Menopause and Libido

What is libido? 

Your libido is also known as your ‘sex drive.’ It can vary from woman to woman and can be influenced by various factors. 

What causes libido to lower during menopause? 

There are many causes of a lowered libido. A significant factor is the decline of the sex hormones estrogen and testosterone during menopause. Decreased levels of these hormones can hamper desire and arousal, leading to physical changes that may make you less interested in or uncomfortable during sex. 

Mental and physical health challenges, such as mood changes, anxiety, body image concerns, and changes in your personal, social, and professional life, can also contribute to a lower sex drive. 

What is happening inside your body? 

 Decreasing estrogen levels lead to changes in the body that may make sex less enjoyable. Two common change includes vaginal dryness and vaginal atrophy, the thinning, drying, and inflammation of the vaginal walls, which can cause pain during sex.

Hormone-driven shifts elsewhere in the body can also reduce your sex drive and overall desire for sex. Lowered testosterone levels in the brain contribute to the loss of spontaneous sexual desire. Fluctuations in weight may lead to body image issues. Hot flashes and night sweats may make sex seem unappealing. Insomnia or sleep issues may leave you feeling too tired to be interested in sex. Mental health issues, like anxiety and depression, can also decrease desire. 

How is lowered libido diagnosed during menopause?

Talk to your provider about your symptoms, and they will discuss treatment options, both holistic remedies and potential prescriptions, based on what you are experiencing.

What are some medical-provider-prescribed treatments for menopause-related low libido?

Menopausal Hormone Therapy: Also known as hormone replacement therapy, helps you reduce vaginal dryness and atrophy that may cause discomfort during sex. ‍

Testosterone therapy, although not FDA-approved for use in women is often used for low libido as a compounded preparation. However, is difficult to prescribe through telemedicine since it is regulated as a controlled substance in many states and that we are working to be able to prescribe it in the future.

Dehydroepiandrosterone (DHEA): This hormone is prescribed as an FDA-approved vaginal suppository to treat painful sex caused by vaginal atrophy. 

Ospemifene: This oral pill is FDA-approved to treat vaginal dryness and painful sex caused by vaginal atrophy. 

Medications for mental health: Your provider can help you identify whether your lowered sex drive is due to mental health issues and recommend a tailored treatment plan. 

What are some non-medical treatments for low libido in menopause?

Vaginal moisturizers and personal lubricants: If you are experiencing painful sex due to vaginal dryness or atrophy, a non-hormonal vaginal moisturizer or either silicone or water-based lubricant can help make sex more comfortable.

Set the mood: During perimenopause and after menopause, many women may not experience spontaneous desire, but they can still feel responsive desire. With some upfront effort, you may be able to get in the mood even if you were not feeling it from the start. Setting the mood can include listening to, reading, viewing erotic material or getting started with a sex toy before your partner joins in. 

Kegel exercises: The pelvic floor, which is made of the muscles encircling the vagina, uterus, and bladder, can weaken during menopause. When done correctly and consistently over several months, Kegel exercises can increase the strength and tone of the pelvic floor muscles, leading to more intense orgasms. 

Exercise and yoga: Physical activity can help boost your sex drive because it triggers the release of endorphins—improving overall mood, health, and self-confidence. 

What should you do next?

Let’s get you prepared to be paired with your provider! 

Select and submit all of the symptoms you are currently experiencing so your doctor can assess and provide a tailored treatment plan for you.