Loss of Libido During Perimenopause
As a woman who enjoyed a healthy sex life before I entered perimenopause, I can tell you without a doubt, that the thought of losing my libido due to hormone imbalance simply terrified me. To be honest, the thought of menopause in general terrified me, but that’s another story for another day. Loss of libido during perimenopause is a very real and distressing problem for a lot of women, and it can also be quite distressing for their spouses as well.
What Causes Loss of Libido in Perimenopause?
Like every other symptom of perimenopause, the loss of libido is due to hormone imbalance, and in particular, the changes in progesterone, estrogen, and testosterone levels.
Progesterone and testosterone are the two hormones which primarily influence the sex drive and desire in women. Progesterone directly influences our sexual urges and desire, based on the ebbing and surging patterns during our monthly ovulation and menstrual cycles. Barring any specific physical problem or health issue, most women will experience a surge in sexual desire around the time of ovulation, due to the rise in progesterone levels.
During perimenopause, however, when progesterone levels begin to drop considerably, one of the unpleasant side effects is a lagging sex drive. Estrogen also plays an important role in our sexual function. Without healthy estrogen levels women often experience vaginal dryness, thinning of the vaginal walls, and vaginal atrophy; all of which can make intercourse very painful. And let's face it: who wants to have sex when it's painful?
Estrogen is also necessary for normal sexual response and orgasm. So, in addition to vaginal dryness, atrophy, and the thinning of vaginal walls, the ability of a woman to actually physically respond and reach orgasm can also be significantly diminished as well.
Testosterone levels also fluctuate for women during perimenopause. Given that testosterone is a powerful influence on the sex drive in both men and women, any drop in testosterone is going to have a definite effect on sexual desire.
Many women are also physically exhausted and emotionally over-wrought during perimenopause due to issues with insomnia, mood swings, and very often depression as well. Given the complex nature of a woman’s sexuality, and that it is as emotionally driven as it is physically driven, even if she weren’t suffering with the physical issues tied to hormone imbalance affecting her sex drive, her emotional state can have a significant impact on her loss of libido as well.
Some physicians prescribe testosterone therapy for women to help with loss of libido during perimenopause. As one who has personally used it, I can attest to the effectiveness of it firsthand. It definitely works.
It should also be noted that testosterone pellet therapy has been approved by the FDA for use in treating perimenopause and menopause symptoms in women, and has been safely used in Europe for decades.
Testosterone can also be used in a cream or gel form, and applied directly to the genital area. If a woman’s’ progesterone levels are also low, a bioidentical progesterone can help considerably. Estrogen can also be prescribed to address issues of vaginal dryness and atrophy.
This Too Shall Pass
Finally, it’s important to note that any loss of libido during perimenopause is not necessarily a permanent condition. Once the hormonal upheaval of perimenopause has passed, and menopause is reached, many women report the return of their sexual desire. With the added benefit of hormone therapy to address any potential physical issues, there is no reason that women in menopause cannot continue to enjoy a healthy sex life as long as she wishes.
Magnolia Miller is a certified healthcare consumer advocate in women’s health and a women’s freelance health writer and blogger at The Perimenopause Blog.