Our goal is to help you have the sex you want. The physical and emotional changes brought on by menopause can take its toll on your self-confidence when it comes to intimacy. Sexual and reproductive health expert, Zoe Sever, explains what steps you can take to boost how you feel about yourself in the bedroom and improve your sexual satisfaction.
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What is sexual self-esteem?
You may find that your appearance changes during menopause, leaving you unable to recognise and accept your body. If this is you, you are far from being alone with these thoughts.
One large study of postmenopausal women found that 83% were dissatisfied with their appearance.”
How you feel about your body undoubtedly affects your sexual behaviour and satisfaction. Sexual self-esteem is how you view yourself sexually and whether you believe you are sexually attractive, capable, and worthy. Having low sexual self-esteem can leave you feeling unsatisfied in the bedroom and with your relationship.
What does low sexual self-esteem look like?
Low sexual self-esteem may present itself in varying ways. You might:
- Avoid certain sexual positions that you believe may be unflattering
- Want to keep the lights off
- Keep clothing on
- Not believe you are sexually attractive
- Go all out to avoid sex because you don’t feel confident in your body
Unfortunately, focusing on what you look like during sexual moments can leave you feeling like a spectator. It removes you from the moment – from pleasure and connection. Ready to make a change? Let’s talk about can you overcome low sexual self-esteem.”
Sexual self-esteem is how you view yourself sexually and whether you believe you are sexually attractive, capable, and worthy.
Redefining your sexual narrative
Various highly personal factors influence your sexual self-esteem, and these may be psychological, interpersonal or sociocultural. It is crucial to reflect on how you perceive and define yourself sexually and where this may have originated. Ask yourself:
- What stands in the way of expressing yourself sexually?
- Have you been shamed, judged, or embarrassed in the past – something many women have experienced?
- Maybe you feel as though you’re not worthy of being desired or feel guilty for experiencing pleasure?
- Are you holding on to any hurtful comments or encounters?
Reflect on how your experiences have influenced the way you feel about yourself sexually. Accepting your body and your past experiences helps build sexual confidence and self-esteem.
Changing how you view your body
It is impossible to have a truly satisfying sex life if you are insecure about your body or feel that you are undeserving of sexual pleasure.
Sexual pleasure is your right, and your body is perfect and beautiful exactly the way it is.”
If you don’t believe this, try the exercise below to help shift negative self-talk.
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Shifting negative self-talk
The way we talk to ourselves ultimately influences the way we feel and act. The good news is, you can train yourself to have conscious, positive thoughts. The following exercise originates from the renowned sex educator Emily Nagoski (which we have slightly revised):
- Find two minutes to undress and stand naked in front of a mirror.
- Look closely at yourself and notice where your thoughts go. It is likely that some of the first thoughts that arise will be self-critical. This is natural. Just acknowledge these and set them aside for now.
- Then, verbally acknowledge to yourself (aloud) all of the things that you like about what you see. Don’t forget to include the genitals! These may even be small things like the colour of your eyes or the shape of your chin.
- Repeat this daily, reminding yourself of all the things you like about your body.
Over time you will notice that your body is amazing exactly the way it is. This exercise is excellent at promoting self-love, compassion, and gratitude. Self-awareness gives you the opportunity to remove yourself from fixed ideas about your body.
Sexual communication
Open and honest communication is the foundation not only for sexual satisfaction and pleasure but also for sexual self-esteem. In fact, good sexual communication is directly linked with higher sexual self-esteem because expressing our sexual needs and boundaries increases confidence. For example, you may be more likely to ask a partner to use a condom, change to a sexual position that’s more pleasurable for you, or to voice any sexual concerns.
As your sexual desires are diverse and constantly shifting throughout your lifetime, conversations about sex are essential. After all, your partners are not mind readers. Although this may initially feel difficult, once you start to have these conversations you will likely feel even closer to your partner and more confident about being sexual.
Engage in mindfulness
When you have lower sexual self-esteem and are critical of yourself during sex, you get pulled away from being in the present moment. Rather than engaging in sensations, indulging in self-criticism can quickly move you from pleasure and connection to anxieties and worry.
Who wants to be absent during their own sexual experiences? When this happens, try to acknowledge the negative thoughts, and choose to let them go. Focus instead on engaging with the moment by tuning in to your senses. This can help remove you from what you are thinking to what you are experiencing. Ask yourself, what do you feel? What do you see, touch, hear, smell and taste? The more you practise this, the easier it will become.
The importance of self-care
Self-care is vital for maintaining a healthy relationship with yourself and looking after your wellbeing. It comes from deliberate acts that foster self-compassion and kindness. This can, in turn, build self-confidence and sexual self-esteem.
Your self-care regimen needs to be suited to you, based on what you associate with relaxation. This could mean going for a walk, reading, taking a bath, putting on a face mask or even masturbation (whatever feels good to you). Anything that helps you show yourself some love. It doesn’t have to take place every day or for multiple hours, just enough to check in with yourself and to serve as a reminder that you are capable and worthy.
Jeanette’s story
Coming to grips with my changing body as I entered perimenopause was difficult. My sexual self-esteem certainly took a hit and I no longer felt like my confident self during sex. But as I continue to age, I find that I don’t catch myself comparing or worrying about how I might appear nearly as much as when I was younger. I am learning that my body does some amazing things and that I deserve to feel good in my own skin. Over the past few years, I have slowly come to accept myself as I am. This has felt liberating!”
Final word
Having a pleasurable sex life requires that you respect and value yourself. Shifting away from negative self-talk, prioritising sexual communication and practising mindfulness and self-care can help you feel your best sexual self.
Read more about menopause on our blog or in our symptoms library.
Ginsberg RL, Tinker L, Liu J, Gray J, Sangi-Haghpeykar H, Manson JE, et al. Prevalence and correlates of body image dissatisfaction in postmenopausal women. Women Health. 2016;56(1):23-47.
Thomas HN, Hamm M, Borrero S, Hess R, Thurston RC. Body Image, Attractiveness, and Sexual Satisfaction Among Midlife Women: A Qualitative Study. J Womens Health (Larchmt). 2019;28(1):100-6.
Bornefeld-Ettmann P, Steil R, Höfling V, Weßlau C, Lieberz KA, Rausch S, et al. Validation of the German Version of the Sexual Self-Esteem Inventory for Women and its Application in a Sample of Sexually and Physically Abused Women. Sex Roles. 2018;79(1):109-22.
Firoozi M, Azmoude E, Asgharipoor N. The relationship between personality traits and sexual self-esteem and its components. Iran J Nurs Midwifery Res. 2016;21(3):225-31.
Jonovska S, Jengić VS, Zupancić B, Klarić M, Klarić B, Marinović M, et al. The relationships between self-esteem, emotional reactions and quality of life in pediatric locomotory trauma patients. Coll Antropol. 2009;33(2):487-94.
Erol RY, Orth U. Actor and partner effects of self-esteem on relationship satisfaction and the mediating role of secure attachment between the partners. Journal of Research in Personality. 2013;47(1):26-35.
La Rocque CL, Cioe J. An evaluation of the relationship between body image and sexual avoidance. J Sex Res. 2011;48(4):397-408.
Snell WE. New directions in the psychology of human sexuality: Research and theory. Cape Girardeau M, editor: Snell Publications; 2001.
Ménard AD, Offman A. The interrelationship between sexual self esteem, sexual assertiveness and sexual satisfaction. Canadian Journal of Human Sexuality. 2009;18:35-45.
Oattes MK, Offman A. Global self-esteem and sexual self-esteem as predictors of sexual communication in intimate relationships. Canadian Journal of Human Sexuality. 2007;16:89-100.
Grower P, Ward LM. Examining the unique contribution of body appreciation to heterosexual women’s sexual agency. Body Image. 2018;27:138-47.
Wu T, Zheng Y. Effect of Sexual Esteem and Sexual Communication on the Relationship Between Body Image and Sexual Function in Chinese Heterosexual Women. The Journal of Sexual Medicine. 2021;18.
Godfrey CM, Harrison MB, Lysaght R, Lamb M, Graham ID, Oakley P. The experience of self-care: a systematic review. JBI Libr Syst Rev. 2010;8(34):1351-460.
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