Thursday, April 14, 2011

Loss of Libido (Sex Drive) in Women during Menopause

“At this age, it’s unusual for somebody to do a love scene, to be making love... (But) we still are alive... it’s authentic. The whole idea that you have to look a certain way and be a certain way to earn love is ridiculous.” (Actress Meryl Streep, about her on-screen sex scene at age 60, as quoted in The Times (London) (12/21/2009)).

Loss of libido can be one of the most difficult symptoms of menopause to manage, often because a woman might not understand how and why she has lost the desire to be physically intimate with her partner. It is important to recognize that loss of libido during menopause is common, affecting as many as 20 to 40 percent of women.

Learning more about loss of libido, its myriad causes, and how it can be managed, can not only bring a woman peace of mind but is the best step towards resolving this complex symptom of menopause.

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About Loss of Libido

Loss of libido is a complex phenomenon with psychological, relational, physical, and hormonal dimensions as unique as the women who experience them.

The term libido has long been used to describe a person's sexual drive and their desire for sex. Loss of libido, medically termed "hypoactive sexual desire disorder," is a reduction or lack of interest and desire in sexual activity.

Loss of libido is chiefly characterized by a lack of interest or desire for sexual activity. Many women with loss of libido find that they are less in touch with their sexuality. Sexual feelings come less frequently and energy for sex drastically dwindles or disappears from a woman's life.

Loss of Libido Overview

While loss of libido differs from the inability to become aroused or achieve orgasm, menopausal women may also experience these symptoms of sexual dysfunction.

While male sex drive is easy to define -- and relatively easy to restore -- that's often not the case for women. Because the female sex drive is multi-factorial, the desire to make love is not only influenced by physical issues, but emotional ones as well.

"Part of the desire to make love is clearly physical, but part is also emotional – depression can make a difference, so can any emotional issue in a woman's life; female sex drive is very multidimensional," says Glenn D. Braunstein, MD, an endocrinologist and chair of the department of medicine at Cedars Sinai Medical Center in Los Angeles. While emotions are frequently behind a loss of sex drive in younger women, doctors say it is frequently the aging process itself that's causes changes in desire in women over age 45. "The very fact that a woman is no longer ovulating regularly, or not ovulating at all, automatically takes her sex drive down a few notches," says Steven Goldstein, MD, professor of ob-gyn and NYU Medical Center in New York City. He also continues that trying to avoid sex because of associated difficulties only leads to more pain. The old "use or lose it" theory really does apply. "From a strictly physical standpoint, the less sex you have the more painful it is when you try to have it," he says.

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Causes of Loss of Libido

Like many menopausal symptoms, the primary cause of loss of libido has its roots in hormonal imbalance. However, physical, psychological and relationship issues can affect the libido during menopause as well.

Hormonal Causes of Loss of Libido

During menopause, one of the most common identifiable causes of loss of libido is hormonal imbalance. Reductions in the levels of three major hormones can contribute to the reduction of sexual drive and energy.


Estrogen plays a vital role in female sexuality by increasing sensations, assisting in the production of vaginal lubrication, and maintaining the health of vaginal tissue.

As a woman approaches menopause, her body begins to produce less estrogen. This can cause a host of symptoms that can contribute to a woman's loss of libido, such as hot flashes, night sweats, irregular periods, and vaginal dryness.


Progesterone hormones are also integral to maintaining sexual health. When levels are too low during menopause, the resulting irregular periods, fatigue and other menopause symptoms can cause loss of libido.

Androgens/ Testosterone

As with estrogen, the body begins to produce lower levels of androgens (e.g. testosterone) with age. Experts believe that this drop in androgens can also cause women to experience loss of libido around the time of menopause.

While hormonal change is often a major cause of loss of libido during menopause, other factors can also cause or contribute to a woman's loss of libido. Read on to learn about these other causes of loss of libido

Other Causes of Loss of Libido

In addition to hormonal causes of loss of libido, several other factors can lead to this common menopausal symptom. The other causes can be separated into three categories: physical, psychological, and relational causes. These other causes are listed below.                                                                                                            

Physical Causes

• Sexual dysfunction
• Pain-related conditions
• Medication use
• Hysterectomy
• Diabetes
• Heart disease
• Anemia
• Chronic disease
• Vaginal dryness     

Psychological Causes

• Stress
• Fatigue
• Changes in self esteem and body image
• Concerns about aging
• Feelings about sex
• Psychological disease (e.g. mood swings, depression, and anxiety)   

Relational Causes

• Changes in partner's   physical health
• Intimate relationship   changes
• Availability of partner
• Lack of communication   between partners
• Changing social role
• Family changes
• Low sex drive in partner
• Major life changes

Loss of libido is a complex symptom of menopause with many potential causes.

Chronic Stress and Sex Life

Most of us know that chronic stress isn’t healthy, but we may not realize the toll it takes on libido. The body interprets ongoing stress as life threatening, so naturally, survival is prioritized ahead of pleasure. Stress over-burdens the adrenal glands, “stealing” the substances normally used to make estrogens and testosterone, both vital to desire and sexual response.

Many women we talk to at the clinic and in our Personal Programs tell us they feel overwhelmed by stress. This puts them at significant risk for adrenal imbalance. If you are under constant stress, you’re not going to feel much like having sex. So in the interest of your health, and your sex life, it may be time to reassess the conditions that are creating stress in your life.

There’s also a connection between nutrition and libido, because nutrient deficiencies stress your internal systems and set the stage for hormonal imbalance. Many women diet continually to improve their appearance, unaware that ongoing nutrient deprivation can have a drastic impact on physical health, energy levels, and self-image. All of these effects make you feel awful and drain your sex drive. Note that low-fat diets are especially problematic, because your body needs lipids and cholesterol to make hormones, including the testosterone needed for sexual response.

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Treatments for Loss of Libido

Fortunately, loss of libido can easily be treated through a variety of methods. Oftentimes lifestyle changes such as a few changes in diet and exercise patterns will not only help to treat loss of libido, but corresponding stress and anxiety as well.

You CAN improve your sex drive by...
  • Restoring balance between the three major sex hormones.
  • Practicing sound nutrition to support physical and emotional health, and taking steps to get regular, restorative sleep.
  • Exercising, to build energy and stamina, both elements of libido. Exercise can also directly reduce menopausal symptoms.
  • Healing old emotional wounds, and being aware that stress takes both an emotional and physical toll on your libido.
  • Understanding that your self-image and sexual identity evolve throughout your life. It’s a gift to allow yourself to be (and look like) the woman you really are.
Recommended Foods

  • Oysters, Red Meat, Liver, Kidney Beans (zinc)   
  • Leafy Greens, Almonds, Buckwheat (magnesium)
  • Lean Meats, Fish, Nuts, Dairy (protein)
  • Edamame, Tofu, Miso, Soymilk (soy products)

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Recommended Exercises

  • Yoga (increased flexibility, relaxation)                                                                                            
  • Kegel Exercises (strengthens vaginal muscles)
  • Aerobics (heart health, circulation)
  • Stretching (relaxation, stress relief, improved muscle tone)                                                        

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However, because the root of the problem for women going through menopause is a drop in hormone levels, the best way to treat this problem is to go directly to the hormonal source. Natural supplements are an excellent and safe way to achieve this.

In more extreme cases, there are medical solutions such as surgery or pharmaceutical options, though due to risk of side effects or other complications this should be the last resort.

Sources and Additional Information:

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