Perimenopausal Pleasures

Perimenopause can be the fire with which we burn away the bullshit and reclaim our bodies, our boundaries, and our pleasure 🔥

On hormones, embodied pleasure, education, healing, and why this is your moment to reclaim your body, for you.

Perimenopause can be a launchpad into the greatest pleasure of your life... or a shut-off valve. If you wish to choose the path of pleasure... keep reading!

Being in perimenopause means that everyday you have a chance to drop into your body, giving her breath and stillness and pleasure and grace to be exactly as she is.

You can also choose to fully drop out (and I totally get why sometimes we want to drop out). This post might not be for you.

Below, I’ll share my holistic, pleasure-forward approach to perimenopause: how it can be a launchpad for the best pleasure of your life, why the medical model is necessary (but lacking), and how to (literally) take pleasure into your hands.

Perimenopause is a Pleasure Launchpad

After years of doing the work of sexual healing with myself and with my clients (as an educator and coach), what I know is that perimenopause can either be an introduction to your deepest pleasure or a shut-off valve. Perimenopause can absolutely be a portal to finding your deepest truth, your innate power, and your wild sexuality... the vibrant energy that we’ve hidden or ignored, in service of being a ‘good girl’ or a ‘good wife.’

Perimenopause can be the fire with which we burn away the bullshit and reclaim our bodies, our boundaries, and our pleasure 🔥

But this take conscious efforting... because otherwise, the overlapping (and often overwhelming) symptoms and bodily changes might make you feel so terrible that you want to give up, and you’ll want to use perimenopause as the shut-off valve. I know that feeling of wanting to give up, and I know so many other women have told me they want to give up, too. It doesn’t have to be that way.

If you got married in your 20s or 30s and have been with the same partner for decades, you might not be having the best sex of your life. Statistics offer us generalizations of our population, and the stats are NOT good, my loves. There’s the orgasm gap, there’s the fact that most hetero couples only have sex for 5-7 minutes, and there’s all the other data about people just having less sex overall (and often not liking the sex they are having).

Then there is the general lack of education about hormones, bodies, sexuality, and desire that leaves us fumbling in the dark. So many women in my workshops and classes have never known their pleasure was for themselves.

But you can grab the reigns of your body and your pleasure, and start to prioritize it for yourself. And once you start claiming your body, your boundaries, your needs, everything will shift—you’ll set yourself free to become so much more fulfilled.

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Medicine ≠ Pleasure

Sexual wellness is so much more than the narrow medical model that doctors and hormone specialists present, so it’s vital to include pleasure into the conversation.

The medical model of perimenopause is having a moment. From the New York Times to TikTok and Instagram, my life is full of (peri)menopause wisdom. We’ve been lied to for so many decades, and women are PISSED OFF and demanding answers. And there are some superstars in this field doing great work. Some of my favorites are @drrachelrubin (who trained under Dr. Goldstein), @drmaryclarehaver (a brilliant, funny menopause doctor), and @drmillhouse (hilarious vaginal and urology info).

I’m a proponent of hormones, supplementation, and regular medical care of all sorts. I think adding hormones back into our body to keep our brains sharp, our bones strong, and our tissues soft is VERY, VERY important.

But we need more than that, too—so often women need help beyond just feeling ok.

Far too often, PLEASURE is missing from the conversation—knowing how to take back our bodies, and own our desires, and our experience of pleasure. Understanding that you are responsible for your own sexuality is key here.

And context is missing from the conversation. If your pussy feels great on hormones but your partner doesn’t understand why you need to update your sex scripts, no one is happy.

This cascade of hormonal changes might feel like chaos—you may not know who you are or what you want. But if you tap into the fires that are starting to burn off that which you no longer want or need in life... your sexuality can become YOURS again (or for the first time).

Far too often, women are told that we have to be available, sexy, and turned on for others—for a relationship, for a partner, for the performance of desirability. But at this time of change, I want to present an alternative: I want you to be turned on for yourself.

I want you to be so full of pleasure and aliveness that you can’t help but feel turned on by the world. I want you to feel so in love with your body and so excited about your pleasure that you feel whole all on your own. And I hope your partner does the work to keep up with you during this shift.

Much of the work I do with individuals and couples is about helping people re-imagine what sex can be, and perimenopause is often the perfect moment to re-imagine your sex life from top to bottom.

This means that taking care of your sexuality starts right now... no matter where you are in your journey. Even if you never want to have sex with another human again, taking care of your sexual health and your pussy is FOR YOU. I just had someone tell me the other day that after years of a sexless marriage, she met someone new. But because she had not tended to her hormonal health, the sex with her new partner felt terribly painful, and her tissues were so delicate and sensitive that sex didn’t feel good.

PLEASE don’t wait until it’s too late, until you have the right partner, until you fix your sex life.

Because here’s other deeply important thing: sex, pleasure, and orgasm in our bodies is actually healing. Masturbation and pleasure can help make our perimenopausal transition easier, and can make our transition to menopause more delightful. Pleasure is physically good for us, mentally good for us, and sexually good for us—it builds on itself.

The more pleasure you have, the more pleasure you want, and the more vital you become. But if we turn off the spigot—if we shut down access to our pleasure—then it only moves in one direction, and it isn’t upward.

How To Take Pleasure Into Your Own Hands

Touch your body. Get to know your breasts, belly, butt, and pussy as she is now. Notice what’s new, different, and what might need attention. There are a zillion symptoms of perimenopause, from frozen shoulder to cognition to itchy ears to digestive stuff to join pain that has nothing to do with your genitals. But you may notice less lubrication, more sensitive tissues, your orgasm being further away.

Give yourself pleasure. Yes, to self-pleasure and masturbation (but here are 31 ways to explore self-pleasure in new ways)... but also... delight yourself. Sniff the flowers, get a new body wash, eat the yummy dessert, buy the coziest pajamas, get a massage... let yourself love your body and her innate desires and delights. You deserve them all.

Trust your gut. If you think something might be wrong, trust yourself. Do not let a doctor gaslight your very real symptoms. Seek a second opinion, ask for referrals from friends, and find someone that listens to your concerns and doesn’t just give you anti-depressants. One of the most common first signs of perimenopause is noting, ‘I just don’t feel like myself.’ So learn to rigorously trust yourself.

Be willing to learn. Not only do you need to learn about your body, your hormones, and your options, but also relearning what sex and pleasure can be. This is where YOUR FAVORITE SEX COACH comes in (🙋🏻‍♀️). Not only am I in this with you, I’m armed with both research and pleasure practices to help you understand yourself and feel awesome in your body. Whether you choose to explore bedroom communication with your Beloved, or rediscover self-pleasure for midlife babes, or dive into sacred sexuality, there’s a world of pleasure that awaits. See my workshop below for more about this!

This is the best work you can do in your lifetime. Come join me on the adventure! When you ready to explore your perimenopausal pleasure journey, connect with me here.

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Pleasure is medicine. And midlife is your reclamation era.

I’m Andrea Devon Bertoli, a Pleasure Coach and Sex Educator devoted to the erotic lives of women in midlife. My work lives at the intersection of science, sacred sexuality, and the slow, gorgeous practice of coming home to your body.

Here on Substack you’ll find thoughtful essays, embodied practices, and the kind of honest, warm conversation about sex and intimacy you didn’t know you needed. I offer deep-dive resources on my website, coaching sessions for those ready to go further, and alongside my husband, I host wildly popular workshops online + in-person in the Bay Area. Ready to journey inward? Fill out my New Client Intake form and let’s find out what is possible.

Welcome to Love in Adulthood… where you’ll tap into perimenopausal pleasures, sexual sophistication, and midlife intimacies for all.