Body Image, Menopause, and Intimacy: Navigating Change with Compassion
Menopause is a significant transition for many women and AFAB (assigned female at birth) people; it brings changes that go far beyond hot flashes or missed periods. One of the most challenging shifts can be weight gain, especially around the belly. These changes are not just physical; they can deeply affect how people feel about themselves, their self-esteem, and even their relationships.
Why Does Weight Gain Happen During Menopause?
As women and AFAB people move through menopause, hormone levels like oestrogen and progesterone drop; this shift can slow metabolism, change how the body stores fat, and make it much harder to lose weight, even if eating habits and activity levels stay the same. Research shows that menopause often leads to more visceral fat, which is fat stored deep in the belly. This kind of fat is stubborn and not easily lost through simple “eat less, move more” advice.
Example:
You might find that, despite eating the same foods and staying active, your clothes fit differently or your body feels unfamiliar. This isn’t a personal failure; it’s a normal, hormonal response.
The Pressure of Diet Culture and Unrealistic Standards
Our society is obsessed with youth and thinness; we see images everywhere, on TV, in magazines, and online, of people who are slim, toned, and wrinkle-free. These images are often airbrushed and unrealistic, but they still shape how we see ourselves. There’s a message that women and AFAB people should always look young, never gain weight, and never show signs of aging. This pressure can make natural changes, like weight gain during menopause, feel like a personal failure instead of a normal part of life.
Example:
A client shared that she avoided swimming with her partner because she worried about her “menopause belly.” She felt embarrassed, even though she loved the water and missed the connection.
The Impact on Self-Esteem and Relationships
When women and AFAB people feel uncomfortable in their bodies or worry about looking “less attractive,” it can take a toll on self-esteem; this often spills over into relationships. Some may avoid intimacy with their partners, feel embarrassed about their bodies, or pull away emotionally. Others might feel pressure to try extreme diets or even consider surgery, hoping to “fix” what’s happening. In fact, eating disorders and gastric bypass surgeries increase significantly among people in midlife, partly because of these unrealistic expectations and the emotional pain they cause.
Example:
It’s common for people to start skipping meals or over-exercising, believing it will help. Instead, this can lead to more anxiety, lower mood, and even disordered eating patterns.
Hormones, Libido, and Lack of Support
Menopause can also impact libido; lower oestrogen and testosterone can lead to vaginal dryness, discomfort, and less interest in sex. Unfortunately, many women and AFAB people are not offered real solutions. Hormone replacement therapy (HRT) can help, but it’s often not discussed or offered, partly because many doctors aren’t trained in menopause care. Instead, people are told to “just eat less and exercise more,” advice that doesn’t address the real issues and can leave people feeling frustrated and alone.
Example:
A partner might notice a drop in intimacy and misinterpret it as a lack of interest when, in fact, discomfort or hormonal changes are the cause. Open conversations and medical support can help bridge this gap.
Why “Eat Less, Move More” Doesn’t Work
The old advice to simply cut calories and exercise more doesn’t work for everyone, especially during menopause. Visceral fat, which grows during this time, is influenced by hormones, inflammation, and genetics; studies show that stress and sleep can play a bigger role than diet and exercise. Blaming people for their weight gain ignores these facts and can make things worse, not better.
Example:
Someone might try every diet under the sun, only to find their weight unchanged. This can lead to feelings of shame and defeat, even though the real issue is hormonal, not willpower.
Strategies to Improve Body Image, Intimacy, and Wellbeing
So, what actually helps? Here are some nuanced, practical strategies to support yourself or a loved one during this time:
1. Practice Self-Compassion and Reframe Self-Talk
Instead of blaming yourself for changes, try to notice and challenge harsh thoughts. For example, if you catch yourself thinking, “I look terrible,” pause and ask, “Would I say this to a friend?” Try replacing it with, “My body is adapting to change, and it’s normal for bodies to change; I deserve kindness.”
Activity:
Write a compassionate letter to your body, thanking it for all it does: carrying you, allowing you to connect with loved ones, and adapting through life’s phases.
2. Use Dialectical Strategies: Making Lemonade Out of Lemons
Take difficult moments and look for opportunities. If you feel upset after a binge or a tough day, use it as a chance to reflect: “What was going on for me? What can I learn from this, and what can I do differently next time?” This helps turn setbacks into learning experiences.
Example:
After feeling self-conscious at a family event, reflect on what triggered these feelings and brainstorm ways to support yourself next time: maybe wearing an outfit you feel comfortable in, or having a supportive friend nearby.
3. Problem-Solving and Solution-Analysis
Acknowledge the problem, then brainstorm alternatives. If intimacy feels challenging, talk openly with your partner about what you need (without shame or guilt), and explore strategies like planning more time for affection, using lubricants, or exploring new ways of being close that aren’t just about sex.
Example:
One couple started a weekly “connection night,” not focused on sex, but on cuddling, massage, or sharing stories. This created space for intimacy without pressure.
4. Reject Diet Culture and Embrace Health at Every Size
Remind yourself that health is about more than weight; gentle movement, joyful activity, and balanced meals support wellbeing without strict diets. Focus on how you feel, not just the number on the scale.
Activity:
Try a new form of movement that feels good, such as dancing, swimming, gentle walking, or weight-bearing exercises.
5. Seek Knowledgeable Medical and Peer Support
If you’re struggling with menopause symptoms, look for professionals who truly understand menopause and can discuss options like HRT, pelvic floor therapy, or sex therapy (not all doctors or specialists have this expertise, so do your research). Follow medical and mental health professionals online who are up-to-date on menopause care from a weight-inclusive lens, and connect with support groups or online communities for shared experiences and tips.
Example:
A client found relief by joining a Facebook menopause support group; she learned about HRT options and found solidarity with others facing similar challenges.
6. Cultivate a Sex-Positive, Open Mindset
Intimacy can change and grow in new ways. Explore what feels good now because it’s okay for your needs to change. You should explore this and communicate these needs honestly with your partner(s). For example, maybe use different personal products, try new routines, or simply be present with your partner.
Example:
Some couples find that scheduling intimacy, rather than waiting for spontaneous desire, helps keep connection alive; others explore non-sexual touch or shared activities that foster closeness.
Final Thoughts
Menopause is a natural stage of life for women and AFAB people; it’s not a problem to be fixed. Your weight or age does not define your worth; by challenging diet culture, seeking support, and nurturing your body, mind, and relationships, you can move through this time with compassion, confidence, and connection.
If you’re struggling, know you are not alone. There is support, so please contact us at Prismatic Compassion as we’d be honoured to help!
