64. Why Good Sex is Good Medicine in Perimenopause
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In this raw and empowering episode of Perimenopause Simplified, we’re diving into one of the most overlooked, yet powerful ways to support your health in midlife: sex.
From the hormonal magic of oxytocin to the emotional benefits of intimacy, I’ll share how good sex can actually help ease perimenopause symptoms—while also addressing the very real challenges modern couples face when it comes to connection.
I’ll also open up about a dry spell in my own relationship, and how we found our way back to each other. Whether your libido is MIA or you’re craving deeper connection, this episode is for you.
You’ll learn:
- How oxytocin release during sex can lower cortisol and reduce perimenopause symptoms
- Why connection and pleasure are essential forms of self-care in midlife
- The difference between responsive vs. spontaneous desire—and why it matters
- How shame, judgment, and silence impact intimacy in long-term relationships
- Real talk about what happens when couples stop making time for sex
- Simple ways to rebuild emotional and physical connection with your partner
Why We Need to Talk About Sex in Midlife
Welcome back to the show! Today, we’re talking about sex. I know…this might feel uncomfortable or even the last thing on your mind, especially if you’re deep in the chaos of midlife. But I want to offer something today that could radically shift your perimenopause experience and it has nothing to do with supplements or lab tests. It’s about connection. Intimacy. Oxytocin. And yes…good sex.
Why Perimenopause Can Disrupt Intimacy
Look, the hormone shift in perimenopause can make you feel like your body’s betraying you. For many women, your libido tanks, you’re exhausted, moody, and touch can feel overstimulating or even irritating. Especially when you have little kids – at the end of the day, you’re probably sick of being touched. So the idea of sex? It’s often the last thing on your to-do list.
The Hormonal Power of Oxytocin
But: good, connected sex—can actually help ease many of the symptoms you’re dealing with.
Oxytocin, the ‘bonding or love hormone,’ is released during orgasm, touch, and even eye contact. It plays a pivotal role in reducing anxiety by dampening the activity of the amygdala—the brain’s fear center.
It helps lower cortisol, relaxes your nervous system, and fosters feelings of connection, trust, and safety. All of which are vital during perimenopause.
What the Science Says About Oxytocin
One study published in Biological Psychiatry, found that oxytocin release, especially in the context of positive social interactions (like intimacy, touch, and support), reduces cortisol levels and buffers the body’s stress response. So Oxytocin doesn’t just make us feel connected—it actively helps the body regulate stress hormones, improving emotional resilience and physical health.
Another study from 2023 in Frontiers in Endocrinology found that oxytocin levels significantly decrease in postmenopausal women, compared to their premenopausal counterparts. This decline is associated with increased risks of cardiovascular disease, osteoporosis, urinary incontinence, sexual dysfunction, obesity, and reduced metabolism (likely due to low hormones). The researchers suggest that enhancing oxytocin secretion could be a vital strategy for improving women’s health while aging.
I’m also going to link to an article about oxytocin from Dr. Lindsey Berkson, someone I’ve learned a lot from over the years. She’s really dug into the science behind it.
Sex as a Full-Body Reset
When we engage in pleasurable sexual activity, the body releases a surge of other feel-good hormones like dopamine and endorphins.
Endorphins act as natural pain relievers, helping to ease headaches, joint discomfort, period pain, and other common perimenopausal symptoms.
Sexual activity also promotes deeper, more restorative sleep by calming the nervous system and enhancing relaxation.
Plus, research shows that these hormonal shifts can have a powerful impact on metabolism—by improving insulin sensitivity, reducing chronic inflammation, and supporting overall metabolic health, which becomes increasingly important during perimenopause.
It’s a full-body reset IMO, one that most of us aren’t accessing nearly enough.
Why Intimacy Often Falls to the Bottom of the List
But I understand the challenges that many couples face.
It’s not always easy to get there. Between work, kids, aging parents, the stress of life, and our own shifting hormones, intimacy often falls to the bottom of the list.
Understanding Desire Mismatch
Plus, men and women often approach sex differently. Some of us have more of a responsive desire, meaning we don’t walk around feeling aroused, we need the right environment: emotional safety, affection, touch throughout the day, and time to slow down and get in tune with our body and what we need in that moment.
Meanwhile, others may have a more spontaneous desire—they’re ready to go without much warm-up.
When those two styles don’t match, it can lead to miscommunication, hurt feelings, and avoidance.
And many people assume men have spontaneous desire, like they’re ready to go at any time, and women have responsive desire, taking them longer to get aroused.
But that’s actually not always the case. Many women, myself included, have spontaneous desire. And many men, like my partner, have responsive desire. More on that later.
The Role of Shame and Vulnerability
So here’s the other layer: shame. We weren’t taught how to talk about sex. Many of us grew up with religious constructs. We were told sex is bad or dirty. Even in sex ed, we were taught how to avoid pregnancy, not really how to experience pleasure. Or you may have had sexual trauma. It’s a heavy topic.
And even if you’re in a long-term relationship, it can feel so vulnerable and uncomfortable to talk about it. We internalize guilt, judgment, stories about what’s ‘normal’—and then suffer in silence when things don’t feel good or aligned.
But what if sex didn’t have to look like it does in the movies or porn for that matter? In fact, neither of them are reality. What if it could just be about closeness, touch, laughter, exploring together, or simply allowing ourselves to receive without pressure?
Our Personal Story: Rebuilding Connection
Full transparency, Mike and I went through a dry spell. Life got busy, work has been very stressful for him, he had some health issues come up, I’ve been so focused on the business, I’m navigating perimenopause, so we were pretty disconnected for awhile – even without kids. Although Dawson, our dog, can be a handful. We love him, but he’s added a lot of stress to our life. When you adopt a dog, you don’t always know their history, any trauma they experienced so it’s been a lot to deal with at times.
So getting back to intimacy, neither of us really knew how to initiate properly or ask for what we needed. It even felt transactional at times, like something to check off the list.
And me being the spontaneous desire type, would often initiate in a sort of an abrasive way, which Mike didn’t always appreciate, because he’s a romantic, he’s a sensitive guy. And often, my timing was terrible. Like I said, he had a lot of work stress and sometimes I didn’t know how to read the room. So as a result, I didn’t feel desired. He felt frustrated. And we didn’t really know how to fix it.
You know, it’s easy to blame hormones. And yes, those play a role. And should be supported. But it wasn’t until we had some very vulnerable, difficult conversations—where we put down our walls, moved past our fears, and just showed up as two humans who love each other deeply and crave closeness—that things began to shift for us.
What Helped Us Heal
It wasn’t easy, we thought we were broken, but we were committed to resolving this. So a few things we did was:
1) Talk about sex without judgement – our likes, dislikes, what we’re willing to try, and more
2) We examined our polarity – meaning masculine and feminine energy and they were a bit out of balance. Someone I love to learn from about this is Jake Woodard. I’ve taken some of his workshops and implemented a lot of what he teaches, and it’s really improved not just my relationship, but I’ve really slowed down, and I’m feeling so much better all around.
3) We started prioritizing sex and sort of scheduling it at times when we knew it would happen vs. setting ourselves up for failure. There’s an awesome sex therapist on Instagram I’ve been following for awhile. She actually was on Mel Robbins’ podcast recently. Her name is Vanessa Marin. Her and her husband are adorable and give great tips for couples. One thing they talk about is having sex first – before you go out, before you eat a big dinner. Because so many couples wait until the end of the night when they’re exhausted and it tends to not happen. So some food for thought.
I also encourage you to listen to the episode I did with Susan Bratton.We dove into a lot of this and she and her husband also hit a wall in their 40s, repaired their relationship and are having the best sex of their lives.
It’s Not About Perfect Sex—It’s About Connection
And looks, it’s not about having a perfect sex life. It’s about reconnecting with the person you love. Rebuilding trust. Being vulnerable. Self reflecting on your role in this, b/c as the saying goes, “it takes two to tango”. And it’s about creating space for pleasure. And believing that you deserve it.
So if you’re in that place right now, where intimacy feels like one more thing to do—or not even on the radar—I want to gently invite you to start exploring.
If You’re Struggling, Start Small
Start with small moments: hand-holding, cuddling, deep conversations, more eye contact, time together without your phones, and sharing what feels good or what you miss.
Sex isn’t just physical—it’s emotional, hormonal, relational, and deeply human.
And when we give ourselves permission to slow down, to feel, to receive… it’s not just good for our relationships. It’s healing for our bodies. Especially in perimenopause, where we really do need to move at a different pace.
So I’ll leave you with this: your hormones, your mood, your energy—they all respond to love, safety, and connection.
Your Body Responds to Love and Safety
So no, this isn’t about performance or pressure. It’s about reclaiming one of the most nourishing forms of self-care that we have access to.
And if this episode stirred something in you—maybe a desire for more closeness or maybe even a little grief about what’s been missing—just know you’re not alone.
Many couples struggle with this and I too felt alone and frustrated. But I had hope and luckily, a partner who was willing to open up and try new things. We’re in such a better place now. In fact, things have been better than they’ve ever been for us.
These conversations matter. So if you’ve been resistant to talking to your partner about this, think of me as your cheerleader, encouraging you to move past any fear or shame and start the conversation. There’s no right or wrong way – but do so without blame. Because when we come at our partners with blame, shame, pointing fingers, that does not give them a safe space to truly open up and connect.
Alright, folks, until next time.
Links mentioned:
The Difference Between Spontaneous and Responsive Sexual Desire
Episode 56. Reignite Desire & Skyrocket Pleasure in Midlife with Susan Bratton
Sources:
https://pubmed.ncbi.nlm.nih.gov/14675803/
https://drlindseyberkson.com/oxytocin-new-hormonal-kid-clinical-block/
https://www.sciencedirect.com/science/article/abs/pii/S0924933810701553
https://www.sciencedirect.com/science/article/pii/S0306987719312575
https://pubmed.ncbi.nlm.nih.gov/23430983/
Claudia Petrilli is a Functional Health Coach, Integrative Nutrition Coach, Women’s Health Educator, and creator of The Perimenopause Method. Having experienced debilitating periods, digestive issues, a sluggish thyroid, a pituitary tumor, and perimenopause symptoms in her late 30s, she knows exactly what it’s like to get dismissed by doctors and spend years searching for answers.
Connect with Claudia:
FREE GIFT: Peri-What?! The Must-Have Guide for Women 40+ Navigating Hormone Changes
FREE GIFT: Perimenopause Daily Checklist
WORK WITH US: The Perimenopause Method
BOOK A CLARITY SESSION: Perimenopause Clarity Session
HRT COURSE: Perimenopause HRT Roadmap
QUESTIONS? EMAIL: claudia@claudiapetrilli.com
