Real Talk: What To Do When Your Libido Takes a Nose Dive
Everything you need to know when you've lost that lovin' feelin' and you want it back.
Hello from Columbus, Ohio where the whiplash between winter and spring is a thing of wonder. Last Monday we woke up to a very unexpected 4 inches of snow (surprise!!!) and now it’s sunny and deliciously warm. Since I seem to be solar powered, I’ll be out soaking up as much warmth as possible before it gets cold again in a few days.
I was chatting with a friend recently who told me her libido has taken a major hit since turning 50. Our conversation was the motivation I needed to revisit the email series on low libido I sent out a few years ago and get it posted to Hot & Bothered.
As always, my goal is to provide helpful foundational information and then to point you to experts in the field. Thankfully, there are some amazing resources I’m excited to share with you.
But first of all, let’s get to some basic information I think all midlife women should be know:
What is low libido?
Low libido (officially known as Hypoactive Sexual Desire Disorder) is defined as a prolonged decrease in your baseline level of sexual desire that you find bothersome.
Basically, you’ve lost that lovin’ feelin’ and you want to get it back. If low or nonexistent libido doesn’t bother you, you don’t need to treat it.
It’s important to understand that low libido can involve biological, psychological and social factors. In other words: there are a lot of puzzle pieces to consider when troubleshooting low libido, not just hormones.
What pharmaceutical options are there?
Flibanserin is FDA-approved to treat low libido in both pre and post menopausal women.
Bremelanotide is FDA approved to treat low libido in pre-menopausal women only.
Testosterone is not currently FDA-approved for treating low libido in women, although many doctors will prescribe it off-label. The Menopause Society does recommend testosterone therapy for low libido in appropriately screened postmenopausal women.
*Please note that testosterone dosing in women needs to be VERY carefully considered (the dosing is a fraction of what would be prescribed in men) and hormone pellets are not a safe way to take testosterone.
Are there any resources you recommend if I want to know more?
Menopause expert Dr. Lauren Steicher has a podcast series focused on the biological factors involved in post-menopausal libido, which you can listen to here when you subscribe to her Substack. The small subscription fee is worth it, especially since you’ll gain access to the rest of Dr. Streicher’s menopause-focused content, which is an excellent resource for midlife women.
Anything else I should know?
Yep. A few things:
Medication to increase desire isn’t going to be helpful if you’re too exhausted to think about sex, resent your partner, can’t stand to be touched because you’re experiencing body confidence issues, or the sex is painful. This is why The Menopause Society talks about recommending testosterone in “appropriately screened” women vs. all women with low libido.
That said, if you’re experiencing low libido, there is every reason to hope. There are so many aspects of low libido you can explore/troubleshoot with great rates of success - so stay tuned!
xo, Rebecca
P.S. Do it for her.
P.P.S. Happy International Women’s Day!