What… the Menopause?
Each week we spotlight an unexpected and frustrating symptom of menopause that no one warned you about. Because menopause is more than just hot flashes and missed periods.
This week’s spotlight: Loss of Libido
What’s going on? Why does menopause affect libido?
Hormonal changes, especially declining estrogen and testosterone, directly impact sexual desire, arousal, and physical comfort.
Libido (your sexual desire or interest in sex) is influenced by a mix of hormones, brain chemistry, emotional connection, and physical well-being. During perimenopause and menopause, your body undergoes major hormonal shifts that disrupt this balance.
Here’s what’s happening:
Estrogen drops: This can lead to vaginal dryness, reduced blood flow, and discomfort during sex
Testosterone declines: Yes, women have testosterone too, and it plays a key role in desire and arousal
Cortisol may rise: Chronic stress (hello, midlife pressure) suppresses libido
Sleep disruption: Poor sleep affects mood, energy, and sexual interest
Brain chemistry shifts: Neurotransmitters like dopamine (pleasure) and serotonin (mood) can fluctuate
Stale relationship: Hey, let’s be honest. When you’ve been married for 20 or 30 years doing the same routine day in and day out…that gets boring. Who would want to eat at a taco stand every day when your body may be craving a gourmet Italian dinner?
Trauma: Sexual abuse sadly is not uncommon and disrupts our feelings of desire, safety and arousal.
History and experience: Guilt, shame and fear have a lot to do with the difficulty to get aroused.
Loss of libido in menopause is not just “in your head.” It’s a physiological, hormonal, psychological, sociological and neurological shift.
Here’s a relevant episode from my Hack My Age: Menopause Upgrade podcast with Dr. Saida Désilets, exploring hormones, desire, and sexual health during menopause.
You’re not alone. How common is low libido in menopause?
Very common! This affects up to 50 to 70% of women during perimenopause and menopause…including me!
Low libido is one of the most underreported symptoms because many women feel embarrassed, confused, or assume it’s just part of aging.
What the data shows:
- Around 40 to 55% of menopausal women report reduced sexual desire
- Many also experience painful sex (dyspareunia), which further reduces interest
- Emotional factors like relationship dynamics, body image, and stress can amplify the issue
Why it’s not talked about:
- Cultural stigma around female sexuality
- Lack of education from doctors and society at large
- Dismissive attitudes (“it’s normal, just live with it”)
If your libido has changed, you’re in the majority, not the exception.
What can you do? How to increase libido during menopause
You need a multi-layered approach: hormonal, physical, emotional, and lifestyle.
There is no one-size-fits-all fix, but there are evidence-based strategies that work.
1. Address hormonal imbalances.
- Hormone Replacement Therapy (HRT): Can restore estrogen levels and improve vaginal health
- Testosterone therapy: Prescribed off-label for women with low desire
- Vaginal estrogen or DHEA*: Helps with dryness and discomfort
Talk to a menopause-informed practitioner, not all doctors are trained in this. Read this blog to learn how to find one.
2. Improve vaginal health
- Use high-quality lubricants* (avoid ones with irritants)
- Try vaginal moisturizers* regularly, not just during sex
- Consider pelvic floor therapy to improve blood flow and sensitivity
3. Reduce stress and support your nervous system
- Chronic stress = libido killer
- Try:
- Breathwork
- Cold exposure (yes, really)
- Mindfulness or meditation (download the free Insight Timer app)
- Nervous system regulation practices
4. Optimize sleep and energy
- Prioritize 7 to 8 hours of quality sleep
- Support circadian rhythm (morning sunlight, limit blue light at night)
- Address sleep disruptors like night sweats
5. Reframe desire (this is big)
Desire doesn’t always just “appear” anymore. Hire a sexual therapist for more guidance*
There are two types:
- Spontaneous desire: Happens out of nowhere (more common in younger years)
- Responsive desire: Builds after arousal begins (more common in menopause)
You may not feel desire first, you may need to create the conditions for it.
6. Support your body with targeted supplements
Some evidence-backed options:
- Maca root: May improve sexual function
- Ashwagandha: Supports stress reduction
- Omega-3s: Improve circulation and hormone balance
- L-arginine: Supports blood flow
Always check with a practitioner before starting anything new.
What worked for me?
I’ve explored the topic of libido deeply through my own menopause journey and through countless conversations on my podcast.
My approach isn’t about a quick fix. It’s about biohacking the entire system.
What I focus on:
Hormonal support matters: I’ve dialed in my estradiol, vaginal estrogen and progesterone and had to play around with a variety of formulations of testosterone. So far, just a pea sized drop of Testogel is bringing my old libido back.
Data-driven experimentation: I track my symptoms, test interventions, and adjust as needed
Strength training & fitness: Not just for how I look, but for confidence, energy, and hormonal balance
Open conversations: We need to remove the shame around sex and menopause, so I shamelessly talk about sex, libido, desire and emotions.
I’ve learned that libido isn’t just physical, it’s deeply connected to how I feel in my body and in my life.
There’s no “magic pill.” But when I support my hormones, manage stress, and stay connected to myself, my libido comes back online.
Loss of libido during menopause can feel confusing, isolating, and even identity-shaking.
But it’s not permanent. And it’s not something you just have to accept.
When you understand what’s happening and take a proactive, whole-body approach, you can rebuild not just your libido, but your relationship with pleasure, intimacy, and yourself.
*Vaginal serums and lubricants:
Inana code ZORA for 25% off
Velvet code ZORA for 10% off
Julva (DHEA) code ZORA for 10% off
Therapy
Contact Dr. Saida Desilets code ZORA for 10% off her programs
FAQs: About Libido and Menopause
Can libido come back after menopause?
Yes. With the right combination of hormonal support, lifestyle changes, and emotional connection, many women regain their desire.
Is low libido always caused by hormones?
No. While hormones play a major role, stress, relationship issues, mental health, past history and physical discomfort also contribute.
Are there medical treatments specifically for low libido in women?
Yes. Options include HRT, vaginal estrogen, DHEA, testosterone therapy and even medications under medical supervision.
How long does low libido last during menopause?
It varies. Some women experience temporary changes, while others need targeted support to restore desire.
Does exercise help increase libido?
Yes. Strength training and cardiovascular exercise improve circulation, hormone balance, and body confidence, all of which support libido.
Should I talk to my doctor about this?
Absolutely. If your doctor dismisses your concerns, consider finding a menopause-informed specialist.
Download the Menopause Symptom Tracker to help you figure it all out.
Zora Benhamou is a gerontologist who studies aging and is dedicated to challenging menopause stigma and ageist stereotypes. As the host of the Hack My Age podcast, she focuses on empowering women navigating the menopausal transition through evidence-based techniques that support your 80 year old self.