Topics · Desire · 47 episodes, 34 guests

Why don't I want sex anymore?

Losing interest in sex is common in midlife, and for most women desire now shows up after touch and closeness begin.

Three out of four midlife women notice a change in their libido.
Stress, fatigue, hormones and relationships often stack up together.
Mindfulness, planned time together and goal-free touch all help.
Pain or dryness deserves a visit, and most causes are treatable.

Gabriella Espinosa, host of Pleasure in the Pause · built from 15 episodes

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I've asked 34 doctors and experts about desire

Tap anyone to meet them and hear our conversation.

Is it normal to stop wanting sex in midlife?

Yes. Three out of four midlife women notice changes to their libido, so you’re in good company.

When I went through perimenopause, it felt like a light switch had been turned off. Nobody had prepared me for it, since the silence around midlife sex was handed down from our mothers and grandmothers.

Ep 4 · 19:40 Ep 70 · 2:23

The reasons usually stack up together: stress, fatigue, hormonal shifts, relationship dynamics, cultural shame and life circumstances. Dr. Shahzadi Harper sees the same thing in her patients, and she adds sleep, work and things left unsaid in a relationship.

Ep 70 · 4:23 Ep 4 · 22:26

So if this is you, you’re in the majority.

Why does desire feel different now?

For most of us, desire now shows up after things begin. That’s called responsive desire.

Arousal builds in response to touch and closeness. Our bodies are changing too, since clitoral sensitivity often drops as estrogen declines, so arousal takes longer and what used to work may not work the same way.

Ep 70 · 16:36 Ep 80 · 12:39

**Dr. Kelly Casperson**Urologist · Episode 28Plays from 11:28

Dr. Kelly Casperson, a urologist, says desire might come before, during or after intimacy. Many women only feel it once the setting feels safe.

Ep 28 · 7:36

What actually helps desire come back?

Slowing down, paying attention, and making time for it on purpose.

Dr. Lori Brotto studies mindfulness and desire. In her studies, an eight-week mindfulness program improved desire and lowered sexual distress, and women kept the benefits months later.

Ep 9 · 24:49

Here’s what the experts on the show found...

An eight-week mindfulness program improved desire, and the benefits lasted months.Dr. Lori Brotto · Ep 9 · 24:49
Every study of testosterone for low libido in women beat placebo, though it does not help everyone.Dr. Susan Hardwick-Smith · Ep 42 · 7:51
Communication is the number one factor in a woman’s sexual satisfaction.Dr. Sadaf Lodhi · Ep 19 · 23:02
Sensate focus: 15 minutes of touch each, no goal, two to three times a week.Dr. Sadaf Lodhi · Ep 19 · 35:04

Planning helps more than waiting. Dr. Brotto says vacation sex works because it is planned, and you can plan it at home too.

Ep 9 · 48:20

**Jackie Giannelli**Nurse practitioner · Episode 47Plays from 26:43

What can I try this week?

Start small: one pleasure a day, one honest question, one touch with nowhere to go.

Notice one small, everyday pleasure. It trains your brain to feel pleasure.Ep 28 · 22:33
Ask yourself what you want right now, in this body, at this stage of your life.Ep 64 · 13:05
Set a three-minute timer and write “I desire” on repeat, an exercise from Carly Mountain.Ep 10 · 25:06
Offer touch with nowhere to go, like a slow, gentle back rub.Ep 110 · 15:16

I go deeper on all of this in my article, Why Don't I Want Sex Anymore.

When should I talk to a doctor?

When sex hurts, or when dryness or burning shows up. Most of these issues are treatable.

Pain changes everything, since when sex hurts, libido drops as the pain rises, as Brooke Bralove puts it. Ask your provider about localized hormone therapy for dryness, burning or pain. I call vaginal estrogen the gold standard.

Ep 101 · 15:32 Ep 22 · 5:05

Before your visit...

Write down your symptoms, when they happen and how they affect your life.Ep 70 · 14:22
Book an appointment just for sexual health.Ep 70 · 14:22
Search the Menopause Society website by zip code for a trained practitioner.Dr. Maria Sophocles · Ep 6 · 47:22
For sexual health, look up a provider on the ISSWSH website.Dr. Rachel Rubin · Ep 21 · 31:47
If you don’t hear the answer you need, keep asking.Dr. Susan Hardwick-Smith · Ep 42 · 40:15

**Gabriella Espinosa**Your host · Episode 70Plays from 17:37

How we verified this pageWhat we checked, what we couldn't, and who read it.Built from 15 episodesEvery quote checked against the transcript

What this page is forOne question a midlife woman asks about desire, answered from the podcast.

Our lensWe help women in midlife reconnect with their bodies and their pleasure. We are not clinicians and we say when a question needs one.

More questions women ask me

Why does sexual health matter for women in midlife?

Sexual health is essential to your whole health and longevity. It's directly tied to physical vitality, mental well-being and overall life satisfaction. Three out of four midlife women are experiencing changes to their libido, and most of us never talk about it. Most of these issues are completely treatable. Try this: before your next appointment, document your symptoms, their timing, and how they're affecting your life. Prepare specific questions, and make an appointment specifically to address your sexual health.

Gabriella Espinosa · More on sexual health

What do hormones do in my body, and why do I feel so different in menopause?

Your entire life, hormones have been orchestrating your reproductive system, your mood, your energy, your very sense of self. Estrogen receptors exist throughout your entire body, in your brain, your gut, your skin, your bones, your heart. When these hormones fluctuate and eventually decline, it impacts everything, especially the neurotransmitters that regulate your emotions, your pleasure and your motivation. When you don't feel like yourself during menopause, your body is speaking to you.

Gabriella Espinosa · More on hormones

Why do I need to feel safe before I can feel desire?

Pleasure requires safety. It asks you to be present to sensation, to surrender into the moment. And you can't do that when your nervous system is scanning for danger. Your body keeps asking, is it safe to relax? Is it safe to speak? Is it safe to be seen, to be touched? When you feel safe, your heart rate slows, your breathing deepens, and you feel calm, present, available for intimacy and connection. Try this: ask yourself, what state am I in right now? Then take a micro pause. One deep breath. One unclenched jaw.

Gabriella Espinosa · More on safety before desire

How do I talk to my partner about what has changed?

If this conversation feels hard, nothing is wrong with your relationship. You're both human beings who were never taught how to do this. Start with your own feeling instead of what they do wrong, like I feel disconnected when we don't have physical intimacy. Then tell your partner what has changed in your body and what feels different now.

Gabriella Espinosa · More on communication

How do I feel close to my partner again?

Your body may be asking for something different, like gentleness, slowness and safety. Sit or lie down facing each other, gaze into each other's eyes, place a hand on your heart or belly and breathe in sync for a few minutes. You don't even need to feel close to begin. Beginning is how you get there.

Gabriella Espinosa · More on intimacy

Start with these three episodes

If you only listen to three, make it these.

Episode 70 · Sep 24, 2025 · 26 min