Hormones and low sex drive

During perimenopause and menopause, changing oestrogen levels can cause vaginal dryness or pain with sex, while sleep disruption and mood symptoms can reduce interest. Genitourinary syndrome of menopause describes ongoing changes in vaginal and urinary tissues after lower oestrogen exposure. Low desire can also occur without a hormone problem, so a sensitive assessment looks at timing, discomfort, stress, contraception, medicines and personal circumstances. A low sex drive becomes a health concern when it troubles you or affects your wellbeing.

Note whether desire changes with pain, dryness, fatigue, mood or a medicine. Lubricant during sex and a regular vaginal moisturiser may improve comfort; allow enough arousal time and choose activities that feel comfortable. A clinician can review medicines, examine symptoms when appropriate and discuss menopause treatment. Testosterone therapy for women is a specialist option in selected situations, not a general solution for every change in desire.

Book an appointment if low desire persists, causes distress, follows a medicine change or occurs with pain, dryness, bleeding, discharge or urinary symptoms. Seek prompt care for severe pelvic pain, fever, sores or unexpected bleeding. Ask for support sooner if low mood, anxiety, coercion or relationship safety is affecting intimacy.

Could dryness or pain be affecting desire? Might a medicine, thyroid problem, sleep issue or mood change contribute? What treatment could improve comfort, and is hormone therapy appropriate for me?