What Is A “Couplepause” And What Can You Do If You’re In One?

There’s a persistent myth that sex is a young person’s game – a myth that has been roundly debunked, we hasten to add. In fact, we know that age alone need present no barrier to a fulfilling and adventurous sex life, although some of the side-effects of aging can put a dampener on things in the bedroom. In recent years, researchers have coined the term “couplepause” to describe the combined impact of age-related sexual dysfunction on a couple’s sex life. But what can you do if you’d like to hit “play” again?

What is a “couplepause”?

Male or female, as we age our bodies go through a series of changes that can have a knock-on effect on sexual function.

In 2018, scientists Emmanuele A. Jannini and Rossella E. Nappi conducted a review of studies into how aging can impact sex in relationships, and concluded that treatment is more effective if the needs of both partners are considered in tandem, rather than individually.

“Therefore […] we introduce the concept of couplepause,” they wrote, “and the need for a new diagnostic and therapeutic paradigm that addresses the sexual health needs of the aging couple as a whole rather than treating the individual patient in isolation.”

Since both sexes can experience age-related hormonal changes affecting sexual function, same-sex and opposite-sex couples may be equally affected by this phenomenon.

Menopause and andropause


Menopause is effectively the reverse of female puberty, occurring naturally around the age of 45-55 in most people. Early menopause may also occur spontaneously, or as a result of surgery to remove the uterus and ovaries.

The term “menopause” literally refers to the end of the monthly period, which may be the most obvious sign of the hormonal changes going on beneath the surface, but there are a range of symptoms that can arise in the several years leading up to menopause (called perimenopause) as well as afterward, many of which can impact sex life.

Around half of post-menopausal people are thought to experience symptoms affecting the genitals, sexual functioning, and the urinary tract, collectively known as the genitourinary syndrome of menopause (GSM). The symptoms are caused by the sharp drop in estrogen levels that is seen during this time of life, and can include:

Vaginal dryness/lack of lubricationDiscomfort/pain during sexIrritation or burning sensations around the genitalsRecurrent urinary tract infectionsPain/urgency with urination

In addition to these physical symptoms that can make sex challenging, the menopause can also herald a decrease in libido. Some people experience a drop in their testosterone levels as well as estrogen, which can result in low mood and a lack of sexual desire.


The term “andropause” is not as widely recognized as its female equivalent, as not all males will experience a drop in testosterone levels as they age. However, for those who do develop testosterone insufficiency, the symptoms can include both emotional and physical changes, such as:

Low libidoImpaired ejaculationErectile dysfunction

Erectile dysfunction is a fairly common problem in general, with some recent data suggesting as many as 322 million men worldwide will be affected by 2025. The risk increases with age – by age 70, it’s thought that 70 percent of people with penises are affected in some way, with around 15 percent unable to achieve an erection at all. It can have a substantial psychological impact on both partners in a couple.

Couplepause: what can be done?

In the case of a relationship where both partners are affected by some of the symptoms of menopause or andropause, it’s clear to see how their sex life can begin to suffer.

Jannini and Nappi highlighted the need for physicians to consider a couple seeking treatment for these kinds of issues as a whole, for a number of reasons. For example, it minimizes the risk of one partner’s treatment having a negative impact on the other.

In 2022, a working group was set up to help define the best way for healthcare providers to approach couplepause. The results of its first meeting, published in The Journal of Sexual Medicine, explain that breaking down barriers and opening up communication, both within the couple and with their physician, is a key part of the process.

The paper emphasizes a need to define the midlife period as “a new beginning, promoting a healthy sex life and overall well-being.” It also highlights the importance of education – Jannini and Nappi’s original research uncovered gaps and disparities in how people of each sex view age-related hormonal changes in the other. More openness and understanding of the symptoms of menopause and andropause can only help with this.

But the important message for those who may be in the midst of a couplepause of their own is that there is help out there – and sometimes, starting with the simple stuff is the best way.

Speaking on a recent episode of the BBC Radio 4 program Woman’s Hour, therapist and writer Lucy Cavendish said, “If we have been in long-term relationships, what we all tend to do is we forget to do the work.”

“What I ask my couples to do is to re-contract their relationship […] By the time they get to their late 40s, early 50s, most people have stopped being curious about the other person. It’s all gone a little bit humdrum. The idea of getting jiggy makes everybody think, ‘Uh, no I’d rather read a book.’”

To counteract this, Cavendish suggests that couples start by gazing into each other’s eyes, and then by introducing more physical intimacy – holding hands, for example – and by actively being curious about their partner and having those deeper conversations that can fall by the wayside as we get older.

As well as these therapeutic approaches, there may also be a need for medical intervention to treat some of the symptoms. A number of medications exist to help with erectile dysfunction, and many people experience relief from menopause symptoms by using hormone replacement therapy – these are just a couple of examples, and lots of other symptomatic treatments could be helpful.

The main thing, as Jannini and Nappi stress, is that this whole process of seeking medical and psychological help be undertaken with both partner’s needs in mind. That way, a couplepause can be just that: a temporary pause in nocturnal activities, and certainly not the end of the story.

All “explainer” articles are confirmed by fact checkers to be correct at time of publishing. Text, images, and links may be edited, removed, or added to at a later date to keep information current.

The content of this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.

Leave a Comment