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Many factors contribute to a low sex drive and hormones are just one of them. Whilst you may not feel you are missing anything, low libido affects relationships and avoidance of sex impacts vaginal health. 

Low libido refers to having a low or absent desire for sex. When we speak about ‘sex’ here we are speaking about all sorts of activities that are associated with arousal, stimulation and physical pleasure (and can involve yourself alone, another person of the same or different sex or gender, or multiple other people). 

Sex is definitely not just male-female intercourse! 

Having low sexual desire may not cause you any concern at all, however it can impact relationships and also the health of your vagina as the tissues are more likely to become thin and dry without regular use.

Almost half of midlife females experience low sexual desire and for around 15% this causes personal distress. Your changing hormones are only one cause for low sexual desire and we cannot blame them alone. Let’s take a look at all the contributing factors.


Previous level of sexual interest

If you have previously had low sexual interest then you may not notice any changes around the menopause. You may also rest on vaginal discomfort as an excuse to avoid it altogether from here on.

Don’t confuse the golden time of your relationships with sexual desire! The first 6 months to 3 years are filled with infatuation and lustful steamy desire, but they do not last. Relationships move toward attachment (or to another relationship for more limerance!)

“Limerance” is the obsessive infatuation occurring early in a relationship. It doesn’t last!

Desire discrepancy

Typically, men have higher sex drives than women. This causes great tension between couples especially when exacerbated by an arousal disconnect – men and women get aroused by different things. She by romance, intimacy, communication, help with chores and he by visual interest, spontaneity, novelty, an interested and responsive partner and feeling sexual prowess.

Women need intimacy to feel sexy, men need sex to feel intimate.

Relationship issues

Many cultures still value long term monogamy as the unit of family and social stability. Given novelty and new experiences are often exciting, a consequence of this for many couples is a gradual decline in sexual interest. This does not mean you cannot create novel experiences within long term partnerships. Compounding this are relationship problems. This is the most important place to start if your relationship is stressed and part of this is being reflected in low sexual desire.

Dry vagina

If the skin and tissues of your vulva and vagina are dry they can become irritated and painful when touched or during penetrative sex. This can be easily addressed with vaginal oestrogen or moisturisers and a good quality lube. Don’t let a dry vagina stop you.

Partner medical issues

Sometimes your partner has physical problems that interfere with their participation in your sex life. For males, erectile dysfunction or inability to achieve or maintain an erection becomes increasingly common with age. This can be difficult to discuss but there are good treatments available so speak with your doctor.

Your hormones

Your most powerful hormone when it comes to libido is testosterone. Whilst males have much higher levels, females also have testosterone. Your testosterone levels peak around 20 to 30 years of age and then slowly decline overtime. This differs from your oestrogen and progesterone which take a sharp dive around the time of menopause. Testosterone increases your libido, improves your ability to get aroused and climax, and also makes you feel energetic. Oestrogen and progesterone probably have an impact on your libido as well.

Females with low libido that is impacting their life can consider using a small dose of testosterone cream. This can have unwanted side effects such as acne and facial hair so your blood levels need to be monitored. Testosterone is only used when oestrogen replacement is already being taken. Tibolone is a type of hormonal therapy that has weak testosterone-like effects and may also increase your libido.

Going SOLO

If you want to kick start your sex life, one of the best tips is to go solo. Masturbation has numerous advantages. It is convenient, readily available and you can spend time exploring what makes you feel good. Regular sexual activity including masturbation is important for healthy vaginal tissues. The more you understand your own body and what feels good for you, the more readily you will reach climax and the easier it will be to communicate with any other sexual partner you enjoy time with. 

Most females find the clitoris is the easiest part of their body to stimulate in order to reach climax (you may need a saucy book or movie to warm you up). This can be done with your finger or with any sex toy. Female sex toys no longer look like large penises and vibrators are now available that are small, tastefully designed and quiet. There are plenty to purchase online but if you feel adventurous and visit a sex shop, the best place to try out a vibrator is on the tip of your nose!

Making sex important

Many of us simply believe that we need to ‘feel’ like it to have sex – in other words the arousal or interest needs to happen before the action. Most women experience “responsive desire” (meaning you warm up and then feel like it). We can decide that sex is important for us with the knowledge that the more we participate the more we will feel like it and the easier it will be to become aroused. We can create an environment or rituals leading up to sex (females in particular like a long warm up of intimate communication or erotic stimulatio). 


A few more tips on midlife sex:

  • be open to different experiences

  • redefine what sex means for you

  • understand what you both want and need
  • be processed or pleasure focused (rather than outcome or climax focused)

  • be honest with yourself and others

  • use Lube

  • look after your vagina (with moisturiser and oestrogen)

  • make a conscious and deliberate decision to have sex regularly

  • go through the day collecting things that fill your ‘love’ tank  🙂


As you can see low libido is complex and can’t be attributed simply to the menopausal hormonal changes alone. There are many professional sex therapists to give you great advice. As you rock into the next phase of your life, spend some time being generous, kind and curious with your own body. 


This information is for general educational purposes only and does not constitute medical advice. Please see your health professional for advice that is personalised to you.

Libido is impacted by many things, your hormones are just one of them.

Regular sex is good for your intimate relationships and your vaginal health.

You don’t need desire for a satisfying sex life, try starting at step 2!



Where did my libido go? A book by Dr Rosie King

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