If your libido seems to have quietly packed its bags somewhere around perimenopause, you’re definitely not the only one. Here’s what might be happening – and, importantly, what can help.
There was a time when sex might have been something you actually thought about.
Then somewhere between work, family, poor sleep, fluctuating hormones and wondering why you’ve walked into the kitchen for the third time today, desire may have slipped rather a long way down the list.
Perhaps you still love your partner. You still find them attractive. You still enjoy sex when it happens.
You just… don’t particularly think about having it.
Or maybe the change has been more dramatic and your sex drive feels as though it has disappeared altogether.
If that sounds familiar, you’re far from alone. Changes in sexual desire are common during perimenopause and menopause – but that doesn’t mean you simply have to accept them.
First: what actually happens to your sex drive during menopause?
There isn't one single "libido hormone".
Sexual desire is influenced by a complicated mixture of hormones, physical comfort, sleep, stress, mood, relationships, medication, body image and what's happening in the rest of your life.
And midlife has a habit of throwing several of those things at us simultaneously.
Changes in oestrogen and testosterone around menopause can affect sexual desire and arousal. Falling oestrogen can also cause vaginal dryness and changes to the tissues around the vagina and vulva.
And unsurprisingly, if sex has become uncomfortable or painful, your brain may become rather less enthusiastic about suggesting it.
Add in hot flushes, night sweats, exhaustion, stress and perhaps feeling slightly less at home in your changing body, and it's not difficult to see why sex might not be top of the agenda.
"But I still love my partner..."
This is an important one.
A lower sex drive doesn't automatically mean there's something wrong with your relationship.
It's surprisingly easy to interpret a lack of desire as a lack of attraction:
"Why don't I fancy them anymore?"
"Have we lost our spark?"
"Does this mean something is wrong with us?"
Sometimes relationship issues are part of the picture. But sometimes your body and brain simply aren't generating desire in quite the same way they used to.
There's another interesting change that can happen too.
You might not feel desire until you've started
We tend to think sexual desire works like this:
Desire → arousal → sex
You suddenly fancy sex, initiate it and everything follows naturally.
But for many women – particularly in long-term relationships and during midlife – desire can become more responsive.
That can look more like:
Connection → touch → arousal → desire
In other words, you don't necessarily feel wildly in the mood before anything begins.
You might start with a cuddle, kissing or massage because it feels nice, and discover that desire arrives afterwards.
That doesn't mean forcing yourself to have sex when you don't want to. Consent and comfort always come first.
It simply means that waiting for spontaneous desire to strike might not always work the way it once did.
So... can you get your sex drive back?
Quite possibly.
But rather than searching for one magical libido-boosting solution, it helps to work out what's getting in the way.
1. Deal with discomfort first
If sex hurts, burns or feels uncomfortable, don't assume it's simply something that happens as you get older.
Menopause-related vaginal and vulval changes can cause dryness, irritation and painful sex. You may hear this described as genitourinary syndrome of menopause (GSM).
Depending on the cause, things that may help include:
- a good lubricant during sex
- a vaginal moisturiser used regularly
- vaginal oestrogen
- reviewing your wider menopause treatment with a healthcare professional
And yes, lubricants and vaginal moisturisers are different things. We'll cover that properly elsewhere because it's something many of us were never taught.
Most importantly, persistent or new pain during sex deserves proper medical advice rather than being silently tolerated.
2. Look at your menopause symptoms as a whole
It's difficult to feel sexy when you haven't slept properly for six months.
If hot flushes, night sweats, anxiety, low mood or poor sleep are making you feel permanently exhausted, treating those symptoms may indirectly help your sex life too.
If you're using HRT but still struggling with symptoms, it's worth discussing this with your GP or menopause specialist rather than assuming your current treatment is as good as it gets.
3. Take the pressure off "having sex"
One of the quickest ways to make intimacy feel like another job on the to-do list is to make intercourse the expected destination every time you touch each other.
Try widening the definition of intimacy.
Kissing. Cuddling. Massage. Touching. Lying together without phones. Going to bed before you're completely exhausted.
Pleasure doesn't always need a goal.
Removing the expectation that affection must lead to sex can sometimes make it easier for desire to reappear naturally.
4. Work out what actually turns you on now
What worked at 25 doesn't necessarily work at 45, 50 or 55.
And that's not necessarily a bad thing.
You may need more time to become aroused. You might prefer different types of touch. You may need lubricant when you never did before. Things you once enjoyed might feel less appealing – and other things may suddenly become interesting.
Think of it less as trying to get your old sex life back and more as discovering what works for you now.
That might mean talking more openly with your partner, experimenting with massage or toys, trying something new, or simply giving yourself permission to explore what feels good without worrying about what you should enjoy.
5. Check whether something else could be affecting your libido
Menopause isn't always the culprit.
Low sexual desire can also be affected by stress, depression, anxiety, relationship difficulties, certain medicines, health conditions and simply being completely overwhelmed by life.
Some antidepressants, for example, can affect sexual function.
If the change was sudden, severe or is bothering you, talk to your GP. It's worth looking at the whole picture rather than automatically blaming your hormones.
What about testosterone?
You've probably heard testosterone described as the missing piece of the menopause puzzle.
It can be helpful for some women, but it's not a universal libido booster.
In the UK, testosterone may be considered for women after menopause who have low sexual desire associated with menopause when HRT alone hasn't helped enough. A clinician should assess whether it's appropriate and monitor treatment.
It's worth having the conversation if low desire is causing you distress, but buying unregulated "testosterone boosters" online isn't the answer.
And sometimes... life is just exhausting
There is another possibility worth acknowledging.
Perhaps your libido hasn't disappeared because something is medically wrong.
Perhaps you're working, parenting, caring for other people, running a house, waking up at 3am, dealing with menopause symptoms and carrying approximately 847 things around in your head at any given moment.
Desire needs a little space.
And sometimes there simply isn't much space left.
That doesn't mean your sex life is over.
It may just mean it needs a little more intention than it used to.
Start small
You don't need to announce that tonight is the night you're going to FIX YOUR SEX LIFE.
Please don't. That's an enormous amount of pressure for a Tuesday evening.
Start smaller.
Have a conversation.
Go to bed half an hour earlier.
Kiss for longer than three seconds.
Try a lubricant.
Give each other a massage.
Buy something you've been curious about.
Or simply acknowledge that things have changed and decide you'd quite like to explore what comes next.
Because getting your spark back doesn't necessarily mean becoming the person you were twenty years ago.
It might mean discovering a version of you that you haven't met yet.
When to speak to someone
Consider talking to your GP or another qualified healthcare professional if low sexual desire is causing you distress, sex has become painful, you have vaginal or vulval symptoms, you've noticed bleeding during or after sex, or you're concerned about a sudden change in your sexual function.
There are treatments available, and you don't have to be embarrassed about asking.
Hot Again says...
There is no "correct" amount of sex you should be having.
Some people want sex frequently. Some occasionally. Some don't want it at all.
The issue isn't whether your libido matches somebody else's idea of normal.
It's whether you're happy with yours.
And if you're not, it's absolutely reasonable to want to do something about it.
This article is for general information and isn't a substitute for individual medical advice. If you're concerned about symptoms or changes in your sexual health, speak to a healthcare professional.
