The Best Sex Positions for Perimenopause

As an AASECT Certified Sex Therapist and a 45-year-old woman in perimenopause, I I have learned from my clients that the best sex positions during this phase of life are often the ones that prioritize clitoral stimulation, comfort, and airflow. Because nothing kills the mood quite like a hot flash while someone is lying their full body weight on you.

Hot flashes can make sex feel very hot, very quickly. Positions where your partner isn’t directly on top of you can help. Standing doggy style with your hands on the bed or a modified missionary where your partner is more upright can give you more airflow. A partner can even blow soft, cool air across your chest or body, which can be surprisingly erotic and incredibly comforting.

You can also lean into temperature play. Glass or metal toys can be cooled in cold water and used on the body. Think of it as turning the thermostat down while turning everything else up.

For clitoral stimulation, being on top is a classic for a reason. Cowgirl or lying on top of a partner allows a woman to grind, move her hips in circles, and control the pressure and rhythm. Positions that leave room for a vibrator during penetration are also great because penetration and clitoral stimulation don’t have to be an either/or situation.

Perimenopause can also come with fatigue, stiffness, and joint pain, so sex does not need to become an athletic event. Scissoring or side-lying positions can allow for grinding, penetration, or clitoral stimulation while pillows support your hips and knees. There are no bonus points for making your joints suffer.

For women who enjoy internal stimulation, experimenting with the G-spot area along the front vaginal wall or deeper stimulation sometimes referred to as the A-spot can feel good, especially when combined with clitoral stimulation. Elevating the hips with a pillow can change the angle and make these areas easier to reach.

And finally, oral sex is sex, and often preferred. Sometimes the best position is simply lying comfortably on your back, supported by pillows, while receiving consistent clitoral stimulation from a partner’s mouth or hand. Comfortable, pleasurable, and no Cirque du Soleil skills required.

Perimenopausal sex doesn’t have to look like sex did at 25. Your body is changing, and your sex life can change with it. The goal isn’t to push through discomfort or recreate what used to work. It’s to stay curious about what feels good in the body you have right now.