Sex After 40

By: Dr. Stacey Naito – Physician and IFBB Pro

The Shifting Tide

Those of you about to turn the corner and enter the 40 and over zone may be concerned about the impact that getting older will have on your sex life. You may have questions about whether you must resign yourself to becoming a dried-up old lady, with no fun to be had in the bedroom. Thankfully, the reality is that you can have more fulfilling and enjoyable sex than you had in your 20’s or 30’s.

What’s more, society has gotten wind of the idea that people want to live completely fulfilled lives into their advanced years. It’s true that 40 has become the new 20, and the concept is supported by empowered celebrities like J. Lo proclaiming their eternal youth and sexual vitality without shame. So instead of allowing the aging process to shut you down, it’s time to look forward to a new and more sexually fulfilling chapter in your life.

Why Getting Older Is Great For Your Sex Life

I don’t know about you, but I wouldn’t trade the knowledge and life experience I obtained over my 52 years on the planet to return to my 20’s, because aging has positively impacted every aspect of my life, including what happens behind closed doors. With age comes acceptance of who we are, body flaws and all. Let’s face it, we accumulate stretch marks, cellulite, scars, etc. over time, all of which could send us into a meltdown if we stressed out about them. We have become more comfortable with who we are, which translates to greater body confidence. That body confidence works to our advantage in the bedroom, because we no longer feel uneasy or ashamed of how we look sans clothing. When we are comfortable naked, we can finally relax and enjoy intimate encounters to the fullest.

A woman in her 40’s or 50’s is less likely to take desperate measures to entice her man, such as dressing up in sexy but uncomfortable lingerie, or wearing a pair of high heels guaranteed to aggravate her plantar fasciitis or her bad back. In contrast, it seems there are plenty of women in younger age brackets who follow ridiculous wardrobe guidelines to garner the attention of potential sex partners or followers on social media channels. A woman in her 40’s of beyond doesn’t have the inclination to make a fool out of herself to guarantee a romp in the bedroom. She is older, wiser, and doesn’t have time for such nonsense. She doesn’t feel like she needs to try so hard to win her partner’s favor. Her attitude tends to be more along the lines of, “This is what I got, take it or leave it.” Besides, I am willing to bet that such an attitude is far sexier to a man these days. In addition, most men tend to be more excited about the notion of getting you naked, and once you are in the buff, they aren’t scrutinizing your body for flaws.

Older women are also less selfish in bed, and bolder about declaring what they want. They know their bodies, their likes and dislikes. If single, they are more discerning about how they procure partners, so they are less likely to engage in risky activities which expose them to sexually transmitted diseases. For older women in a relationship, there is a greater likelihood that they have been with the same partner for many years, and have developed a level of intimacy which only comes from a longer term committed relationship. A 40-something woman is usually confident enough to turn to her partner and say, “I really like it when you use your hands on me more”, and not fret about whether her partner will accept her sexual preferences.

Chances are that for older women, there are far fewer household distractions which can impede the natural progression of an afternoon of flirting into a full-blown lovemaking session. Such interludes are pretty much impossible if a baby is crying, or young children are demanding attention. Once children have become old enough to be relatively independent, say from pre-teens on, there may be more opportunities to roll around in the sheets with your partner without any interruptions. That kind of freedom can result in more spontaneous sexual encounters and greater satisfaction.

For those past menopause, Aunt Flo’s monthly visit no longer interferes with any amorous advances. Furthermore, there is no concern about getting pregnant and having an unplanned family addition. It’s incredibly liberating.

Sexual Issues and Aging

Though I have painted a rosy picture of the sex life of older women, there are some issues which can interfere with optimal sexual activity. However, this doesn’t mean that all women over 40 will experience sexual dysfunction. As geriatric psychiatrist and senior editor Ken Robbins states, “Impaired sexuality and sexual function aren’t normal consequences of aging.” (

Women can experience symptoms of perimenopause as early as 35, and the diminishing estrogen and progesterone levels can result in vaginal dryness and thinning of the vaginal mucosa, both of which can make intercourse painful. If this occurs, make sure to obtain a pelvic exam with a physician who can diagnose and treat the condition. In many cases, a lubricant is sufficient, but hormone replacement therapy may be offered as an option as well.

Some women may experience a decrease in sexual desire as they age, but many others experience a surge in libido from the increased testosterone to estrogen ratio, which increases as estrogen levels continue to diminish. The sexual benefits of testosterone are also enhanced by regular weight training, which naturally boosts testosterone levels in the body. However, the ebb and flow of sexual desire often fluctuates more in women over the age of 40, a result of associated dips and surges in hormonal levels. In addition, the hot flashes, night sweats, and mood swings associated with plummeting progesterone levels don’t exactly make a woman feel amorous.

If you are a woman over 40 who is experiencing symptoms of perimenopause, such as hot flashes, and they are frequent enough to disrupt your daily life, seek the advice of a physician. During your visit, you may ask if the addition of hormonal support supplements like maca or dihydroepiandrosterone (DHEA) would be helpful in decreasing the symptoms you are experiencing.
Most importantly, reduce stress in your daily life, get plenty of rest, and communicate with your partner about any sexual concerns you may have.

Hot and Cold


Many women who are in their early 40’s and beyond experience a roller coaster ride with their internal thermostats which is absolutely maddening. They can go from sitting comfortably one minute, to a sudden sweat and flush which makes them feel like they are standing next to a fiery blaze the next minute. Such a roast-fest can last from seconds to minutes, after which a woman may feel pretty comfortable. But the pendulum can swing the other way, and the woman may suddenly feel very cold once the air conditioning has kicked in, prompting her to put on a sweater. Guess what? Chances are that sweater will be peeled off in a matter of minutes when the woman has another hot flash. Hot, cold, hot, cold, hot, cold. Fun times. Such fluctuations in a woman’s perception of temperature, coupled with her constant putting on and taking off layers of clothing, are often perceived as pretty nutty by people who don’t have a clue about the torture these women go through.

I can relate to the constant temperature fluctuations because I have been suffering from it for over a year now. I fully realize that my body doesn’t know what temperature it is. Thanks to hormonal imbalance and the decline associated with peri-menopause, I am very familiar with the sweating which is sudden and intense, and I know that feeling of desperation which has me peeling off clothes, fanning myself, and sticking my head in freezers and in front of blowing fans. However, I only recently began experiencing the feeling that I am suddenly freezing my butt off, and I truly can’t stand it. My perception of the ambient temperature can go from upper 70’s, to 120 degrees, to 60 degrees, within 5 minutes flat.

woman with chills

On my worst days I will have maybe five or six of these episodes, so the daytime hours aren’t too bad, but my evenings make up for the relative break I get during the day, because I am hot and sweaty for many hours and cannot cool down at all, even if I wear a cooling towel around my neck, lie on the floor under my ceiling fan (the darned thing is positioned right over the foot of the bed and doesn’t cool me off at all when I am in bed), and lie over the covers. My bedroom feels like it is 100 degrees and I cannot get away from the heat because, of course, the heat is emanating from ME. My hypothalamus is tricked every night into perceiving that my body needs to release excess heat. I know that this is the result of low estrogen levels, but my professional knowledge of estrogen therapy is enough to keep me from ever supplementing with estrogen, so I will continue to suffer as long as my hypothalamus triggers the way it does. At least I know I am not alone: about 85% of women who are peri-menopausal experience hot flashes. Hot flashes can last from several months up to 15 years, with an average of 2 years. I hope and pray that I fall into the average! Seriously, hot flashes and night sweats are absolutely miserable. I often get as little as two hours of sleep at night when my night sweats are in full effect!

Who Turned Up The Heat?


If you have ever awakened in the middle of the night with the feeling that you are burning up, and find yourself drenched in sweat, you have experienced night sweats. Though night sweats can be aggravated by spicy foods or alcohol, or sleeping in an overheated room, the true culprit in night sweats for the majority of peri-menopausal and menopausal women is fluctuating estrogen levels. Such fluctuations falsely signal the hypothalamus to cool down the body by triggering perspiration and blood vessel dilation. For those of you who have experienced this phenomenon, you know how much it interferes with normal sleep patterns!

What can you do to minimize night sweats? Regular exercise can reduce the severity of symptoms. I have also seen a marked improvement in night sweat symptoms in my patients after they have introduced maca root into their daily regimens. On a personal note, maca has been helpful in reducing the intensity of my night sweats so that I don’t wake up completely drenched in sweat in the middle of the night. If you have severe symptoms, you might want to consider being evaluated for bio-identical hormone replacement therapy. I strongly advocate the use of bio-identical hormones for individuals who suffer from the symptoms of hormonal decline or imbalance.

The battle to eradicate my night sweats has not ended. I had a nice little break from them for about five months, then they crept back into my nightly patterns. To combat this, I decided that my comforter needed to be put in storage until the winter, and I purchased a cotton coverlet set. I also purchased a special mattress protector which is comprised of a cooling material, and though it was a bit pricey (about $100 for a Cal King), it was a godsend for me. Here are a couple of brands which are great:

Another thing I highly recommend is to put a fan in your bedroom. I have a ceiling fan in my bedroom, and I almost always sleep with it on so that I can keep cool air circulating over the bed. Make sure the thermostat in your home is set to a cooler temperature so that you don’t overheat during the night, or open a window to allow a cool night breeze drift into your bedroom.

Hopefully these suggestions will have you sleeping more comfortably this summer!

Did Someone Turn Up The Heat?

hot flashes
I have always heard peri-menopausal and menopausal women complain of hot flashes like they were horrific occurrences, yet I figured they were similar to getting flushed, so they really couldn’t be THAT bad. Oh how wrong I was! Hot flashes can best be described as a SUDDEN and intense heat and sweating in the chest, neck and face which feels like someone cranked up the heater to a thousand degrees. To use fancy medical terminology, it SUCKS. Women look like they’re crazy when they rapidly start loosening and removing clothing, fanning themselves with magazines, standing in front of fans, and sticking their heads in the freezer. I can tell you that I have done every one of these things, and when I am in the midst of finding a way to cool down, I don’t care one whit who thinks I have gone bonkers. You would be in a rush too if you were being cooked from the inside!

If you are still trying to imagine what a hot flash feels like, picture this: you are going about your usual business, when out of nowhere, a switch gets flipped inside your upper chest and you experience a heat quite similar to Bikram yoga rooms. It is relentless too, causing instant sweating and discomfort. Recently I have been experiencing some very strong hot flashes which have necessitated desperate measures such as ripping off every shred of clothing and lying on a linoleum floor to cool off, wrapping a cool pack around my neck while I sat in front of my computer and worked, and walking around Chicago O’Hare International Airport wearing a tank top and fanning myself while everyone else wore heavy coats which were appropriate for the 35 degree Fahrenheit weather outside.

The main reason why hot flashes occur is a drop in estrogen levels which the hypothalamus misinterprets as an increase in body temperature, causing the body to react to cool it down. These episodes can occur at any time, but in my estimation are the worst when they occur during sleep. Over the past two weeks, it has been impossible for me to sleep for more than an hour before I experience a SEVERE hot flash which has me running to the freezer to grab an ice pack to snuggle up with! It has become a ritual: Fall asleep, wake up an hour later drenched in sweat. Spend the next 15 minutes trying to stop sweating, then finally fall asleep exhausted. Repeat cycle each hour to two hours until alarm goes off in morning. It is utter misery. This also may occur for up to fifteen years, even after I go through menopause. In the current vernacular, all I have to say to that is, WTF???