Low progesterone and sex drive: what to know

Progesterone varies across the menstrual cycle and may become less predictable during perimenopause. A change in desire may occur alongside hot flushes, poor sleep, anxiety, low mood, vaginal dryness, or discomfort with sex. Genitourinary syndrome of menopause can cause dryness, burning, urinary symptoms, and pain, all of which may reduce interest in sex. Other contributors include stress, depression, relationship strain, postpartum changes, some medicines, and medical conditions. A low progesterone result by itself does not identify the cause of low sex drive.

Note when desire changed, whether it follows a cycle phase, and whether pain, dryness, sleep problems, or mood symptoms occur at the same time. Review medicines and contraception with a clinician rather than stopping them independently. Lubricants or moisturisers may help some dryness, while persistent pain deserves an examination. Treatment should target the contributing problem. Testosterone therapy for women may be discussed in selected situations, but it is not a general remedy for every change in desire.

Make an appointment if low desire persists, causes distress, follows a major hormonal change, or occurs with painful sex, bleeding after sex, vaginal symptoms, or urinary problems. Seek prompt help for sudden severe pelvic pain, unexplained bleeding, or thoughts of self-harm. A private, non-judgmental assessment can separate physical, emotional, medication, and relationship factors.

Ask whether dryness, pain, sleep, mood, medicines, or menopause-related changes could be contributing. Ask which examination or tests are useful and what benefits and risks apply to any hormone treatment being considered.