Low sex drive in menopause: what can help

Menopause may bring hot flushes, night sweats, disrupted sleep, mood changes, and changes in genital comfort. Genitourinary Syndrome of Menopause can cause vaginal dryness, burning, or pain with penetration; discomfort can reduce interest and anticipation. Perimenopause may bring similar symptoms while periods are still changing.

A clinician can discuss whether symptoms are connected and check for other causes. Desire may be affected by grief, stress, medicines, body-image concerns, or relationship changes at the same time, so one explanation does not fit everyone.

Track pain, dryness, sleep, hot flushes, mood, and desire so you can describe patterns. A clinician may suggest lubricants or moisturisers, treatment for vaginal symptoms, support for sleep or mood, counselling, or relationship and sex therapy. Testosterone therapy for women may be considered in selected situations by an experienced clinician after discussing benefits, monitoring, and alternatives.

Make an appointment if low desire or painful sex is distressing, lasts beyond a short-lived change, or affects closeness. Report bleeding after sex, bleeding after menopause, new pelvic pain, unusual discharge, or significant mood symptoms. Seek urgent help for severe pain or thoughts of self-harm.

Could vaginal symptoms or sleep disruption be affecting desire? What treatments are suitable for dryness or pain? Do I need an examination? What are the benefits and risks of hormonal options? Could counselling support me or my relationship?