Take Pause: Where has my libido gone?

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In my practice as a menopause specialist, this is one of the most common questions women ask. If you have experienced loss of desire for sex, you are not alone. Many woman feel confused and distressed by a loss of sexual urges.

Why does libido decrease in woman?

The intensity of sexual desire and sexual satisfaction may decrease as we age. The reasons for this change are complex. Some are physical and hormonal, but life circumstances, a woman’s general wellbeing, and relationship factors are also important.

Physiologic changes affect libido

  • Testosterone is an important hormone that influences sexual desire in both men and women. With age, testosterone production declines. Women who have their ovaries removed experience an abrupt loss of testosterone, sometimes at a young age. Women who experience surgically induced menopause experience more extreme loss of sexual feelings compared to women who go through menopause naturally
  • Estrogen is important for sexual satisfaction. Loss of estrogen at the time of menopause causes thinning and dryness of the vagina, labia and clitoris. When sex is not pleasurable and painful, it is natural to lose desire.

Medical problems can interfere with sexual desire

  • Depression and antidepressant medication
  • Chronic pain, Diabetes, Urine leakage, Arthritis
  • Weight gain


  • Low sexual desire is reported more often by women in a relationship for 20-29 years
  • Unresolved anger, or lack of emotional closeness in a relationship can make sex undesirable

Life tasks and responsibilities

  • Demands of caring for children, career, and aging parents
  • Lack of time for sleep, exercise, and intimate time with one’s partner


For women who experience distress about their loss of libido, treatment may include estrogen to relieve painful sex, managing underlying health problems, addressing relationship issues, improving wellbeing through exercise and weight loss, and sometimes counseling. While there is no testosterone product approved by the FDA for women, testosterone is sometimes prescribed off label.

Online education on Sexual Health & Menopause

The North American Menopause Society has developed a comprehensive online education module that addresses all aspects of sexuality in midlife women. It discusses safe and effective treatments and interventions available for addressing sexual problems, a directory of resources, and responses to frequently asked questions.


Take Pause is a series of blogs from ADC Menopause and Osteoporosis certified specialist Michele McDermott, MD, CCD, NCMP.   Follow Dr. McDermott on Twitter @TakePauseADC.