You’d think by now we’d have gotten the hang of this sex thing. After all, we’ve been at it for 20 years or more. But if you’re feeling the ground has shifted a bit (or a lot), there’s a reason: In midlife, hormones are fluctuating, relationships are changing, and self-esteem is soaring. The net net: Bedroom moments may be more challenging in some ways but can also be much more fun.
Here, three leading women doctors tackle the sex questions of women like you. Our experts include Jennifer Berman, MD, director of the Berman Women’s Wellness Center in Los Angeles and coauthor of For Women Only: A Revolutionary Guide to Reclaiming Your Sex Life; Christiane Northrup, MD, author of The Secret Pleasures of Menopause; and Gail Saltz, MD, professor of psychiatry at the New York-Presbyterian/Weill-Cornell Medical Center and author of The Ripple Effect: How Better Sex Can Lead to a Better Life.
Q. How is sex different for women over 40?
Northrup: It’s often a lot better. In midlife, you get to a place where you realize you’ll never again have the body you had at 18. But because of your ego strength, skill set, and clout in the world, you can have sex on your own terms. You know what you like, and if sometimes you don’t know, this is the time of life when you’ll find out. Your soul is waking up. You have the spirit and sense of adventure that 9- to 11-year-olds have — so you can reinvent yourself sexually. The truth is, most men don’t care if you are 40, 50, or 60. What they want is someone who is fun, who responds, and who makes them feel good.
Q. Why do many midlife women find it harder to climax?
Northrup: You may have trouble reaching orgasm because your body is asking for more. "Wham, bam, thank you ma’am" simply won’t work anymore. Your body is demanding that you recruit other neurological pathways. Your job is to explore the pleasure potential of your body. It’s not going to be what it was in your 20s when you were horny as hell and ready to reproduce. But you’re not going for Ripple anymore; you’re going for fine wine. You don’t gulp that, do you?
Saltz: If it’s difficult to climax, there’s the possibility that your estrogen has dropped so much that arousal has been affected. You may have lost a lot of lubrication, causing painful intercourse and making it more difficult for you to have an orgasm. Or your testosterone is lower and that’s diminishing your libido. A word about testosterone: It, not estrogen, is the hormone of desire. If you really feel no desire at all, you should ask your doctor about checking your testosterone level. The hormone is not approved for women in general, partly because it carries cardiac risks. There are other negative side effects as well: You might find yourself growing a beard, speaking in a lower voice, developing acne, and feeling more aggressive. Simply bringing testosterone back up to a normal level with a patch will not cause these problems, but your doctor ought to watch you carefully.
Q. What else can help women achieve orgasm?
Berman: Topical sensation; enhancing products like Zestra or Vibrel can help by enhancing arousal and increasing sensations in the genital area.
Q. After 20 years with my husband, things have gotten pretty routine in bed. How can I make sex fun again?
Saltz: By midlife, most couples are doing exactly the same thing over and over. It’s pretty hard to get excited about that. But people tend to be nervous about being rejected by their partner if they try something new, even if the couple has been together for a long time. If you’re thinking of experimenting, I recommend you bring up the subject outside the bedroom. Suggest trying a different position or some form of foreplay that you haven’t used, or watching a little erotica beforehand. If you talk about it when you’re not having sex, you won’t lose your nerve. And it can create some anticipation.
Northrup: Figure out what would be really fun for you, and practice with anything that turns you on — underwear, wigs, whatever. Sex research shows that women are turned on by most erotic acts they see: men with men, men with women, two women together.Men have a much narrower repertoire of enjoyment. So explore your range!