Ask Charlotte experts: What do you want to know about intimacy in perimenopause?

Welcome to Sex, Sweat and Sanity, CharlotteFive’s new Q&A column about all things intimacy and perimenopause answered by our experts.

Rachel Murray is a nurse practitioner who specializes in menopause and sexual medicine. She owns Virago Health in Waxhaw. Liz Mallers is a certified sexologist and owner of Liz Mallers Sexology.

Send your questions to asklizandrachel@gmail.com.

I’m in perimenopause and experiencing a super low sex drive. How do I stay interested in sex when it’s the furthest thing from my mind?

Rachel: One of the most common (and frustrating) changes women notice during perimenopause is a dip in sexual desire. Hormonal shifts, sleep disruption, stress and even certain medications can all play a role.

It’s important to remember that low libido is not a “failure” or a personal flaw — it is normal, common and can happen in various stages of life.

It is a misconception that any one individual should want intimacy as much as their partner. Women are often responders to desire, whereas men typically experience spontaneous desire.

Instead of focusing on “fixing” desire, think of this as an opportunity to explore what intimacy looks like for you right now. Desire can often return in new ways once you take pressure off the idea of how it should look. There are various teaching resources available to enhance the individual perspective on libido and how any individual might like to experience it. The Rosy App is an excellent place to start.

Liz: Make sure to have ongoing conversations with your partner about what to expect throughout this change in your experience. Your sex life will look different, and it would do a disservice to your intimate connection to count on it being the same. Open communication can help level-set expectations, as well as take the pressure off to have sex when you simply don’t want to.

Keeping connection when you don’t want sex

Rachel: One of the most common reasons for low desire is neuroplasticity, the brain’s response to the surrounding environment. Over time, pathways in the brain are formed that translate certain associations with libido. One way to address low desire is to counter those pathways by exposure to intimate concepts that make sex feel more fun and less like a chore.

Self-guided tools that can help with this are: The Rosy App, meditation, sex coaching or sex therapy.

Liz: Ask yourself (and each other), what is the goal of sex? Orgasms are great, but typically the answer leads to intimate connection, bonding and physical closeness.

With that in mind, consider your intimacy, not just sex. What else can you do to reach that goal? Carve out time to cuddle before sleeping, swap hand massages while listening to relaxing music, reminisce about how you fell in love.

This is a prime opportunity for you both to get creative in different ways to feel intimately bonded without relying on sexual intercourse. Brainstorm ideas together to ensure the mental load doesn’t fall on one partner.

The bottom line

Perimenopause is a chapter of transition — not the end of intimacy or desire.

This is an opportunity to evaluate the intimate experience and become closer to it, not to be scared of it.

This story was originally published November 10, 2025 at 6:45 AM.