching).
  4. Show your partner how you like to be touched. Guiding their hand and encouraging them to think about the pressure, speed and motion that feels pleasurable for you is important.
  5. Think about incorporating sex toys or vibrators to help increase your pleasure. If you find penetrative sex uncomfortable but still want to engage in this type of sex, a clitoral vibrator can be helpful in making the experience more comfortable. Use the vibrator at the same time as you are having penetrative sex and think about varying the speeds and pressures of the toy as things hot up.
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Changing hormone levels during perimenopause and menopause can cause symptoms that impact both your desire to have sex and your physical experience of sex in the moment. If you are experiencing symptoms because of perimenopause and menopause, you may want to think about using hormonal treatments to help relieve discomfort. Lots of women use a combination of estrogen and progesterone to stabilize fluctuating hormone levels and find great relief with starting HT.

The addition of estrogen can often be enough to resolve symptoms, but for those struggling with low libido, the addition of testosterone may prove helpful. Testosterone is not currently widely prescribed to women experiencing menopausal symptoms, but it has been reported to have a big impact on improving their libido.

If you are experiencing discomfort around your vulva or vagina you may also want to explore using a topical estrogen to help with symptoms. You can apply local estrogen directly to your vulva and vagina. It can be very helpful in helping to soothe irritation. Over time, it will also help to resolve any skin issues or muscle degeneration. This can be helpful in not only making sex more comfortable but in rebuilding your confidence too.

You can ask your clinician for a prescription of local estrogen. Despite warning labels, local estrogen has been found to be highly effective in relieving symptoms and safe to use.

Sex is most pleasurable when we feel comfortable both mentally and physically. Investing in a few essential products to help make things more enjoyable!

In particular you should think about investing in:


While some people feel anxious about the idea of lube, particularly when it comes to suggesting its use to a partner, lubricant can reduce friction and address any dryness. This ultimately makes sex more comfortable and pleasurable. Lubricant can be applied to the opening of your vagina, any sex toys you are going to use, or to your partner’s fingers or penis. Water based lubricants are best as they are less likely to create irritation. They are also safe to use with condoms.

Vaginal moisturizer

If you are noticing dryness or skin irritation, you may want to think about using a vaginal moisturizer. This can be applied inside and around the vagina a few times every week. Making sure you are moisturizing regularly helps to keep your vagina and vulva soft and well lubricated. It will also address any dryness, itching or discomfort, potentially making it easier for you to have sex.

Vaginal estrogen

If you have vulvovaginal symptoms of perimenopause and menopause, vaginal estrogen can be applied alongside HT, or on its own to reduce discomfort (such as soreness and burning of the vagina). Vaginal estrogen works by releasing estrogen into the surrounding tissue. There are a few different options available, and you can talk to your healthcare provider to help you decide which is best. You can also find more information on vaginal estrogen here.

Clitoral vibrator

While Freud did a good job at convincing his peers that women can reach orgasm from penetration alone, contemporary research has very much dispelled this myth!

The majority of women climax from stimulation directly to the clitoris, or as a result of internal stimulation that reaches the many nerves connected to the clitoris! Using a vibrator on your clitoris while having penetrative sex with a partner, or alone, can make all the difference to your pleasure. If you’ve not tried something before, opt for something small with a few different pressure options to try.

We cannot stress this enough, only use products designed for intimate use. If you’re not sure whether a product is OK to use on your vulva or vagina, speak to your doctor or beforehand.

Additionally try and avoid using any products that contain perfumes or fragrances (such as washes or soaps). These can increase dryness and irritation of the vagina and vulva and equally upset your natural pH balance.

As well as thinking about products to experiment with, you may also want to consider different types of sexual play that help your vagina to become lubricated before penetration.

There are many different options when it comes to sex toys. If you’re not sure where to start, make sure to ask questions when you are thinking about making a purchase. While the idea of asking for advice may feel embarrassing, staff members in a sex shop are there to help! They will be happy to assist you in making the experience fun and help you to find something that’s right for you.

An added bonus you may want to think about is going with a partner to select a toy. Picking out something together can help to bring you closer, increasing intimacy. It may also help get you excited and in the mood for sex!

Ensuring you are eating nutritiously and exercising regularly will ensure you feel healthy, energized and raring to go. As well as potentially improving the relationship you have with your self-image, exercise has been shown to boost the production of a chemical in your body called serotonin. This helps to regulate and improve your mood! Exercise also increases blood flow to your vulva and vagina, which may increase feelings of sexual desire.

Finding out how to improve your self-esteem and the relationship you have with your body is personal. While eating well and exercising may work well, other self-care practices could prove to be the secret to your sexual success. Making sure you get enough good quality sleep and finding time to relax and rest all help with libido.

A lot of what we have discussed focuses on techniques to try. It’s important to remember however that sex is meant to be fun! When we are feeling frustrated because our body is failing to cooperate, or because we can’t get out of our heads, taking things back to basics can be a great place to start.

If you have a partner, think about how you can make the experience more light-hearted. You can try setting rules and boundaries to build anticipation (such as only kissing) or explore things like playing games with one another.

If sex is causing you anxiety or you find yourself getting overwhelmed, even if it’s hard, communicate this. You can take a break, stop, or try again another time when you feel more positive about the experience.

Equally, try to learn what you like. If you don’t currently have a great relationship with your body, or haven’t explored yourself sexually, give it a go. You may find it to be a fun and enjoyable experience that helps you to feel more in control in situations with a partner too. Everyone benefits from feedback – so long as it’s constructive! Plus, we can only produce positive pointers if we’ve done our own homework too.

As much as we wish we could give you all the answers to ensure you feel like a pleasure pro, everyone’s relationship with sex is unique and often, complicated. The important thing to remember is that you should never feel pressured to have sex, particularly if it’s not something you want to do.

Equally, if you are struggling with sex in any way, it is OK to ask for help and to seek support. While you may feel uncomfortable talking to a doctor about how you are feeling about sex, or don’t want to ask for advice, it is a part of their job! Your doctor may be able to refer you to a therapist if they feel this could be helpful, or equally recommend treatment options if you are experiencing physical discomfort. Fundamentally, factors connected to our hormones or our mental health should not be a reason to stop having sex if it is something you enjoy.

If you don’t feel able to talk to your clinician about what you are experiencing, try to think of any other safe supportive peers you could confide in. Accessing support in any capacity can be really helpful. Remember, sex is different for everyone, and your situation is unique. Try not to compare yourself to others when it comes to the ways in which you enjoy or have sex, or equally, how frequently you engage with sex. As long as you are happy that’s the important thing.

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