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Low Libido In Menopause And What You Can Do About It

Hormone Circuit

By: Michael Lam, MD, MPH; Carrie Lam, MD; Jeremy Lam, MD

an illustration of the word menopause showing time is running out with a pink backgroundLow libido in menopause is more common than most people realize. Menopause is the time in a woman’s life heralding the end of her reproductive years. This tends to go together with a decrease in the production of certain hormones that may lead to a loss in sex drive. Fortunately, this state does not have to be permanent, and you can have a fulfilling sexual relationship.

What Happens During Menopause?

Low libido in menopause may be a confusing time for most women and their partners as well. It may not only result in a loss of self-esteem but could potentially cause relationship problems. While this could be stressful for some women, other women may view menopause as a transitioning experience, with many post-menopausal women finding a new lease on life without the worry of pregnancy and of having to deal with their menses. The bottom line is that each woman experiences menopause differently.

Before looking at why some women experience low libido in menopause, it is worth looking at the different stages of menopause and the changes your body experiences in each. On a side note, low libido in menopause may only last for a certain period before your libido picks up again. But once again, all women are different and there is much you can do to get your sex life revving on all engines once more.

Essentially, natural menopause usually happens when a woman is in her early fifties. The term ‘natural menopause’ implies that menopause is not the result of a medical condition or surgery. Menopause is considered after it's been one year since your last menstrual cycle.

The menopausal period can be broken down into three stages:


Your perimenopausal period is a time of transition and could start up to ten years before you reach menopause. During this timeframe, your ovaries produce increasing amounts of the estrogen hormone. This usually occurs when you are in your forties but could even start while you are in your thirties.

You go through perimenopause right up until the time you go through menopause and your body no longer releases eggs and your menses stops. Please note that the last year or so of your perimenopausal period may see a sharp decline in estrogen production. Many women also start to experience lower libido and other menopausal symptoms. Please remember that although you are going through perimenopause, you can still become pregnant as you may still experience your menstrual cycle albeit irregular during this time of your life.


As mentioned, the term menopause refers to the time when your menstrual periods stop. Then your body no longer produces any eggs, and your estrogen production goes through a very significant decrease. You are considered to have reached this stage once you have not had a period for one full year.


Once menopause is reached, you are postmenopausal and will be such the rest of your life. Menopausal symptoms may also ease up or stop during this time, although some women may still experience these symptoms for up to ten years later.

Due to the sharp estrogen decline experienced, you may not only experience low libido in menopause but may see an increased risk in many health conditions like heart disease and osteoporosis. There is much you could do to decrease your possible risk factors, however, such as making certain lifestyle changes and even potentially going on hormone replacement therapy. The latter may have its own set of risks and consequences.

Low Libido In Menopause And Other Menopausal Symptoms

a great presentation of the word hormonal balance with the doctor holding it in a backgroundPlease note that we are talking about natural menopause. In other words, age-appropriate menopause without any health or other complications. Some women do go through menopause at an earlier age due to several reasons. If menopause occurs before the age of 45, it is referred to as early menopause. If it occurs up to and including 40 years of age, it is referred to as premature menopause.

The most common symptoms showing you are menopausal include:

  • Frequent hot flashes
  • Cold flashes and night sweats
  • Frequent urination
  • Insomnia
  • Irritability, mood changes, and even depression
  • Vaginal dryness
  • Dry skin
  • Irregular periods
  • Heart palpitations
  • Unexplained weight gain
  • Unexplained hair loss
  • Aches and pains in your muscles and joints
  • Concentration issues
  • Low libido

Menopause And Your Adrenal Glands

Many women have what is termed 'estrogen dominance' during perimenopause. But how can you have estrogen dominance when estrogen production declines during this period?

The control of both your adrenal and ovarian systems starts in your brain, or, to be more specific, your hypothalamus. In turn, your adrenal hormones are governed by the Hypothalamic-Pituitary-Adrenal (HPA) axis, and your ovarian hormones by the Hypothalamic-Pituitary-Gonadal (HPG) axis. These, and other various axes, work in harmony to keep your body, and its hormones, in a state of balance.

While your ovaries produce estrogen, the hormone is also, albeit in smaller quantities, produced in adipose (fat) tissue and in your adrenal glands. Furthermore, your ovaries, besides producing estrogen, also produce progesterone.

So, what happens now is that while your progesterone and estrogen production in the ovaries may decline, your adipose tissue and adrenal glands still produce estrogen. This implies that although your estrogen hormone production may decrease in its entirety, your progesterone levels go down relatively more in comparison. You may thus sit with a situation that shows estrogen dominance, but, the levels of both these hormones are low. In other words, while your estrogen levels may see a gradual drop as you progress through perimenopause, your progesterone levels show a much more exaggerated decrease. This may result in many of the symptoms mentioned, including loss of libido in menopause.

How To Counteract A Loss Of Libido In Menopause And Other Symptoms

Many women seeing a loss of libido in menopause become anxious to regain their sex drive. This is perfectly normal because a woman in her fifties is far from old and may still want to engage in sexual activities with her partner. There is something you can do to help remedy the situation.

Using Natural Remedies

a presentation of healthy foods carved and formed into a word eat healthyMany women opt for natural remedies to counteract their loss of libido in menopause. The most popular natural remedies include soy, black cohosh, and red clover.

Please be sure to first talk to your healthcare professional before taking these remedies because each has its benefits. Soy, for example, contains estrogen and may interact with other estrogen therapies if you are on them. Your healthcare professional may also suggest other natural remedies that better suit you to increase your libido.

Making Appropriate Lifestyle Changes

Lifestyle changes start with healthy eating. A balanced diet may provide your body with the vitamins and minerals your body needs to combat many of the different symptoms associated with menopause. Exercise is another. Just thirty minutes of regular exercise may help reduce many menopausal symptoms, including a lower libido.

If you happen to find sex uncomfortable, do consider using a water-soluble lubricant. Do make sure it is water-soluble, however, especially if you use condoms as protection because silicone-based and non-water-soluble lubricants could weaken condoms and rupture.

You and your partner could also consider going for sex therapy to explore ways to overcome any libido issues you may have.

Hormone Therapy

an illustration of hormone therapy as diagnosed and written by a doctor towards patientMany women opt for hormone replacement therapy (HRT) when suffering from menopausal symptoms. Please note that HRT has its own set of possible side-effects and associated symptoms. If considering HRT, please make sure to ask your healthcare professional to explain all the risks to you in detail so that you can make an informed choice as to the suitability for you. Commonly deployed hormones include estrogen, progesterone, testosterone, melatonin, DHEA, and pregnenolone. It is recommended to use hormone sparingly and only as needed. Multiple hormone replacement for those with adrenal fatigue tends to be problematic unless the body is well balanced at the foundational level. Excess or indiscriminate use of hormones can bring many undesirable side effects, including adrenal crashes, ache, hair loss, hirsutism, insomnia, and anxiety.

Besides HRT, you could also consider prescription estriol cream that one applies directly to the vaginal area for vaginal dryness.


Going through menopause may be very difficult for some women. Many symptoms could manifest during this time to make life very uncomfortable. Yet, although it is no consolation, many of these symptoms disappear or see a considerable reduction once you reach menopause. One that concerns many women is a loss of libido.

If you are suffering from a loss of libido in menopause, these are some things you can do.

  1. Try natural remedies like black cohosh, red clover, and soy.
  2. Consider making lifestyle changes as mentioned.
  3. Explore the use of hormone replacement therapy or estrogen cream with your primary healthcare professional.

If you would like to know more or need more assistance with the loss of libido in menopause, the team at Dr. Lam Coaching can help. We offer a free** no-obligation phone consultation at +1-626-571-1234 where we will privately discuss your symptoms and what your options are. You can also send us a question through our Ask The Doctor system by clicking here.

© Copyright 2021 Michael Lam, M.D. All Rights Reserved.

Dr. Lam's Key Question

This is a difficult question to answer because low libido in menopause is often the result of the accompanying reduction in hormone production. That being said, though, adrenal fatigue could influence your hormonal imbalance. So, while adrenal fatigue may not cause menopause, it could worsen your symptoms.

© Copyright 2001-2021 Michael Lam, M.D. All Rights Reserved.
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