Sex coaching is a powerful way to help people of all ages and backgrounds resolve their sexual issues. It takes into account all the things that make us who we are, like our life circumstances, identities, and age. And let’s be real, while sex is just one part of being human, it’s all interconnected. Our experiences with sex can change and evolve over time, and it’s important to recognize that women have their own unique set of concerns as they age. So, what do we need to know about the experience of older women in sex coaching? What tools can we use to help them resolve their concerns? And how can we give them the accurate and effective support they need?

Last year, our beloved founder Dr. Patti Britton gave a presentation to the India Sexology Conference 2022 about sex coaching for the midlife woman. Her powerful talk has inspired the following article, which will give an overview of the common issues faced by women as they age and how sex coaching can help! And if you want to dive deeper into this topic, grab Dr. Patti Britton’s free book on Happy Sexy Aging here.

[For more on sexuality in aging couples, check out this article in Age Times, which quotes Dr. Patti: “How often do 50-year-old marries couples make love?“]

Common Sexual Concerns for Midlife Women

As women age, there are naturally occurring changes that take place in the body. The biggest change is hormonal and perimenopause/menopause can have significant impacts on a woman’s sexuality. Aging women also experience changes in their weight, hair, skin, breasts, bone health, and beyond. 

Changing life circumstances can affect their sexuality, too. Women in their 50s and 60s are often experiencing widowhood, divorce, a newly empty nest, or retirement—all lifestyle changes that are interconnected with their sexual experiences. Other things like diet, exercise, medical conditions, and stress are huge contributors, as well.

So how do all of these natural and normal life adjustments relate to the sexual experience of a midlife woman? 

In the presentation that inspired this article, Dr. Patti shared, “I always coach my clients that feeling sexy is an inside job.” She was also quoted in an article for Age Times in which she urged us to keep our sexuality alive throughout our lifetime.

The issues that midlife women bring to a sex coaching session will vary so much, because each woman is unique in her own interpretations, visions, expectations and experiences. However, there are common threads woven throughout this demographic—and it’s important to be informed in this way before working with midlife women.

As women age, their prevalent sexual concerns might surround shifts in desire. They might want sex more often than they did before, or a whole lot less. Addressing their sexual satisfaction is important! They might also struggle with a multitude of different body image conflicts relating to anything from weight gain/loss to graying hair to changes in their skin. Some women will experience issues with vaginal dryness and painful sex; some might experience a dip in frequency of sexual connection with their partner(s). 

While not an exhaustive list—these are the issues that most predominantly show up in a sex coaching session, and they are all things that can be worked through with a professional. 

The most important aspect of addressing these concerns is to work through the blocks in a holistic and person-centered way. And the best way to do this is through the MEBES™ Signature System (clinical model), developed by Dr. Patti herself.

Using MEBES™ to Coach Midlife Women

As Dr. Patti says in her presentation, “MEBES™ is a system or a model or a process by which you can actually look at (with your client) where flow is occurring or where blockages are occurring, either within the person or between persons.” 

MEBES™ stands for mind, emotions, body/body image/behaviors, energy, and spirit—and it’s an all-encompassing, holistic lens through which to evaluate your client and their concern. When a client comes to sex coaching with their concern(s),we assess them through the filter of these five categories and then develop action steps within each realm.

For the midlife woman, a sex coaching session using the MEBES™ model might look like this:


The mental realm of this client type might involve their self-talk, fantasies, myths around sex as we age, or negative self beliefs relating to their own sexuality. 

When working through a blockage in the mental realm, an action plan might involve mental reframing of negative self-talk and helping the client override the habit with positive affirmations. It might also include education about how aging affects vaginal lubrication, or how hormonal changes affect libido. We might encourage playing with different fantasies and strategies for increasing their arousal.


The emotional realm of this client type might involve grief around aging, sadness around changes happening to their body, or shame surrounding their sexuality. 

To unblock an emotional obstacle, we can address emotions through healthy release and validation. We can remind the client that all of these feelings are normal and valid, and all emotional reactions are welcome in our sessions.


Body image issues or typical behavior patterns would fall into this category—and they might involve a dislike for how their body is changing, or falling into a sexless relationship. This client type might be experiencing painful sex or issues around vaginal dryness. 

In this realm, we can recommend safe and effective lubricants, or even refer her to a vetted specialist for hormone replacement therapy or pelvic floor work. We can also give suggestions for new and exciting ways to experience herself sexually, such as toys, tantra, or sensual massage.


Their energetic space might involve a particular flow between them and their partner, or it might involve personal energy levels being too low. 

For the energetic realm, we can find ways to uplift our client’s energy states with things like mindfulness, exercise, or increasing joy and playfulness. We might suggest a fun dance class or writing more poetry. We can also empathize and guide them through a practice of extreme self care!


Finally, their spirit realm might include spiritual or sacred perspectives—but it also might revolve around their essence or true self. Dr. Patti explains it like this: “I like to liken it to a little blue flame. That’s like the pilot light. Most of the clients who seek me out as midlife women have lost their contact with that little blue flame. And for many of them, the little blue flame is out and they’re looking for ways to reignite it.” 

For the spirit realm, we can guide our clients toward a pathway back to their true self. This might involve getting back into a creative outlet they have abandoned, or spending more time in nature. Whatever feels true and aligned with the client’s authentic self is what we would encourage and promote here.

When working with midlife women, the MEBES™ model is an effective, holistic, and client-centered approach. We can use this tool for assessment as well as developing action plans and it gives us a complete view of our client’s experiences and concerns. 

Applying MEBES™ to a Sample Client

So how might this work in real time? Let’s take a look at an example! Sue is a fictional woman in her 50s who is seeking help regarding her dissatisfaction with her sexual life. Since she has started aging, sex has been on the decline. She believes her age is at fault and that it’s only going to get worse. She is feeling angry about this and is grieving her younger body. Her body’s sexual function is changing (vaginal dryness and low desire for sex) and she doesn’t find herself attractive. Her energy is constantly up and down, and she feels as though she doesn’t know who she is anymore.

When we look at this case through the lens of the MEBES™ model, we can recognize the mental narrative of her belief (M), the emotional blockages of anger and grief (E), the changes in her bodily function (B), her out-of-whack energy levels (E), and her disconnection with self (S). From this perspective, we can begin to create action steps for Sue to unblock each of these areas. 

Sue needs support in reframing her mental narrative to one that is hopeful. “How can we change the narrative here?” her coach might ask. Through education and support, we would help Sue reframe her inner narrative from “the end of sex is here for me” to “I can experience sex at this stage of life!”

She also would benefit from releasing her emotional blockages through validation and normalization. We would offer her a safe container in which she can express her feelings however she needs to. We would explain how other clients feel a similar way, and how research shows it is common to react this way. If the emotional distress is severe, we may refer her for psychotherapy in tandem with our powerful sex coaching.

For Sue’s changes in bodily function, it might be a good fit for hormone replacement therapy—in which case, we would refer to a specialist. She might also benefit from a new exercise plan or diet changes. We would also offer exercises that encourage body acceptance, like mirror work.

To address her energy levels, we would find out what fills Sue up. Is it a creative outlet? Is it exercise? Is it reading? Whatever it is, we would help her explore different ways to uplift her energy.

As her coach, we would find out when she feels closest to herself. How can she work to accept this new iteration of her life? What’s great about this new version of herself and how can we celebrate it? We would suggest a new self care practice that feels aligned with her and encourage her to listen to what her soul or essence needs. 

Although the period of our lives known as “midlife” can be a challenging and confusing time in a woman’s life—sex doesn’t have to end when we start aging. We all deserve access to pleasurable sexual experiences! And sex coaching is a wonderful modality to help women reconnect with and celebrate their sexual self, even as they age. 

How would you address the common concerns brought to sex coaching by this client type? If you want to learn more, check out the expert! You can grab Dr. Patti Britton’s free book on Happy Sexy Aging here.