Why Do I Feel Like a Virgin at 50?

And Other Frequently Asked Midlife Pelvic Health Questions

Photo by Simran Sood on Unsplash

There are some questions I hear often in my pelvic health clinic. Framed in a few different ways and contexts. Mostly always coming in a slightly hesitant voice. And there is one that I hear all-too-often from women in their late 40s and 50s who are crossing or have just crossed the peri and menopausal bridges.

These are women who have suddenly or gradually found that sex has become painful. Or that their bodies aren’t responding to touch in the same way they used to.

‘Why do I feel like a virgin again with my husband of 20 years?’

‘I’ve just met a new partner after a few years of celibacy and everything feels different – and not in a good way.’

‘Am I your only patient who feels like this?’

The overwhelming emotions emanating in these conversations are fear, humiliation and loneliness. But if these are questions you’ve also been asking, I want you to know that you are not alone. And you are not broken. The good news is, there’s a whole glorious life ahead of comfortable sex. If you choose. These changes are opportunities to understand yourself and your body at an even deeper and more intimate level. These changes are 100 percent worthy of exploration. They have highly positive outcomes and greatly respond to treatment. With the right guidance and understanding of your body.

WTF is Actually Happening To Me?

My friend recently recounted a story of taking a lover when she was 49. The connection went quiet for a whole year and there was no intimacy in that time. She reconnected with him after 12 months. To her embarrassment, she found that penetrative sex was so excruciatingly uncomfortable that she had to stop. She confided in me with tears in her eyes, and confessed that she had no idea how things could change so quickly.

It might help to see this firstly in relation to the physical changes that can happen relatively quickly during the peri-menopausal, menopausal and post-menopausal years which are like a bridge. The average age for menopause is 51 in Australia. It is complete when there have been 13 consecutive months of zero periods.

During the bridge, declining oestrogen affects vaginal and vulval tissues. Reduced lubrication and thinning of the tissues of the vaginal walls (genitourinary syndrome of menopause GUSM) and a decrease in elasticity, contribute to greater levels of vulnerability in the tissue. There can be a narrowing and shortening of vaginal canal width and length due to these changes. Meanwhile, pelvic floor muscles, which form a sling underneath your bladder, reproductive organs and bowel, may become atrophied and weak. Especially if you haven’t paid particular attention to pelvic muscle toning exercise.

These changes can make penetration feel uncomfortable, tight, and sometimes even impossible. Penetrative sex can result in some vaginal bleeding. It can perpetuate further discomfort when the nervous system decides that you are not safe to engage sexually. Resulting in pelvic floor muscle guarding. Unfortunately, many women decide that sex is not something to prioritise and pursue, which can perpetuate the changes even more. Because healthy sex is a cornerstone of pelvic health.

These physical changes are very real. But they’re rarely spoken about.

We live in a culture that assumes a woman’s sexuality either disappears after 40, or that she should be a high-performing seductress who doesn’t experience these changes and challenges. Neither narrative leaves space for the nuanced truth of what it’s like to live in a changing body. And all the mental and emotional aspects that play into these changes too.

When a woman in midlife says ‘I feel like a virgin again’, what she’s often really saying is:
I feel the physical discomfort and I also feel awkward because my body has been changing in ways that culture doesn’t appreciate or respect.

At 50, arousal requires more time, more presence, more trust and so much more safety. Automatic and quick responses feel hollow and meaningless. The body is calling for more intimacy and depth rather than just stimulation or shallow connection.

What women are navigating at this time isn’t failure. They’re facing a transition into a wiser, intentional sexuality. Which isn’t about getting back to normal. Because these changes are a new normal. And there’s a new way of exploring sex that never stops evolving as you age.

The good news is that there are practical, science-backed solutions for the discomfort you might be experiencing:

Topical vaginal oestrogen cream or pessaries or DHEA pessaries can restore tissue health, strength and hydration. These are both prescription-based solutions and rely on a medical professional to screen for safety and appropriateness. When we lose oestrogen in these sensitive tissues, it can cause thinning and atrophy.

Pelvic floor physiotherapy can help release tension in pelvic floor muscles (using techniques called down-training and mindfulness), build pelvic floor muscle strength, and support pleasurable function of the muscles responsible for orgasm and arousal. There are wonderful physiotherapists who are so passionate about this work, including me.

Vaginal moisturisers are a great way to ensure that vaginal and vulval tissue are protected from dryness and chaffing. I am a fan of vaginal moisturisers containing hyaluronic acid (HLA), which is supportive to collagen.

Dilators can reintroduce comfort with penetration gently and progressively. Dilators come in staged sizes to gently stretch the vaginal canal tissues and muscles and to provide graded and gradual experience. The vaginal canal needs regular penetrative action to maintain shape and elasticity.

Vibrators can be a helpful way to support libido, stimulate tissue circulation and may even be used instead of dilators if they are fully inserted. The irony is that many women do not realise the importance of insertion and use vibrators clitorally only. It is important for vaginal canal health to have full regular penetration to support patency and comfort.

Therapeutic sex education through sex therapy, touch, bodywork, breath and counselling to address underlying trauma can also be helpful. Menopause often unearths stories that women have been carrying in their pelvis and pelvic floor for decades. It is fascinating to note that pelvic physiology can be affected by cultural and religious factors as well as past events, particularly trauma. Choosing a trauma-informed therapist is a must when discussing deeply personal and intimate pelvic stories.

Most importantly, working with a provider who listens to you without shame, judgement or dismissal is essential. You deserve to be taken seriously and to feel good in your body. You deserve to understand the importance of intimacy with yourself before others. Putting yourself first in this way is not selfish, it is essential for reclaiming your deep connection to your body, a house of divinity. Becoming re-acquainted with your body after each transition in life, particularly menopause, is an act of holy and sacred importance.

Feeling like a virgin at 50 isn’t the same as being inexperienced. It’s being re-sensitised and called back into presence. It’s the body asking to be known again — not as it was when you were younger, but as it is now. And in who you are becoming in all your depth, power, and vulnerability.

If you are grieving a body that once responded like clockwork and now needs slow, more considered attunement, don’t be too despairing or hard on yourself. This is an adjustment. It’s a rite of passage that is worth tuning in deeply for. Because it is a truly powerful thing, to understand your own interoceptive awareness and the power and holiness that lives within you. The erotic self is in a constant spiral of sleeping and resurfacing throughout many of life’s transitions. If you can hold yourself tenderly at this particularly potent rite of passage, there is a lot of freedom, liberation and power on the other side.

Because sexy was never meant to expire.

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With love and kindness,
Lisa

Someone who knows the path back to herself and wants to walk aongside you.