It’s time to get real about something that’s often whispered about in private or not at all—low libido during menopause. If you’re finding that your sexual desire isn’t what it used to be, you’re not alone — I promise. 

But here’s the thing, most of the time, getting back your libido isn’t about finding a quick fix or taking a magic pill. It’s about rewiring your brain, embracing a mindset shift, and committing to daily practices that will slowly but surely bring back that spark. Practice makes practice; we’re here for progress, not perfection.

A Mindset Shift Towards Desire

Many women go through life expecting that sexual desire should just spontaneously appear as it does in the movies. This idea is totally wrong, and you will likely be disappointed if you have this expectation.

Let’s start by acknowledging the truth: menopause changes things, and that includes your sex drive. But rather than accepting a diminished libido as your new normal, it’s time to rethink how you approach your sexual health. It’s about gradually rewiring your brain and your habits to reclaim your desire – with or without a partner.

Sexual desire can be categorized into two types: spontaneous and responsive. 

Spontaneous desire occurs unexpectedly and can be triggered suddenly, much like how it is often portrayed in films. In contrast, responsive desire develops as a reaction to intimacy, where desire builds after the physical or emotional engagement has begun. Research shows that spontaneous desire tends to decrease after a few years with the same partner, while responsive desire becomes more common. This shift is normal, and understanding it can alleviate the pressure to feel constantly “turned on” in long-term relationships.

As you move through menopause, desire may require a more deliberate approach. This change doesn’t signal a problem—it’s simply different and entirely natural. Recognizing this is key to managing expectations and supporting your sexual well-being.

Hypoactive sexual desire disorder (HSDD) refers to a persistent or recurrent lack of sexual fantasies and desire for sexual activity, leading to personal distress or difficulties in relationships.

In the United States, HSDD affects 12.3% of women between the ages of 45 and 65, and 7.4% of women aged 65 and older (Ronghe 2023). Surgically menopausal women are more likely to experience HSDD compared to those who are premenopausal or naturally menopausal, regardless of age (Ronghe 2023). 

Main Contributors

While many people transitioning through menopause believe that low sexual desire is solely due to hormonal changes, research suggests a more complex picture. Sexual desire is influenced by four main factors: biological, psychological, sociocultural, and interpersonal.

Biological factors include medical conditions such as high blood pressure, diabetes, hypothyroidism, and genitourinary syndrome of menopause (GSM). Hormonal changes, like decreased estrogen and testosterone levels, also play a role. Certain medications, such as SSRIs, oral contraceptives, and spironolactone, are known to reduce sexual desire as well.

Psychological factors encompass stress, anxiety, depression, past trauma, and body image concerns, all of which can impact sexual desire and intimacy.

Sociocultural factors relate to the beliefs and norms shaped by upbringing and societal views. For example, the notion that sexual desirability is limited to youth or a specific body type can negatively influence desire. Similarly, rigid ideas about sex—such as focusing only on penetrative intercourse—can limit the broader scope of pleasure and exploration in a sexual relationship.

Interpersonal factors involve the quality of your relationship, satisfaction within the partnership, and communication dynamics. Relationship conflicts, lack of emotional connection, or diminished eroticism in long-term relationships can also significantly affect desire.

By considering all these factors, it becomes clear that sexual desire during menopause is multifaceted and not solely driven by hormones.

Daily Practices: The Realistic Path to Reclaiming Libido

So, how do you start to rewire your brain and rekindle your libido? It’s all about consistency and daily practices. Let’s talk about some of the most important ones:

1. Prioritize Sleep: Poor sleep is a libido killer. When you’re exhausted, the last thing on your mind is sex, and that’s perfectly understandable. Start by creating a sleep routine that gives you the rest you need. Better sleep hygiene not only restores your energy but also sets the stage for sexual desire to reemerge.
   
   
2. Shift Your Self-Perception: How you see yourself directly impacts your libido. If you don’t feel sexy or confident, it’s hard to get in the mood. This isn’t about fitting into society’s narrow definition of beauty; it’s about embracing and celebrating your body as it is now. Introducing daily affirmations, positive self-talk, and dressing to make you feel good in your skin can all contribute to a healthier self-image.
   
   
3. Mindful Movement: Regular exercise isn’t just good for your body; it’s good for your brain too. Physical activity releases endorphins, which can boost your mood and your libido. Find a type of movement that you enjoy and make it a regular part of your routine.
   
   
4. Stay Connected with Your Partner: Emotional intimacy often leads to physical intimacy. Make an effort to stay connected with your partner, whether it is through regular date nights, meaningful conversations, or simple acts of affection. This connection can reignite the spark and remind you both of the importance of intimacy.
   
   
5. Explore Sexual Wellness Products: While the journey to reigniting your libido is largely mental and emotional, there’s no harm in seeking support from sexual wellness products. Lubricants, moisturizers, and hormone therapy can all play a role in making sex more comfortable and enjoyable as you navigate these changes.

Addressing Low Libido: Strategies and Solutions

Understanding that low libido during menopause is both common and manageable is an important first step. Here are several strategies that can help:

1. Vulvar and Vaginal Moisturizers: Using moisturizers or lubricants can ease vaginal dryness, reducing discomfort and making sexual activity more enjoyable. Our friction-free favourites are right here.
   
   
2. Engage Your Erotic Mind Regularly: Finding ways to connect with your own sense of desire, through imagination or exploration, can help maintain sexual interest. Experiment with visualization just like an athlete envisions each step of their sprint before the race.
   
   
3. Schedule Intimacy: While it may feel less spontaneous, setting aside dedicated time for intimacy can foster a deeper connection and allow desire to grow. This practice also increases psychological safety, allowing each partner to mentally prepare and build emotional excitement before the physical experience.
   
   
4. Menopause Hormone Therapy (MHT): For some women, hormone therapy may help alleviate symptoms related to low libido. However, studies suggest that estrogen alone does not significantly improve sexual desire beyond its ability to relieve other menopausal symptoms.
   
   
5. Counselling or Therapy: Consulting with a therapist can be helpful, especially if psychological factors like stress or past trauma are affecting desire. Couples therapy can also improve communication and address any relationship concerns.
   
   
6. Testosterone Therapy: In certain cases, testosterone therapy may be recommended to help increase sexual desire in postmenopausal women, but this should be discussed thoroughly with your healthcare provider as it is considered an off-label use.
   
   
7. Non-Hormonal Medications: Medications like Addyi (flibanserin) and Vyleesi (bremelanotide) are options for premenopausal women diagnosed with hypoactive sexual desire disorder (HSDD). These medications are intended for women experiencing persistent low libido that causes distress, are not related to medical, psychiatric, or relationship issues and are considered off-label use in menopause. 

By exploring and integrating these strategies, you are taking proactive steps to manage low libido during menopause and maintain a fulfilling sexual relationship.

Rewiring Takes Time, But the Results Are Worth It

The key takeaway here is that reigniting your libido during and after menopause is a process requiring practice to see progress. It’s not going to happen overnight, and that’s okay. By committing to daily practices that improve your physical, mental, and emotional well-being, you can gradually rewire your brain and bring back that desire.

Remember, it’s not just about sex; it’s about how you feel in your own skin and how you connect with your partner. Take the time to invest in yourself, be patient with the process, and know that with the right mindset and support, you can reclaim your libido and enjoy a fulfilling intimate life.

REFERENCES

1. Ronghe 2023
2. https://www-ncbi-nlm-nih-gov.myaccess.library.utoronto.ca/pmc/articles/PMC4808247/

FURTHER READING

Written by: Dr. Dolores Fernandez, ND, MSCP from IRIS Inc.