Low libido
Less interest in sex, or less pleasure from it, than before.
What it feels like
Less interest in sex than before, less pleasure from it, or no spontaneous desire at all. For some women it is a relief that goes unmentioned; for others it is a real loss, and a source of tension at home.
Why it happens
Several things overlap. Falling oestrogen causes vaginal dryness and discomfort, which reduces desire on its own. Tiredness, low mood, stress and relationship factors all matter. And testosterone, which women produce in smaller amounts than men, contributes directly to sexual desire and falls with age.
Low libido is not automatically hormonal, and it should not be dismissed as inevitable either.
What can help
- Treating vaginal dryness often makes a substantial difference by itself.
- HRT helps by easing the symptoms that get in the way: poor sleep, low mood, flushes and discomfort. See how HRT works and what it involves.
- Testosterone is considered where desire remains low and distressing despite established HRT. It is prescribed and monitored by a doctor, with blood tests to keep levels within the normal female range.
- Where relationship or psychological factors are central, psychosexual therapy is often more useful than any prescription.
Read more about testosterone for women
When to see a doctor
If low libido is bothering you, it is worth raising. It is common, it is treatable, and a doctor can look at the whole picture rather than one part of it.
A personalised HRT plan looks at desire alongside sleep, mood and comfort rather than treating it on its own. Loss of desire often begins in perimenopause, before any other symptom is obvious.
Often goes with low libido.
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Intimacy
Vaginal dryness
Dryness, itching, soreness or discomfort during sex, sometimes with urinary symptoms.
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Sleep & energy
Sleep problems
Waking at 3am, lying awake, and never quite feeling rested.
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Body
Joint pain
Aching, stiff joints and muscles, often worse in the morning, without an obvious injury.
Free three-minute symptom check
Not sure which symptoms are hormonal? Take the menopause quiz.
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Questions about low libido, answered.
Why has my sex drive dropped?
Vaginal dryness, tiredness, mood changes, relationship factors and falling hormones all play a part. It is rarely one thing, which is why it is worth talking through properly.
When is testosterone considered?
Where desire remains low and distressing after oestrogen and progesterone are established, and vaginal symptoms have been treated. Low desire persisting on good HRT is the pattern that points to testosterone deficiency.
Can women be prescribed testosterone in the UK?
Yes, although there is no testosterone product licensed for women in the UK. Doctors prescribe it off-licence in line with national guidance, using a male preparation at a much lower dose, with blood tests to keep levels in the normal female range.
What if sex is uncomfortable rather than unwanted?
Discomfort usually needs treating first. Vaginal oestrogen is very effective, and there are non-hormonal options too. Desire often returns once sex stops hurting.
Hormones matter.
Let's treat them properly.
Medical care that puts you back in control, with a doctor who listens, clear options and treatment tailored to you.
