Menopause & Libido: The Truth

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Alongside other symptoms, a loss of libido is a common - and often distressing - accompaniment to menopause. It’s a common topic of clinic conversation for Dr Stephanie Goodwin, a London-based GP and menopause specialist. She shares her advice.

Is a loss of libido common with menopause?

In my specialist areas of both Psychosexual Medicine and Menopause Consultancy I often hear the same question from my female patients about loss of libido during menopause and that’s “Why am I experiencing a lower sex drive?

Why do you lose your libido during menopause?

There are two areas concerned with the loss of libido – one is physical and the other is psychological.

In physical terms, you may now be experiencing discomfort during intercourse. This is caused by the decrease in oestrogen which had previously kept the walls of the vagina healthy and lubricated. Lower levels of this hormone can now make those walls dry and irritated which can make things painful. Surveys show that a very large percentage of women find sex painful and the majority of those find this causes a low sex drive which can then negatively impact upon their relationships.

The reducing levels of progesterone also play their part. One of progesterone’s jobs is to stimulate the production of testosterone and this is key for maintaining sexual desire . With lower levels of testosterone you may experience a lower level of desire.

What else affects your libido during menopause?

Let’s not forget those night sweats – which make sleep more difficult, which makes you tired, which makes you much more interested in sleep than sex!

Additionally, if you are on anti-depressants, this may also be a problem since some can lower desire and slow down sexual response. Obviously this will be contributing to your loss of libido.

What about the psychological causes of libido loss during menopause?

In psychological terms some women also find their changing bodies very difficult to cope with and may experience a sense of loss. This of course can be exacerbated by empty-nest syndrome.

Other women may be experiencing the quite common symptoms of menopause in terms of anxiety or irritability neither of which are helpful in getting in the zone for sex – so desire fizzles out.

And, of course,  the onset of greying hair; drying skin and a fuller figure may all conspire to make you feel less attractive which can quickly result in a low sex drive.

What are the effects of a loss of libido?

For some women a gradual decline in libido does not seem to affect their overall sexuality or their quality of life but for others this becomes a source of upset which changes their sense of sexuality and self.

It may also cause concern in terms of relationships and emotional intimacy because it can puzzle and dismay a partner for whom a previously close and active love life was the norm.

How can you deal with menopause libido loss?

Firstly, don’t be embarrassed about talking to your GP.  They see these kinds of problems frequently, understand their impact and can advise on the many forms of available treatment from HRT to vaginal oestrogen and other lubricants which is available in many forms.

You can help yourselves by using a soap free cleanser or just luke warm water for intimate washing.  This is better than using soap or shower gels which can aggravate dryness.

Can talking with a partner help?

Do talk to your partner and help them understand the physical and emotional changes you are experiencing. Ask for what you need – maybe it’s more romance, maybe it’s having a cooling fan on full blast during intercourse!
Try to focus on intimacy rather than sex as this may actually boost your low sex drive.

The quality of your relationships will have an impact on your libido so you may be caught up in a vicious circle. If this is the case it may be worth considering meeting with a sex therapist or psychosexual expert for tailored advice.

My main message is that you should not suffer in silence.

Read more from Dr Stephanie Goodwin and find out about her clinic, at

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