Decreased libido

Women are two to three times more likely than men to be affected by a decline in sex drive as they age. Sometimes the reasons for lack of interest in sex might be obvious. Other times—and quite often in midlife and menopause—the reasons might be more elusive. The good news is that decreased libido is a medical problem, and there are treatment options available.

What is libido?

“Libido” refers to sexual desire, your interest in sex and in being sexual. It has three interrelated components: 

  • Drive – Biological component, manifesting as sexual thoughts and fantasies, erotic attraction to others, seeking out sexual activity, or genital tingling or sensitivity 
  • Attitudes about sexual activity – Your personal beliefs, values and expectations around sex, influenced by culture, religious beliefs, family, peers and even media 
  • Motivation – Willingness to behave sexually at a given time and with a given partner

Is menopause affecting your libido?

Take a self-assessment quiz to learn more about your symptoms.

Man and woman walking on the beach.

Lifestyle tips

Modifying your lifestyle may help improve your sex drive. Try the following tips:

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  • Examine your relationship and situation. What are your turnoffs? Are they physical? Emotional? Find ways to address each one in turn. If your desires and needs have changed, be honest with your partner. Women who learn to tell their partners about their sexual needs and concerns have a more satisfying sex life.
  • If you experience discomfort or pain during sex, try an over-the-counter vaginal lubricant to make sex more comfortable. For longer-acting relief of vaginal dryness, try a vaginal moisturizer or coconut oil. (Do not use oil-based products like petroleum jelly, baby oil or mineral oil.)
  • Schedule a regular date night with your partner. One-on-one time can help maintain and strengthen your emotional connection.
  • Take turns initiating an intimate act, such as a kiss or caress, with the prior understanding that sex is “off the table.” When sex is not an expectation, these intimate connections can bring you closer together.
  • Stay sexually active, even if your desire for sex is less than it once was. Consider activities such as massage, sensual baths, oral sex or manual stimulation.
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  • Limit your alcohol intake. More than one drink per day may weaken sexual desire over time and lessen your ability to become aroused or responsive to sexual stimuli.
  • Eat foods containing phytoestrogens. These foods include:
    • Dark green leafy vegetables
    • Fruits such as apples, avocados, bananas, mangoes, papayas and rhubarb
    • Nuts (almonds, cashews, hazelnuts, peanuts and walnuts)
    • Soy products
    • Wildflower honey
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Get your body moving three times a week for at least 30 minutes at a time. Women who work out have a better sex drive—possibly because of the link between physical exercise and dopamine.

Lifestyle factors
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If you’re a smoker, quit. Smoking interferes with blood circulation and decreased sex drive. Quitting smoking is good for your overall health.

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Learn about the possible side effects of medications and supplements you take. Many antidepressants and blood pressure medications carry a risk of sexual side effects.

Treatment options

If decreased libido disrupts your life, causes trouble in your relationships or physical pain, you should talk to a health care provider. Treatments for decreased libido include lifestyle changes, medications, counseling or a combination of these strategies.

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  • Vaginal estrogen (available in topical creams, vaginal pills, caplets and a slow-release three-month ring) – Reduces and reverses vaginal thinning, dryness or insensitivity.
  • Vaginal atrophy oral and vaginal treatments – Extend the benefits of topical estrogen and testosterone into the vaginal wall.
  • Flibanserin and bremelanotide – Treat hypoactive sexual desire disorder (low sexual desire with no underlying physical or psychological causes).
  • Hormone therapy (HT) – Relieves hormone fluctuations.
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Talking to a qualified sex therapist can help identify problems inside (or outside) your relationship with your partner that may be contributing to sexual dysfunction.

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Choose foods that contain these nutrients, or consider taking a supplement:

  • Folic acid – Supports healthy libido in both women and men. Get natural folate from eating leafy dark green vegetables, asparagus, broccoli, beans, peas, lentils, avocados and citrus fruits.
  • Magnesium – Low magnesium has a connection with lower testosterone levels, which can negatively impact female libido, especially during menopause. Natural magnesium sources include leafy greens, dark chocolate, seeds, nuts, beans, bananas, yogurt and avocados.
  • Red ginseng – One research study shows menopausal women taking red ginseng reported significant improvements in sexual arousal compared with those taking a placebo.
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Some yoga poses strengthen the pelvic and abdominal muscles, improving sexual sensation or easeing pelvic pain during sex. Also, practicing yoga can boost women’s libido, arousal, ability to achieve orgasm, and overall sexual satisfaction.

Frequently asked questions

How common is decreased libido during menopause?
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About 12% of women ages 45 to 64 report having low sexual desire.

What causes decreased libido during menopause?
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If you’re experiencing decreased libido in midlife or through menopause, there can be many causes other than a lack of sex drive. Causes include: 

  • Physical 
    • Chronic stress or sleep deprivation 
    • Hormone changes and fluctuations that interfere with your readiness for sex (e.g., hot flashes, night sweats and vaginal dryness), make sexual activity less pleasurable or reduce sexual thoughts, dreams or interest in sexual activity
    • Medical conditions such as obesity, diabetes, heart disease or cancer 
    • Medication side effects 
    • Pain during sex 
  • Psychological 
    • Anxiety 
    • Body image and self-esteem problems 
    • Concern about sexual performance 
    • Depression 
    • Fear of pain during sex 
    • Stress from work or family responsibilities 
  • Interpersonal 
    • Communication problems 
    • Intimacy issues 
    • Lack of connection with your partner 
    • Lack of mutual physical attraction 
    • Mismatch in your sexual needs 
    • Trust issues, unresolved conflicts or resentments
I just don’t feel like having sex. Is something wrong with me?
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If you’ve recently experienced a drastic change in your level of sexual desire, consider these steps:

  • Determine whether any medications or undiagnosed medical conditions might be to blame
  • Address some of the more common libido-busters for women in midlife:
    • Communication issues with your partner
    • Exhaustion or hormonal fluctuations
    • Relationship stressors and unmet emotional needs
    • Stress
    • Vaginal dryness

If you’re still experiencing low libido, and it’s causing you distress or problems with your partner, you should talk to a health care provider or counselor.

Will my sex drive ever return?
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Many women find their interest in sex rebounds within a year or two of their last period. This could be because the stress of menopause affected your hormones. Or it could be because menopause symptoms like hot flashes and night sweats have resolved. If you are troubled by a lack of sexual desire during menopause, don’t wait to talk.

Contact Us

Talk to a care navigator or schedule an appointment at the Women’s Health & Wellness Center.