I am a man with a female partner – I will be 51 in a few months, and she is 48. Until a little over a year ago we had a very healthy sex life, but she was hit hard by menopausal symptoms, and along with many of the typical problems associated with that situation, her sex drive has plummeted. She started taking Chinese herbal medication about six months ago, and is now feeling much better. However, the medication does not address any hormonal issues, and she has utterly lost interest in sex. I have asked her many times to go to a doctor to discuss this. The problem is that she thinks the current situation is completely normal – that it is natural that people lose appetite for sex when they reach our age. She cannot understand why I still want to have sex, and has even told me that I am the one who should undergo counselling for this.

The situation is starting to damage our relationship, as after being rejected countless times I now feel constrained from even touching her in a sensuous way. What should I do?

When hormonal changes begin to seriously affect a woman’s sex drive, she often experiences psychological issues as well, such as sadness about her dwindling sexual interest and the loss of her ability to bear children, and fears about the future and ageing. She may even begin to redefine her sense of herself as a woman. All of these changes – physical and psychological – will affect her partner as well.

If a woman is fortunate enough to have options to utilise hormone boosting or replacement treatments, she may find her sex drive can be restored, but this is a personal choice. Your partner seems to have chosen to allow nature to take its course: this point of view must be respected.

But your feelings and point of view are valid, too. You want a continued sex life and feel very sad and frustrated about her unwillingness to even try to maintain what is for you a vital aspect of your relationship. The presence of sex hormones in a woman’s body is what makes her organically feel desirous, and without them she could, at least temporarily, decide that sex is essentially unimportant.

Many people enjoy sex throughout their lives, but they are the people who value and continue it. Without blame, help her to understand your sadness and sense of loss of something you feel is precious and important, and talk to her kindly and empathetically about her struggles with menopause. Try to negotiate that, as a couple, you simply explore different options.

If she rejects western medicine, you can find foods and “natural” supplements that might help restore her hormonal balance. Right now, she sees you as part of the problem. Become part of the solution and things will change.

• Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.

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