Wisdom from Christiane Northrup on Sex and Menopause

An excerpt from The Wisdom of Menopause

 According to holistic expert and MD Christiane Northrup, midlife can be a time for both men and women to experience some of the best sex of their lives.

Remember the first time you fell in love? You thought you had discovered the moon and the stars. The lyrics of the songs on the radio seemed as though they had been written especially for you. And chances are you felt so high and full of life that you didn’t even feel much like eating. When a woman falls in love, she begins to experience an almost overwhelming influx of energy, filling her with exhilaration, benevolence, vigor, creativity…and an eager, often insatiable sexual desire.

This can’t-eat-can’t-sleep feeling is not limited to young woman experiencing their first love. It can be experienced at any age, any time we are able to connect at a deep emotional and spiritual level with another person. When that kind of connection is made, we bask joyfully in the knowledge that we are two people seeing, and being seen, as our truest selves.

This wonderful feeling of connection is something we have been led to believe can be experienced only by those in love. Our culture, through its books, movies, and media images, promotes love and sex as the major, if not exclusive, route to happiness. But this is only part of the truth. When we are fully open to the energy that created the universe in the first place — which is another way of saying, when we are in love with our own lives — then we can re-create the chemistry of being in love simply by tuning in to the vitality of the world around us and in us. It’s everywhere — in the beauty of nature, the pursuit of a cause we believe in, the exercise of our creative powers. Falling in love with life itself, whatever form it takes, is an experience so powerful that I’ve known it to cause even woman who were well past menopause to start getting their periods again.

In other words, if we think of sexual energy in the largest possible context — as life force, or as Source energy — then the relationship between the two becomes clear: The health and vitality of our sexuality is inexorably linked to the health and vitality of our lives.

The Anatomy of Desire

By the time we reach midlife, the challenge for each of us is to be able to access that in-love feeling in other ways besides looking to another person for fulfillment and gratification. The call goes out for each of us to expand our personal repertoire for accessing Source energy in our lives. Many men have opted to negotiate this developmental step by forging new sexual relationships with much younger partners. We woman have only recently been granted anything close to equal opportunity in this regard. In the movie Moonstruck, the character played by actress Olympia Dukakis wants to know why men, and her husband in particular, cheat on their wives. She gets the answer when her daughter’s somewhat eccentric finance tells her, “Because they are afraid of death.” Many men at midlife rejuvenate their fading life force through the bodies and fertility of younger woman. In so doing, these men bypass a critical developmental stage: learning how to tap into Source energy directly.

Many women who are in the midst of negotiating this step for themselves find that their sex drive decreases for a while. In one study, 86 percent of woman reported some form of sexual problem during the years immediately before and after menopause, usually in the form of loss of sexual desire, often associated with vaginal dryness, dyspareunia (pain during penetration and intercourse), painful spasms in the vaginal muscles (vaginismus), loss of clitoral sensation, and touch sensation impairment.

A menopause-related deficiency of hormones most often gets the blame, but the truth is, ferreting out the cause of sexual problems can be challenging. Sexual function is a complex, integrated phenomenon that reflects the health and balance not only of the ovaries and hormones, but also of the cardiovascular system, the brain, the spinal cord, and the peripheral nerves. In addition, every factor that affects sexual function has underlying psychological, sociocultural, interpersonal, and biological influences of its own.

Interestingly, of the 14 percent of woman who reported no sexual problems in the study mentioned above, one-third admitted that they had had sexual problems previously but that the problems had resolved themselves when the woman found new sex partners. So much for hormone replacement being the sole viable solution to midlife libido problems! Resolving problems in an existing relationship can have an effect on sex life that’s comparable to that of a new sex partner — when a woman reaches a true partnership with the man (or woman) she loves, she experiences a boost in her life energy, which translates to an equivalent boost in sexual energy.

In turn, an active and joyful sex life can have amazingly restorative effects on life force. Nothing illustrates the parallel circuitry between sexual energy and life energy better than the power of sexuality to heal when it is able to express itself freely. In her 1999 book Reclaiming Goddess Sexuality: The Power of the Feminine Way, Linda Savage writes about her experience of recovering from Crohn’s disease, a chronic disease involving inflammation of the gastrointestinal tract that can result in weight loss, bloody stools, bloody diarrhea, and an increased risk of bowel cancer. Her weight had dropped to eighty pounds when she met a man with whom she began a very remarkable relationship. Within a few weeks all traces of her Crohn’s were gone. She attributes her recovery entirely to the healing power of sexual energy, which is simply one of the many forms the life force takes.

This doesn’t mean I’d recommend running right out and having sex in order to heal yourself of a disease. The only way sexual energy can act as a healing force is if you experience it in the context of an unconditionally loving relationship in which your body, your soul, and your psyche are all cherished by another — or by yourself. Remember, you do not necessarily have to have a partner to experience rejuvenating energy of your own sexuality.

With all this in mind, it is also important to remember that as a woman traverses the perimenopausal transition and all the changes it invites, her libido may seem to go underground for a time, while she reprioritizes her life and the manner in which she uses her energy on a day-to-day basis. This is a perfectly normal diversion of life energy — an investment that can yield great dividends — but it is only temporary. There is no reason for a diminished sex drive to become a permanent feature in the life of a menopausal woman.

What Viagra Tells Us About Our Sexuality

Viagra and the enormous publicity surrounding it speak volumes about the values of our culture. There is no question that is drug can be a boon to quality of life for many couples in which the male partner suffers from erectile dysfunction. But enhanced sexual performance through medical manipulation of the male’s genitals only, cannot heal a relationship that is not working.

Our culture is quick to forget the holistic nature of sexual function and how profoundly it is enhanced when a couple is truly connected via their hearts and minds. The sex researchers Masters and Johnson have described how the excitement and plateau phase of the sexual response can be prolonged if the connection between the man and woman is not only genital but also related to heart and mind. At midlife many couples find that they have the time and the desire to be fully present to each other in this way, and as a result they experience the best sex of their lives. I’ve heard their stories repeatedly in my office. But for some, making love is just another task on he to-do list. Sex therapist Dr. Patricia Love wrote:

“Sensuality, the ability to be comfortable in one’s body, suspend time, and communicate through the skin is what is missing in many marriages…All to often husbands and wives go to bed feeling distracted and numb, reflexively groping for each other’s genitals. The unspoken goal is to go from neutral to orgasm in 15 minutes like a car zooming from zero to sixty.” [1]

This results in what sex therapists call “spectatoring,” which is a mental disconnection during lovemaking, thinking more about work or household chores than about the partner beside them. For the man, this may translate to erectile difficulties; for the woman, difficulty reaching orgasm. The man who looks first to Viagra to “save” him may be discounting the importance of making a connection with his lover. A woman involved with a man who feels he needs Viagra for psychogenic impotence would be wise to ask herself about the quality of their connection. Those things that remain unspoken between them, the issues and feelings that are too uncomfortable to talk about, may be blocking full erection and orgasm, and may also be putting their health at risk in other areas.

Victor and Viagra: Ginny’s Lament

Ginny and Victor had been married for 30 years and had a pretty happy relationship. Victor had always prided himself on his virility, and he and Ginny had enjoyed a vigorous sex life for years, making love about three times per week. When he turned fifty-five, however, Victor noticed that his erections were not as hard as they used to be, and it sometimes took him longer to achieve them. Occasionally he even found that he was unable to sustain an erection long enough to bring Ginny to orgasm. He and Ginny had gradually slowed down in their lovemaking to about once every two weeks. This didn’t bother Ginny, particularly because she was very busy starting a new catering business — something she’s always dreamed of. Her business was taking off, and now that their youngest child had left home for college, her life was no longer focused solely on the needs of her husband and children. But Victor, who was planning to retire in a year or two, was not nearly as happy with his life. It seemed that just as he was starting to slow down, Ginny was taking off in the outside world.

Victor sought a consultation with his doctor, who prescribed Viagra. Victor was elated with the results. Ginny wasn’t. The Viagra introduced a “mechanical” element to their sex life that had never been present before. She didn’t like having to be sexually available just because Victor had taken his pill, and she began to spend more and more time away from home, partly because she was having so much fun at work, partly because she didn’t want to have sex “on demand.” When asked how she felt about Viagra, Ginny replied, “I think were better off without it. I love Victor and it really didn’t bother me when it took him a little longer to get hard. I usually knew how to help. Now I feel as though a vital emotional component of our love making has been replaced by a pill.”

Their situation is not unusual. Victor’s change in sexual function is, in part, related to his sense of decreasing power in the outer world, even though it is his own choice to retire from work. Though Viagra is probably a relatively safe solution for him at the time, he would be best served by finding a new life’s purpose into which to pour his energy. Otherwise he won’t be able to keep up with his wife, in the bedroom or otherwise, without resorting to a drug for support. That doesn’t mean there aren’t valid indications for Viagra. Rather, it is to point out that sexual function is related too much more than the size and duration of an erection.

Menopause Is a Time to Redefine and Update Our Relationship

Five years ago I would have written all of this thinking it did not apply to me. Similarly, many of you may be thinking, “That’s interesting, but my relationship with my significant other is good,” and you may be right, overall. For many of us, the relationships we have maintained over the years have served us well and have been mutually beneficial, even passionate. But it is very often necessary to renegotiate some of the terms of the old relationship as you enter the transformative years of midlife. No matter how good that relationship may have been, what worked for you in your “previous” life will, in all likelihood, need some updating in order to serve the person you are becoming.

One area in which the necessity for change may become apparent is in the waning of a woman’s libido. Just as wild animals refuse to breed in captivity unless everything is in balance in their environment, a woman and her significant other may notice problems in their sexual intimacy if their relationship is in need of rebalancing. Menopause is also a time when what a woman wants from a relationship begins to change.


As we have seen, it is usually the woman who sacrifices career and personal growth for the sake of maintaining and nurturing the family, even if she works full time outside the home. Not only the unwritten rules of society but the hormones flowing through her veins encourage her to give high priority to family, nurturing, nesting, and protection of loved ones. At menopause the hormonal changes are only part of a woman’s ongoing transformation, which begins at an energetic level and triggers changes not only in her biology but also in her perception, intuition, neural pathways, emotions, creative drive, and overall focus. While she spends the first half of her life giving birth to others (literally and figuratively), everything about her menopausal transition suggests that the second half of life is when she is mean to give birth to herself.

If, through the lens of your transforming self, you discover that you are not in love with your life, your libido may suffer as a result. In fact, a fading sex drive may be one of the first places a red flag will pop up, as a signal of a fading love of life — a waning life force. Only if both you and your significant other are willing to question what is no longer viable in your relationship and work together on necessary remodeling can you open the door to rejuvenation of your life energy and the rekindling of your passion, sexual and otherwise. Healing will require a bilateral effort — both you and your partner must be willing to ask, and hear the answers to, some difficult questions in order to restore and renew your relationship.


1. Love, P. & Robinson, J. Hot Monogamy: Essential Steps to More Passionate, Intimate Lovemaking (Dutton, New York, 1994).

From The Wisdom of Menopause by Christiane Northrup, MD copyright © 2001, 2006 by Christiane Northrup. Used by permission of Bantam Books, a division of Random House, Inc.

Christiane Northrup, MD is board certified in obstetrics and gynecology and the past president of the American Holistic Medical Association. She is an internationally recognized authority on women’s health and healing.