Like many women, she thought menopause was only related to the end of periods and hot flashes. She had no idea that her “broken vagina” was simply the result of a lack of estrogen, a normal and common consequence of menopause. Shockingly, few people (including many physicians) do. As an OB/GYN specializing in menopausal women, I see patients every day who are ashamed because they believe there’s something sexually wrong with them and that they’re letting their (male) partner down because he deserves penetrative sex. This is the presenting symptom of what I call “The Bedroom Gap:” the very real differences in sexual expectations, desires, and capabilities between midlife men and women. But, as this introductory chapter makes clear, the physiological changes of menopause, which can ruin a woman’s desire for sex and/or make sex painful, more often than not go unspoken, undiagnosed, and untreated. 

Women suffer in silence, and so the gap widens. The Bedroom Gap not only clarifies what the physical changes of menopause are—and how they affect our midlife sex lives—it also highlights how we developed destined-to-fail gender roles and expectations in the bedroom, and how we can change those expectations, prevent future “Bedroom Gaps,” and embrace new possibilities for sex in midlife.