Clinical Content December 2021 Newsletter

Couplepause: When Andropause & Menopause Collide

By Michael Krychman, MDCM, MPH

AASECT Certified Sexual Counselor and Executive Director of the Southern California Center for Sexual Health & Survivorship Medicine, Dr. Michael Krychman specializes in sexual health and well-being for patients of all genders—and all ages. He has spoken at countless Symposia Medicus conferences over the past eight years. Here, he offers his expertise not only on menopause, but also on andropause, and the challenges couples can face when their hormones are running low—and on parallel tracks.

As we get older, sexual intimacy and our relationships undoubtly change. Let’s take a closer look at what happens when andropause and menopause collide at midlife.  

What is Menopause?

Menopause is technically the cessation of menstrual cycles for 12 consecutive cycles resulting in loss of estrogen and testosterone production. The menopausal woman may suffer from a variety of symptoms including hot flashes and changes in her sexual function. It is not uncommon for older women to complain of vaginal dryness, painful intercourse, increased time to sexual arousal, and less intense orgasmic response.

What is Andropause?

Andropause often happens to men at midlife, and they may experience symptoms such as low energy, fatigue, and lowered sexual interest. They may have changes in erectile strength and may often feel like their erections are not lasting as long as they did in their youth. Most of the symptoms may be attributable to lowered testosterone levels.

What Happens When Menopause & Andropause Collide?

There are undoubted changes in your sexual relationship as you and your partner age. Scientific research indicates that the frequency of sexual intercourse declines with increased duration of the relationship. The longer you and your partner are together, the less penetrative sex you may have. In addition, we often see a shift in sexual activity from intercourse to alternative forms of sexual pleasure such as oral and manual stimulation.

Here Are Some Helpful Hints to Combat the Collision Course of Andropause & Menopause


Seeking medical, urological, or gynecological care is important since you may discover easily correctable solutions to the sexual problems you are experiencing. Hormonal replacement with testosterone and the addition of a phosphodiesterase inhibitor is often the common solution for men with lowered libido and/or erection concerns. For women, locally applied, minimally absorbed vaginal estrogen may ease the discomfort of vaginal dryness. Some women may benefit from systemic hormones including estrogen and testosterone to help restore their mojo.


Talking about your sexual needs and wants is now more important than ever. Have frank, honest conversations with your partner. It is important to discuss your sexual wants and plan your joint sexual journey together as you age into your golden years.


Silicone lube is essential for the older couple. It is long lasting and provides excellent lubricity for enhancing sexual pleasure. Women may need more time to get aroused, and men may need more friction or slickness with a medication-enhanced erection. A silicone lubricant is a simple, easy solution for all of your sexual needs. Water-based lubricants may be helpful as well; use whichever lubricant works best for and is most preferable to you.


Taking a break from the pressures of work, finance, politics, and other adult responsibilities is a necessity. Chronic stress and fatigue zap your sex drive and may impact your sex hormones in the long run. 

Are you mindful or mind full? Are you relaxed, or is there constant brain chatter distracting you from being in the sexual moment? Take some much-needed time to recharge yourself—plan a staycation, get lost in an enjoyable novel, or listen to some soothing music. Exercise can also provide a method to destress. Sex can give you refuge from the chaotic world around you.

Getting older comes with many positive attributes: we have experience, wisdom, may be happier, and have the resources to pursue your dreams. Sexual intimacy is not only for the youth; sexual vitality should be a consistent part of your life as you enter your golden years. You may be surprised—just like a fine wine, sex may even deepen and improve with age and time.   

Michael Krychman is the Executive Director of the Southern California Center for Sexual Health & Survivorship Medicine. He lives in Laguna Beach, California.