My libido has disappeared with my menopause, will it ever come back?
Most menopausal women find that their libido has reduced. Sometimes it can be because of their menopausal symptoms such as low mood, reduced self-esteem, weight gain, reduced stamina and anxiety. However, the hormones oestrogen and testosterone are very important in the way female brains work and the level of these hormones reduces during the menopause, which can directly reduce libido. Some women find that libido improves with time. However, the menopause is a long-term hormone deficiency: hormones do not come back on their own.
I am starting to find sex uncomfortable, how can I address this?
Symptoms related to vaginal dryness affect most menopausal women yet, shockingly, few receive treatment. Having local hormone treatment in the form of a vaginal pessary, tablet, gel or cream can be really beneficial. Many women find taking HRT can also improve these symptoms. Using a non-hormonal lubricant such as Yes or Sylk can be beneficial too.
Which part of HRT helps with libido? Is it the progesterone or oestrogen?
Oestrogen and testosterone are the main hormones that can improve libido. Testosterone is produced in much higher quantities than oestrogen before the menopause and has some important effects on the brain, including improving sex drive.
Can I take testosterone for my libido?
Many women find that when they take testosterone their libido improves. Furthermore, they often find that their mood, energy and concentration also improve. Frustratingly, testosterone is not licensed for women in the UK. It can be NHS-prescribed by giving the male testosterone gels in lower quantities. There is a female testosterone cream called Androfeme that is regulated and licensed in Australia and is available through private doctors in the UK, but it is expensive. It is hoped that this will be available as a licensed preparation in the UK soon.
My partner has lost interest in sex. Is this common? Is there anything to help?
It is important to explore how your relationship is together and having psychosexual or relationship counselling might be beneficial. Libido is not just about hormones and it is important that other areas are fully considered and explored. Some men’s testosterone levels can decline in midlife, which can affect their sex drive. In this case seeing a clinician who specialises in male hormones would be important.
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Can some women have a “sex surge” in the menopause?
A small proportion of perimenopausal women and menopausal women find that they have increased libido. Some of this may be related to the liberty associated with not needing contraception and also other changes in their circumstances, such as children leaving home. However, most women do not experience this.
Dr Louise Newson is a leading menopause specialist and the founder of free support app balance-menopause.com
