A BINTO Q&A with Clinical Sexologist Dr. Kelley Johnson
Though menopause is a natural biological process, the side effects—like hot flashes and vaginal dryness—may feel anything but natural. But while many automatically associate menopause with these physical symptoms, the emotional and interpersonal challenges often get brushed aside. For example, menopause (and aging in general) can be tough on marriage.
We spoke with Dr. Kelley Johnson, a clinical sexologist, about this topic and found her positive and empowering advice to be quite refreshing, especially given how our culture currently views menopause.
BINTO: Thanks for sitting down with us again! For those unfamiliar with your work, will briefly you tell us about yourself and your work?
KJ: I received my Master’s in Public Health Education and went on to teach women’s health and sexuality at the University of North Carolina at Asheville. Later, I received a PhD at the Institute of Human Sexuality in San Francisco. I then went into private practice. I now provide education for schools, the general public, and individuals who are having sexual issues.
I’ve been teaching sexuality classes at a community center for older retirees since 2008. I get a lot of information from them, which helps to form my opinions on topics like this. I’m also postmenopausal myself.
BINTO: In your opinion, why is menopause a challenging time in marriage?
KJ: I don’t believe it’s so much menopause itself that’s challenging, but rather the experience of middle age, during which menopause often occurs. We begin to reassess our past and what we want our future to look like. Often in marriages, this is a time when kids go to college. Once kids leave the nest, couples must figure out what their relationship will be like. Do they want to move forward together or move forward separately?
I find that when women experience menopause, they embrace their more masculine side. After all, their sex hormones are declining. As men age and lose testosterone, they move towards the feminine. For women, after many years of enduring discrimination and being treated as a second-class citizen, menopause helps them find a newfound strength and outspokenness.
Of course, it’s different for everyone. Some embrace not having periods. For some, not being able to get pregnant is a relief. They may now feel more comfortable in their sexuality. But others may see it more negatively, like it’s the end of their sex life—they’re “all dried up.”
BINTO: Do you counsel married couples who are going through menopause in your private practice? If appropriate, can you tell us about your work with them and what you typically observe?
KJ: In my private practice, I tend to focus on helping clients expand their sexuality and redefine what sex is, so it’s not so intercourse-focused. Instead, it’s focused on pleasure, sensuality, and intimacy. You don’t need an erect penis or lubricated vagina to remain sexually intimate.
BINTO: Ha! What a great statement. What are some ways you help them establish this perspective?
KJ: First, the couple must talk about it. Then I suggest they get reacquainted with their bodies through a process called Sensate Focus, which was created by Masters and Johnson. This process involves remapping the body for pleasure. Instead of being so genital-focused, the couple explores what it feels like when you rub or kiss their partner’s head, ears, or neck, for example. We do this for the entire body from head to toe.
Once this is done, they’re ready to become more sexual. Perhaps they introduce a vibrator into the bedroom. I emphasize that you can have enjoyable oral sex without an erect penis. Manual stimulation or rubbing the genitals together can also be satisfying.
BINTO: Tell us more about how menopause impacts physical and sexual intimacy in marriage.
KJ: If you have symptoms like vaginal dryness or thinning vaginal walls, you’ll likely be less interested in penetration. Symptoms like hot flashes can impact the way a couple sleeps. You sweat and throw the covers off. Then, the sweat turns to cold, so you pull the covers back on. Repeat. It may end up being easier to sleep separately. This is OK—thinking that sex can only take place at night is a barrier to intimacy.
There’s also a shift in the body’s erotic zones. While one was menstruating, they might have had a lot of sensitivity in their breasts. During menopause, that may no longer be the case. This is why Sensate Focus is helpful. UTIs are more common during menopause, too. They’re uncomfortable and require antibiotics, which may then cause a yeast infection. Some couples avoid intercourse because this prevents bacteria from entering the urethra.
BINTO: I recently read a statistic from the AARP in the New York Times that says over 60 percent of divorces are initiated by women after age 40. I don't want to jump to any conclusions, but do you think this has anything to do with menopause?
KJ: Yes. I see menopause as a season in life where we feel wiser and stronger. We’re no longer taking any shit.
BINTO: We can get behind that. Let's talk about spouses. Though they may not be the one experiencing menopause, why is menopause still a difficult time?
KJ: From the media, we see this idea of men getting more sexy and sophisticated as they age, whereas women just get older. Because of this, spouses may be questioning the sexuality and femininity of their spouse. They may wonder how it will impact their sex life. If their spouse does have a lot of symptoms related to menopause, it’s hard to see someone you love struggle. Lastly, many women feel more powerful, wise, and strong during menopause. This can cause changes in power dynamics within the relationship, which may be uncomfortable for the spouse.
BINTO: How can spouses be supportive as their partner navigates menopause?
KJ: Listen and be understanding. Reassure them that you see them as a beautiful and powerful bundle of wisdom.
BINTO: You mentioned that you're postmenopausal. If you're comfortable, is there anything you'd be willing to share about your experience and how it's influenced your relationships?
KJ:We’ve grown up in a culture that views sex as something only the young and beautiful do. We need to see more movies that contain older couples being romantic in a healthy way, not a humorous way. This is partly why I’m happy to share my experience.
The way my body responds to sex is better than it’s ever been before. I started having multiple orgasms, way more than I experienced in my earlier life. I now feel much more open telling my partner what I need to be satisfied. Honestly, I feel like a badass. Menopause has brought on feelings of strength and empowerment for me.
Written by English Taylor. Women's health freelance writer and editor. English went to the University of Virginia undergrad and Northwestern for graduate school. She currently lives in the bay area but hails from Nashville (one of our favorite places!).