Perimenopausal woman has super low libido and asks whether losing your libido during perimenopause is normal and what she can do about it. Jessica explains why some women experience a decreased (or even non-existent) libido during the midlife transition and what to do about it.
Ask Jessica is an advice column for women in midlife. We cover all things related to midlife from changing bodies to career transitions to parenting teens to sandwich generation challenges to shifts in marital or life partnerships and everything in between. My hope is that in sharing these questions and answers I can women as we face the midlife journey together. Got a question or challenge you would like me to address? Fill out this form to submit your issue! Want to see the answers to other questions, check out our archive here.
Is Losing Your Libido During Perimenopause Normal?
HEY JESSICA: I’m in my mid-forties and for the past few years I’ve been struggling with my libido. Like, I have none. I mentioned it to my doctor and was told that it’s normal and not to worry about it, but I do worry. I worry that my lack of interest in sex will hurt my marriage (it already has, if I’m being honest). And I worry that my libido will never come back, especially since I used to really enjoy sex. Is it true that losing your libido during perimenopause is normal? Is it something that will pass or am I just going to have to live like this forever? ~Missing the Flame
DEAR MISSING THE FLAME:
Thank you so much for being courageous enough to ask about this! Experiencing low libido can feel very scary and isolating, so I am really glad that you’re reaching out. While it is true that a drop in libido is common among women in their 40s and 50s, it is most definitely not something that you just have to live with. So, let’s take a few minutes to dig into why your libido may have dropped and explore some steps you can take to see if you can rediscover your sexual desire.
So, why is it that many women experience a drop in libido in midlife? Well, the truth is that there are a variety of reasons, but I am going to put them into three main buckets: psychological reasons, logistical reasons, and physical reasons. Let’s dig into each one.
Psychologically, there are many things that could be impeding your sexual desire. The first and most often noted is stress. If you are dealing with high levels of stress at work, in the household, caring for parents, financially, in response to the state of the world, or any combination of these, it can be really hard for your mind and your body to relax enough or to have the energy to feel sexually aroused. Similarly, if your body has changed in recent years, which is to be expected at this stage of life, then your emotions around that change can impact your ability to engage sexually. Your drop in sexual desire could also be a symptom of a more all-encompassing psychological issue, such as depression or anxiety, which can often show up at this stage of life. And, finally, if you have experienced trauma, even if it was in the past, you can encounter a drop in libido, even many years later if something triggers a resurgence of the traumatic memories, which can happen during transition times in our lives, such as midlife.
If these reasons for a drop in sexual desire resonate with you, then it may be time to focus first on your mental health so that you can become more present and available sexually. Talking to a therapist can help you to manage stress, navigate family tensions, come to terms with your aging body, or identify if depression or anxiety might be a factor and what you could do about that, either in therapy or with medication. And even more specifically, working with a sex therapist may be helpful, especially if you have a trauma history or if you feel like your sexual satisfaction could use some help, too. If therapy is not for you, then finding some productive ways to manage your stress can also be helpful. Good options here could include: getting exercise, going outside, engaging in a hobby that brings you joy, and working to simplify life by either asking for help or saying ‘no’ to more things so that you have space for yourself.
Logistically, finding the time and space for sex with your partner can also become more challenging at this stage of life, which can zap your libido real fast. This stage of life is so busy that finding time when both you and your partner are both available and not over-tired can be very challenging. In addition, as our kids get older, not only are they awake more (and later at night), but they also are more aware of what might be happening behind closed doors, which may make you feel self-conscious and therefore less turned on.
If these sound familiar, then getting creative can help! Schedule a date night that involves going to a hotel room for the evening, schedule fun during the day when kids are at school, or shift to early morning nooky while teenagers are still asleep. The point here is to consciously carve out time and then remind yourself that this is an important act both of self-care and of connection between you and your partner.
And, finally, there are the physical reasons. As we reach perimenopause, our estrogen levels drop, which can impact libido in two ways: (1) it can decrease your desire; and (2) it can cause vaginal dryness, which can make sex painful and therefore unappealing. A less well-known fact, though, is that while your estrogen levels drop during perimenopause, so too do your testosterone levels, which can have a major impact on libido. What’s more, these hormonal shifts lead to night sweats and hot flashes, which not only make sex less appealing, but also cause exhaustion, which can negatively impact your libido.
If these physical reasons sound like they could be a factor, then it is time to talk to your doctor. It sounds like thus far your doctor has not been very responsive to your concerns. While I personally find this unacceptable, it is shockingly common. This is because the medical community has historically not been trained on how to support women in perimenopause and beyond (even the lack of research is shocking). So, if you feel comfortable with going back to the same doctor, I would encourage you to be a strong self-advocate. Explain your concerns and ask specifically what interventions are possible for you. Intervention options will vary depending on your specific situation and health history, but options might include hormone replacement therapy (HRT), testosterone, Bupropion (aka, Wellbutrin), or one of the medications that are available for low libido in women. If they are still not open to having a real conversation about this, then it is time to find another doctor. To find a doctor that is open to such conversations and interventions, I recommend asking your community of moms. If you are comfortable, ask your friends. And if you aren’t ready to talk about this openly, consider anonymously asking in a local moms Facebook group or listserv (or, if you are in the DC metropolitan area, feel free to email me for some recommendations!).
As a whole, our society may be structured to ignore the sexual needs and desires of women—especially women in midlife and beyond—but that doesn’t mean we need to accept that. We deserve to have happy and satisfying sexual lives, and with a little bit of persistence I am confident that you’ll be able to get your groove back.