Last Tuesday at 7:30pm your partner put their hand on your shoulder in the kitchen while you were loading the dishwasher and you felt nothing. Not turned on. Not even warm. Just nothing. That was three weeks ago. Wait - actually it's been longer, hasn't it? When did you last actually want sex? February? March? Yesterday at 2:47am you found yourself Googling "low libido early menopause" then clicking through to "thyroid problems no sex drive" then "is this normal at 41" because surely something's seriously wrong. Your periods are still regular. You're not menopausal. So what the hell is going on?
The not-knowing does your head in, doesn't it? We get why you're googling at 2am.
Low sex drive affects up to 55% of menopausal women. Actually, poor lubrication and painful sex are also incredibly common affecting up to 30% and 45% respectively. So you're not broken. You're not alone. This is frustratingly common.
Signs of Low Libido in Women (And Why It Matters)
The signs of low libido in women aren't always obvious. It's not just about never wanting sex. It's about noticing changes in yourself - no sexual thoughts or fantasies anymore, never initiating, feeling distressed about your lack of interest, avoiding situations that might lead to intimacy.
Some people have naturally lower sex drive and they're completely fine with it. But if you're bothered by the change and if it’s affecting your relationship or your sense of self. That's when it matters. That's when the benefits of a healthy sex drive become clear - not just physical intimacy, but emotional connection, stress relief, feeling like yourself.
Reasons for Low Sex Drive in Women: What's Actually Happening
Your libido doesn't just disappear for one neat reason. Wouldn't that be easier? But no.
Multiple factors commonly pile up together - physical changes, emotions, relationship factors affecting female libido, what's going on in your life generally.
Your body's clever about shutting down things it doesn't need right now when it's under pressure. So when life gets overwhelming - work's a nightmare, you're caring for your dad, teenagers, bank account at £47, can't remember when you last slept properly - your body just quietly turns down the dial on desire. The impact of stress on female libido is massive.
Time and again, we see that women with low libido aren't dealing with one isolated problem. They're juggling multiple stressors simultaneously. And their body says: shut it down.
Medication and Female Sex Drive: The Physical Stuff That Tanks Desire
Certain medications mess with libido. Big time. Antidepressants - especially SSRIs - are notorious. Blood pressure meds. The effects of birth control on libido are real too. The pill, patch, implant. If you started something new around when your sex drive disappeared, that might be it.
Long-term health problems affect it. Diabetes, heart disease, underactive thyroid, cancer - they all mess with desire. Either through the condition itself or through being exhausted and worried. (And yes, we know you've Googled whether every single one of these could be what's wrong with you. At 3am. Multiple times.)
Physical sexual problems create this horrible cycle. Sex hurts - vaginal dryness, painful penetration, can't reach orgasm - so you're not exactly going to be enthusiastic about it. Your brain learns: sex equals discomfort. Desire drops. Makes sense.
Being knackered kills libido. We mean knackered. Falling asleep at 8:30pm on the sofa still in your work clothes knackered. The role of sleep in female sex drive is huge - chronic poor sleep directly suppresses desire. Caring for young children. Looking after elderly parents. Working night shifts. When you can barely string a sentence together by evening, sex isn't even on your radar.
Hormonal Imbalance and Sex Drive: When Perimenopause Turns Everything Upside Down
Right. If you're in your 40s and your sex drive's vanished, hormonal imbalance is probably playing a massive role. Even if your periods are still regular.
Here's what you need to know: sexual dysfunction affects up to 88% of perimenopausal and postmenopausal women. That's huge. And low sexual desire is the most common sexual problem women report during this time.
The connection between female sex drive and menopause is undeniable. Perimenopause can start in your early 40s - sometimes even late 30s. Your periods might still be regular. You might not have hot flashes yet. But your hormones? Already fluctuating wildly.
During perimenopause and menopause, estrogen drops. Lower estrogen means less natural lubrication. Thinner vaginal tissue. Sometimes painful sex. Plus hot flashes waking you four times a night. Mood swings. Brain fog. Anxiety that comes out of nowhere. All of which make desire plummet.
The numbers tell the story: 26.7% of premenopausal women experience low sexual desire, but 52.4% of menopausal women do. That jump from pre- to post-menopause? That's hormonal imbalance.
But it's not just about estrogen. The relationship between declining estrogen and testosterone during perimenopause creates this perfect storm for low libido. Your testosterone's dropping too - and testosterone affects desire, energy, mood in women. When it's low, your sex drive can drop significantly.
And here's the thing nobody tells you: sexual problems during perimenopause aren't just about hormones. Psychological factors affecting female libido matter too - you're often at peak stress at this age. Caring for aging parents. Teenagers at home. Career demands. Relationship challenges. Your own aging. All of it piles on.
(We know you're probably worrying whether this means you're "officially" perimenopausal now. Blood tests can check hormone levels, but they fluctuate so much in perimenopause that one test doesn't tell the full story. Your symptoms matter more than the numbers.
What Perimenopause Actually Does to Your Body
The decline in estrogen affects your entire genital area. Vaginal walls get thinner. Less elastic. You produce less natural lubrication. The tissues become more fragile. This isn't just uncomfortable - it directly affects whether you want sex at all.
But there's more. Lower estrogen affects blood flow to your genitals, which affects arousal. Even if you want sex mentally, your body might not respond the way it used to. Female sexual arousal tips that worked before might not work now. Takes longer to get aroused. Orgasms might be less intense or harder to reach. Frustrating doesn't even cover it.
The sleep disruption from perimenopause is brutal too. Night sweats. Waking at 3am. Can't get back to sleep. When you're chronically exhausted, sex is the last thing on your mind.
Impact of Stress on Female Libido: The Anxiety and Exhaustion Factor
The impact of stress on female libido is massive. In a UK survey, 59% of people with low libido said stress was the main reason.
When you're stressed, your body produces cortisol, which suppresses testosterone. Less testosterone equals less desire. Your body's essentially saying: we're in survival mode, reproduction can wait.
Anxiety works the same way. Chronic stress causes this cognitive distraction that pulls your focus away from anything sexual. You're not thinking about sex because your brain's busy running through tomorrow's presentation, whether you locked the back door, that weird thing your GP said at your last appointment.
Depression flattens libido. Everything, actually. When you're depressed nothing feels enjoyable anymore. (And some antidepressants make it worse. Cruel, isn't it?)
Women in perimenopause are particularly vulnerable to mood changes - anxiety, depression, irritability. These aren't "just in your head." They're direct results of fluctuating hormones. And they directly impact your sex drive.
We've noticed that women who are anxious about their low libido create this feedback loop. You worry about not wanting sex, which makes you anxious, which makes you want sex even less, which increases the anxiety. Sound familiar?
Relationship Factors Affecting Female Libido
For loads of women, you need to feel emotionally close before you can feel physically attracted. Can't feel close? Can't feel sexy either. Understanding relationship factors affecting female libido is crucial.
Relationship problems are one of the most common causes. Unresolved fights. Poor communication. Trust issues. Resentment that's been building for months. The role of communication in sexual relationships cannot be overstated. If you're angry about them never loading the dishwasher properly, that anger doesn't just switch off in bed.
Sometimes the issue is your partner's sexual problems. Erectile difficulties become more common as men age too, often happening right when women are going through perimenopause. Both of you dealing with sexual changes simultaneously? That affects intimacy. The awkwardness, the disappointment, the not-quite-talking-about-it.
Learning how to talk to partner about low libido is essential. Hiding it creates more pressure. Opening up about what you're experiencing, what you're worried about, what would help - that's where healing starts.
Lack of privacy kills intimacy. Teenagers who barge into your room without knocking. Your mum living in the spare room. Thin walls. Hard to feel sexy when you're worried about being overheard.
When to Actually See Someone About it
Don't suffer in silence. (68% of UK women with low libido don't tell anyone, compared to only 22% in the US - we're particularly bad at asking for help.)
See your menopause specialist if:
- Your lack of sex drive is distressing you or affecting your relationship
- You're on medication and think it might be affecting libido
- Your sex drive hasn't come back after pregnancy
- You're worried it's linked to another health condition
- You're experiencing other symptoms that might suggest perimenopause (irregular periods, hot flashes, mood changes, sleep problems)
Your specialist can check for underlying causes. Thyroid. Hormones. Other conditions. They can review your medications.
(Mortifying? Yes. But they've heard it hundreds of times. Literally their job.)
How to Increase Female Libido: What Treatment Actually Exists
Treatment depends on what's causing it. (No magic pills, sorry.) But here's how to increase female libido based on the root cause:
If medication's the problem: Your menopause specialist might adjust your dose, switch you to something different, or add something to counteract the sexual side effects. Don't just stop taking medication without medical advice though.
If it's perimenopausal/menopausal: This is where treatment can really help. Hormone Replacement Therapy addresses the physical symptoms - vaginal dryness, hot flashes, sleep disruption - which can significantly improve desire. HRT replaces the estrogen your body's no longer making in sufficient amounts.
For perimenopausal and postmenopausal women, addressing vaginal dryness and pain is crucial. Vaginal estrogen (as cream, tablet, or ring) can restore vaginal tissue health. Makes sex comfortable again, which makes you more likely to want it.
For some women, testosterone therapy alongside HRT makes a significant difference to libido. Particularly if you're postmenopausal and HRT alone hasn't fully helped. This is where Voy Menopause can help - our specialists assess your complete hormone picture and can prescribe testosterone as part of your treatment plan, without the NHS waiting times.
If it's stress or mental health: Talking therapies help. CBT for anxiety or depression. Sex therapy for performance anxiety or sexual trauma. Couples counselling if relationship issues are the main thing.
If it's relationship-focused: Psychosexual counselling gives you and your partner space to discuss what's not working. Communication problems. Mismatched expectations. Unexpressed resentments. Particularly important if you're both dealing with age-related sexual changes.
Natural Ways to Boost Libido in Women: Lifestyle Changes That Help
Natural ways to boost libido in women focus on lifestyle factors that support overall health and hormone balance:
Exercise and female sex drive: Regular physical activity improves blood flow, reduces stress, boosts mood, and can increase testosterone levels naturally. Even 30 minutes of walking most days makes a difference. Exercise also improves body image, which affects desire.
Foods that increase female libido: While no food is a true aphrodisiac, eating well supports hormone production and energy levels. Foods rich in omega-3s (salmon, walnuts), zinc (oysters, pumpkin seeds), and antioxidants (berries, dark chocolate) support overall sexual health. A balanced diet with plenty of protein, healthy fats, and vegetables keeps energy stable.
Sleep: The role of sleep in female sex drive is huge. Prioritize 7-9 hours. Poor sleep directly suppresses testosterone and increases cortisol. If perimenopause is disrupting sleep, talk to your specialist about treatment options.
Stress management: Whatever works for you - meditation, yoga, walks, therapy, saying no to things. You can't think your way to wanting sex when your body's in fight-or-flight mode.
Alcohol reduction: While a glass of wine might help you relax, too much alcohol dampens desire. Keep it moderate.
Best Supplements for Female Libido: What Actually Works
The best supplements for female libido are those that address underlying deficiencies or support hormone production:
Vitamin D: Low levels linked to low libido. Get your levels checked - many UK women are deficient.
Omega-3 fatty acids: Support hormone production and blood flow.
Zinc and magnesium: Essential for testosterone production in women.
Maca root: Some evidence it may help with sexual function, particularly in postmenopausal women.
Important: Talk to your menopause specialist before starting supplements, especially if you're on medication. Supplements aren't regulated the same way as medication, and quality varies hugely.
Getting Testosterone Treatment: Your Options
Short answer: yes, you can get testosterone for low libido. But access varies.
NICE guidance says testosterone can be prescribed to menopausal women with low libido - but it needs to be prescribed by a specialist. You'd typically need to be on HRT already (with other menopausal symptoms controlled) but still experiencing distressing low libido.
Here's where it gets frustrating: NHS waiting times for menopause specialists can be months. And not all GPs feel confident prescribing testosterone, even though it's recommended by NICE.
This is exactly why Voy Menopause exists. We offer testosterone as part of a holistic menopause service - which means you get expert care without the wait. Our menopause specialists can prescribe testosterone alongside HRT, tailored to your specific situation. No referrals. No waiting lists. Just proper, comprehensive care that addresses the whole picture - hormones, lifestyle, support.
Testosterone is prescribed as a gel you apply to your skin daily. In trials, about two-thirds of women responded positively, compared to one-third on placebo. Takes 8-12 weeks to see effects though. Not immediate.
Testosterone doesn't work for everyone. If you have certain medical conditions, or your testosterone levels are already high, it wouldn't be recommended. That's why having a menopause specialist who knows your full medical history matters.
Female Sexual Arousal Tips: What You Can Try Right Now
While you're figuring this out, here are some female sexual arousal tips:
Talk to your partner. Properly. About what you're experiencing, what you're worried about, what would help. The role of communication in sexual relationships is fundamental. Trying to hide it creates more pressure. (Pressure definitely doesn't help.)
Address the physical discomfort if sex hurts. Use vaginal moisturizer regularly (not just during sex). Try lubricant during sex. Consider asking your specialist about vaginal estrogen. Pain during sex is a major barrier to desire, but it's treatable.
Stop forcing it. If you're trying really hard to get turned on, you're creating performance anxiety. Makes everything worse. Sexual arousal is automatic - you can't force it any more than you can force sleep.
Focus on intimacy without sex. Cuddling. Holding hands. Spending time together doing things you enjoy. Sometimes removing the pressure actually makes desire come back.
Try sensate focus exercises. These help you reconnect with physical pleasure without the pressure of sex. Start with non-sexual touch and gradually work up to more intimate touch over weeks.
Address practical barriers. Exhausted? You need sleep, not sex. Worried about being overheard? Play music or wait till you have the house to yourself.
So What Does This Mean for You?
Your sex drive disappearing doesn't mean you're broken. Doesn't mean your relationship's doomed. And if you're in your 40s, it almost certainly doesn't mean you're "too young" for perimenopause. Perimenopause typically starts in the early to mid-40s, and sexual changes are one of the earliest signs.
Understanding the reasons for low sex drive in women - whether it's hormonal imbalance, stress, medication, relationship factors, or multiple things combined - is the first step toward improvement.
The fact that you're bothered matters. Some people have naturally low libido and they're fine with it. But if you're distressed, if it's affecting your relationship or sense of self, then yes - worth addressing.
Treatment exists. Help exists. Natural ways to boost libido in women through lifestyle changes can help. And if hormones are the issue - particularly during perimenopause or menopause - proper hormone treatment including testosterone can make a real difference. That's what we're here for at Voy Menopause: comprehensive, expert care that looks at the whole picture.
This can improve. Your sex drive isn't gone forever.
You just need to figure out what's causing it and what might help.
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⁸- Superdrug Online Doctor. Addressing Low Libido survey. https://onlinedoctor.superdrug.com/loss-of-libido.html
⁹- Balance Menopause. How do perimenopause and menopause affect my sex drive? https://www.balance-menopause.com/menopause-library/how-does-menopause-affect-my-sex-drive/
¹⁰- Hamilton LD, Meston CM. (2013). Chronic stress and sexual function in women. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC4199300/
¹¹- Women's Health Network. Can Stress Hurt Your Libido? https://www.womenshealthnetwork.com/adrenal-fatigue-and-stress/stress-and-sex-life/
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