Sex, Intimacy & Confidence: Reclaiming Your Sexual Health in Midlife
Anna Harrelson • March 30, 2025
It’s time to rewrite the narrative: Your pleasure, your body, your health—at every age.
Let’s start with this: there is nothing shameful or trivial about wanting a healthy sex life.
If you're in your 30s, 40s, 50s, or beyond and wondering where your libido went, why sex feels different (or uncomfortable), or why no one ever warned you about vaginal dryness, you’re not alone. And you’re not imagining it.
At Wondercreek Health, I talk to people every week who feel confused, dismissed, or ashamed about the sexual changes happening in their bodies. Many are thriving in every other area of life—careers, caregiving, health—but when it comes to intimacy, they feel stuck or unseen.
So let’s say this together: sexual health is part of whole-person health.
And pleasure is not optional. It’s a reflection of nervous system safety, hormonal balance, connection, and self-awareness. It belongs to you.
What Happens to Sexual Health in Midlife and Beyond?
Hormonal shifts during perimenopause and menopause can affect every part of your sexual experience. But so can chronic stress, birth control, antidepressants, trauma, and the weight of daily responsibilities. This is never just one thing.
Common symptoms include:
- Vaginal dryness, burning, or itching (genitourinary syndrome of menopause, or GSM)
- Pain with sex (dyspareunia)
- Loss of libido or arousal
- Less intense or harder-to-reach orgasms
- Urinary urgency or UTIs
- Pelvic floor tension or dysfunction
These changes aren’t "just in your head" and they’re not a moral failure. They reflect real shifts in tissue, blood flow, hormones, and brain chemistry.
Sex Isn’t Just for Someone Else’s Benefit
Let’s say the quiet part out loud: many of us were raised to believe that sex was about someone else's pleasure. That we should be desirable, responsive, available—regardless of how we felt. That conditioning runs deep.
But sex isn’t about performance. It’s about connection, intimacy, and pleasure—for you.
Pleasure is your birthright.
Intimacy can be tender, playful, spiritual, or wild—but it should never feel like pressure.
Your desire may look different than someone else's, and that’s okay.
This is true whether your partner is male, female, nonbinary, or you're navigating intimacy solo. There is no one-size-fits-all experience.
Why Your Desire Might Feel "Off"
Sexual changes can happen at any age.
- Oral contraceptives (OCPs) can suppress libido by lowering free testosterone.
- SSRIs and other antidepressants are well known to impact arousal and orgasm.
- Perimenopause often starts in the mid-30s, long before you notice hot flashes.
- Chronic stress and the mental load of caregiving, multitasking, and decision fatigue can leave no room for desire.
Because here’s the reality: desire doesn’t live in your genitals. It starts in your brain. And when your brain is overloaded with to-dos, responsibilities, or unspoken resentment, it’s nearly impossible to shift into a space of curiosity, connection, and arousal.
Unwinding the mind can be hard. For some of us, it means learning to use tools like mindfulness, breathwork, somatic practices, therapy, or just having space and time away from the demands of the world. Creating room for desire isn’t selfish. It’s a form of self-trust and reclamation.
The Good News: This Is Treatable
Sexual health doesn’t have to decline just because estrogen does. There are safe, effective, empowering ways to reconnect with your body and reclaim your pleasure.
1. Local vaginal estrogen (or DHEA or testosterone):
- Restores tissue health, lubrication, and blood flow
- Improves comfort, arousal, and pelvic health
- Safe for most people, even those with a history of breast cancer (with appropriate guidance)
2. Systemic hormone therapy:
- Can improve libido, mood, sleep, and confidence
- Testosterone therapy (when indicated) can support arousal and orgasm
3. Pelvic floor physical therapy:
- Addresses pain, tension, and coordination issues
- Supports better sensation and comfort
4. Nervous system regulation:
- Practices like breathwork, somatic therapy, or trauma-informed care help shift from "fight or flight" into connection
- When the nervous system feels safe, desire can return
5. Sex therapy or coaching:
- Helps explore personal blocks, relationship dynamics, and pleasure mapping
Let’s Talk About Desire
You might notice you don’t feel spontaneous desire anymore—but that doesn’t mean you’re broken. For many people, responsive desire (desire that follows arousal) becomes the norm in midlife. And it’s perfectly valid.
Touch, connection, and intimacy may need more warming up. But your ability to experience pleasure is still intact—and it can grow deeper, richer, and more grounded as you reconnect with your body on your own terms.
Final Thoughts
- You don’t need to be fixed.
- You deserve to be heard.
- You deserve to feel good in your body.
Sexual health is not about keeping up with anyone else’s timeline or expectations. It’s about reclaiming what intimacy and connection mean to you in this season of life.
At Wondercreek Health, I’m here to help you connect the dots, reduce shame, and support you with science-backed, judgment-free options that honor your experience.
Because this is not the end of your sexual story. It might just be the beginning of the most powerful chapter yet.
WonderCreek Health Blog
You’ve probably seen it popping up in wellness podcasts, health stores, or even your friend's supplement cabinet: bovine colostrum. Marketed for gut health, immune support, and recovery, this early-life nutrient source for calves is now showing up in adult wellness routines. But is it worth your time and money? As a lifestyle medicine physician focused on women’s midlife health and longevity, here’s what I want you to know before you jump on the colostrum bandwagon. Let’s Start With the Basics: What Is Colostrum? Colostrum is the first form of milk produced by mammals (including humans) in the first few days after giving birth. It’s loaded with antibodies, growth factors, and immune-modulating compounds designed to jumpstart a newborn’s immune system and line the gut. Bovine colostrum—from cows—is the form used in most supplements. It's freeze-dried and packaged into powders or capsules, and often promoted for: Gut barrier support ("leaky gut") Immune system priming Exercise recovery Anti-aging benefits But let’s be honest: just because something has growth factors doesn’t mean it belongs in your Amazon cart. Does the Science Support It? Evidence in humans is limited— but not nonexistent. Some small clinical studies have shown potential benefits: Gut health: In people with NSAID-induced intestinal permeability ("leaky gut"), bovine colostrum has been shown to reduce damage and symptoms. Immune function: Some data in athletes suggests reduced upper respiratory infections. Exercise recovery: A few studies report improvements in performance, gut comfort, or muscle soreness—especially in endurance athletes. But these benefits aren’t guaranteed. And the quality and dosage of colostrum varies widely, with no standardized formulation across brands. So Should You Take It? Here’s where my clinical voice kicks in: Before you reach for colostrum, ask yourself: Have you addressed the basics? Are you sleeping? Managing stress? Eating fiber and whole foods? Getting enough protein? Building muscle? Moving your body? Supporting your gut with real food (not just powders)? If the answer is no—then colostrum is not your next step. You’re throwing powdered fuel on an engine that’s missing spark plugs. Do you have dairy sensitivity? Colostrum is a dairy product. Even if it's low in lactose, it may not be tolerated by everyone. Are you already taking quality foundational supplements? Vitamin D, omega-3s, magnesium, creatine, iron (when needed), and probiotics have stronger bodies of evidence for many women in midlife. When Might It Be Worth Trying? Colostrum might be a reasonable add-on if you: Have mild gut symptoms (especially post-infectious or stress-related) Are recovering from illness or antibiotics Train hard and experience frequent upper respiratory issues Want to support your immune system during travel or stress Even then, I recommend: A 2–3 month trial only after dialing in basics Choosing a third-party tested brand Tracking symptoms and benefits Cost, Hype, and the Bigger Picture Many women I work with are overwhelmed by supplement costs. Colostrum can run $50–100/month —and that adds up. So here’s what I tell my patients: Just because something is trending doesn’t mean it’s essential. And just because it works for someone on TikTok doesn’t mean it’s the right tool for your body right now. Your body is an incredible machine. When you give it rest, movement, nourishment, and support—it can do amazing things. Colostrum is not magic. It’s just one tool in a very big toolbox. Bottom Line Colostrum may hality sources. You’re not broken. You might just need a reset—not another powder.
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