I Don’t Like My Body, and It’s Affecting My Sex Life

Plus, is oral sex safe?

Ellen Uzelac,

AARP

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Published August 15, 2024

illustration of a woman in a bedroom, covering herself up with window curtains

Kiersten Essenpreis

Sometimes when I look in the mirror, I miss my 30-something body: brown hair, supple skin, a flatter stomach. Body image is an issue for many 50-plus women, much of it driven — no surprise here — by the extra pounds we carry.

In this week’s column, our experts counsel a woman whose weight gain has made her so self-conscious she avoids intimacy and sex.

They also address a topic that — judging from reader emails — is of interest to many of you: oral sex.

Since entering menopause, I’ve gained weight, and I’m self-conscious about it to the point that I don’t want to get naked with my husband. What can I do to get my groove back?

Body shame, as you’ve discovered, can negatively impact our sexual pleasure and sense of desirability, according to certified sexuality educator Jane Fleishman. “When we don’t feel desirable, we don’t feel desirous.” It’s a loop we get ourselves into, she says, and it’s not healthy.

There are strategies to help you accept and enjoy your body. As certified sex therapist Sandi Kaufman bluntly frames it: “Focus on pleasure and sensation in your body and your partner’s body — and tell your brain to shut up.”

Set the stage. Wear something that makes you feel sexy, dim the lights and hop into bed before your partner, Fleishman says. “When you get to that moment and the two of you are in bed together, you’ve already obviated the need to walk to bed in your nakedness.” Use this as an opportunity to redefine your happy place. “Learn to enjoy sexual pleasure in your body as it exists today.”

Create a romantic and sexy mood. Among Kaufman’s suggestions: wear sexy lingerie, light candles, masturbate together, use a vibrator, read erotica, wear a scent you love, watch a sexy movie, hold hands, make out.

More 50+ Sex Advice

As a couple, share your feelings. Your husband’s body has likely changed too, Kaufman says. In fact, he may be feeling the same way you do. Talk about it. Ask him for reassurance. Ask one another, “What do you still find attractive about me?” and “How do you feel about your body and its changes?”

Add a body scan to your morning ritual. Fleishman practices a daily exercise in bed when she first wakes up. “I notice what hurts or what body part I’m unhappy with,” she says, “Then I’ll say I love my neck or I love my belly.”

It doesn’t change the physical nature of the body, but she says it can change your relationship to your body. “It’s a meditative moment,” says Fleishman, who has a PhD in human sexuality from Widener University. “We’re all in this struggle, but we keep it hidden. This is a way to shine light on it.”

Are there any health concerns for my partner and I indulging in oral sex? We are both in our mid-70s and sexually active.

If you’re mutually monogamous, you are cleared to have at it, according to our experts.

As Kaufman puts it: “If that’s what turns you on and makes you happy, there’s absolutely nothing to worry about.”

If your relationship is open or you’ve changed partners, Fleishman says to make sure you protect each other from any sexually transmitted infections (STIs). Chlamydia, gonorrhea, genital herpes and the human papillomavirus, known as HPV, can all be contracted through oral sex.

“Have a discussion before you go down on each other,” Fleishman says. Among the questions to consider: Have there been any changes in your sexual health? Do you have persistent itchiness or rashes that might indicate an STI? If so, Fleishman says to get tested — ideally at a sexual health clinic.

Testing can get “tricky,” according to ob-gyn Maureen Slattery, a certified sexuality counselor. No one test fits all for what you can contract via oral sex.

Here’s what you need to know:

Chlamydia and gonorrhea. The tests for chlamydia and gonorrhea involve oral swabs, which are pretty straightforward, Slattery says. You can get them done in most physicians’ offices, at your local health department or Planned Parenthood.

Human papillomavirus (HPV). A pap smear for women will detect HPV at the cervix and vagina but not at the anus, throat or mouth. There’s no test for men. Slattery says HPV is “essentially ubiquitous” among sexually active adults and it’s “impractical” to advise having sexual activity or not based on a woman’s paps. She recommends talking to a sexual health physician to fully understand the risk.

Genital herpes. There’s a blood test, but the body will test positive only if it has a lesion — which looks like blisters or ulcers on the vulva, perineum, mouth, anus, penis, vagina or cervix.

If you know you have genital herpes, Slattery says to forgo oral sex if you have an active infection. Also don’t have oral sex if you have a cold sore on your mouth or a tingling sensation that signals an outbreak is about to happen. Oral herpes can be passed to the genitals, she says, and morph into genital herpes.

If either of you has an undiagnosed discharge or discomfort in your genitals, Slattery says to consult a doctor.

Do you have questions about sex or relationships as a 50-plus adult? Send them to sexafter50@aarp.org.

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