Recently a reader wrote to us asking for insight into the changes in mikveh observance around peri-menopause. Her question addressed both the physical changes to her body and how not having to go to the mikveh would affect her relationship. Since mikveh and sexual intimacy are inextricably intertwined, we turned to Dr. David Ribner, leading sex therapist and founder of the Sex Therapy Training Program at Bar Ilan to shed light on how to plan for and maintain a healthy sexual relationship through this transition:


Successful sexual partnership begins with a couple’s first physical contacts.  When we are young, anxiety and uncertainty can infuse our initial sexual experiences.  Patience, acceptance, empathy and a sense of humor provide a counterbalance to these negative emotions and help to create lingering, joyful memories and serve as the foundation for future intimate interactions. Despite the inevitable changes that life forces upon us, good sex, like everything in life, needs practice, and remains enjoyable throughout married life when couples share a sense of mutual interest and desire.

The challenges which couples face in maintaining or even enhancing their sex lives are most often experienced during periods of movement and transition, whether positive – childbirth, new jobs, different residences – or negative – illness, injury, and family losses. When life overwhelms us, when we are uncertain or confused, we may have less energy to invest in any kind of intimacy. I recommend trying to maintain a sense of intimate physical contact even during these times, as it can provide comfort, connection and stability during our inevitable ups and downs.

What happens to a couple’s sexual interest and activity as they move across their lifespan? As the general population in the Western world ages, this question has taken on greater significance and is the subject of considerable concern and speculation. Research findings have been confusing and even contradictory. However, there is little doubt that a satisfying sex life can provide fulfillment for as long as husbands and wives remain together. As we add on years, physical intimacy need not diminish in its power to connect us with our partners; it does, however, require understanding, investment and creativity.

To give ourselves “intimacy insurance” I recommend the following:

  • Open communication- Many couples find it difficult to openly talk about sex. They are wary about sharing their feelings, doubts, expectations or fantasies, which leads to misunderstood messages and frustrating experiences. Uncertainty and embarrassment prevent breaking down emotional barriers. To create a more open and comfortable atmosphere,  someone needs to take the first step. This entails a level of risk-taking, not knowing how your partner will respond. But go for it, because the end result can bring great relief to both of you and enhance your intimate experiences for years to come.
  • Mutual sensitivity – Too often, we view the sexuality of our partners solely through our own eyes; we assume that they feel as we feel, want what we want. This perspective essentially prevents us from “tuning in” to our partners and becoming sensitive to their unique needs. Our empathic capacity to see the world through the eyes of our partners paves the way toward building relationships that are mutually fulfilling and able to encompass each individual’s sexuality.


  • Concern for health and fitness – As much as we emphasize the emotional component of sexual experiences, physical intimacy is just that – physical. And like any other physical activity, it works better when partners are healthy and fit. Good health and fitness not only provide bodies that work better, they also enhance body awareness and a more positive self-image. You are more likely to feel good about getting naked with your partner if you feel good about yourself.  Take care of yourselves – quit smoking, drink moderately, eat well and exercise, and check in with your doctor once in awhile.
  • Acknowledge the realities of change and aging – You are no longer 20 year old newlyweds. Lives change and sex lives need to adapt to those changes. Some transitions occur within the natural progression of our lives (childbirth or menopause); some may take us by surprise (illness, financial windfall or twins!!). No two people will experience change in exactly the same way. Menopause is an example of a life transition that may burden some women with the reality of aging while for others it signifies a sexual freedom they never before experienced. Sex as we age will be different, but with the proper investment, no less intimate and pleasurable.
  • Get professional help when necessary – If you get stuck, get help. Sex therapy, provided by a certified professional, can make a world of difference. Online resources are often unreliable. If the need arises, you are best off speaking with someone who will ask the right questions and tailor responses that fit your needs. This link will give you contact information for certified sex therapists in you area;

The investment in your emotional and physical relationship will produce endless dividends! Making this an ongoing focus throughout the course of your lifetimes is as good an insurance policy as you will ever find.

So, enjoy!!

Dr. Ribner is one of the leading sex therapists in Israel. He has been a therapist for over 40 years, and founded the sex therapy training program in Bar Ilan. In addition to his work in a private clinic in Jerusalem, he co-authored The Newlywed’s Guide to Physical Intimacy with Jennie Rosenfeld, and has published numerous articles and blogs on the topic of sexuality in the Jewish (religious) world.