Q&A: No Sex Drive Post-Menopause

Question: I am a 54-year-old female. Only a few years ago, I was one very lusty woman. Now, after going through menopause, I am left without one iota of a sex drive. Not only do I not have the drive, but the idea of doing it seems repulsive and stupid. It isn't just being with my husband that doesn't interest me; no man is sexually interesting to me anymore.

Since I no longer have feelings, I could easily live without sex for the rest of my life, but my husband is unhappy with my total lack of interest. I have talked with two different gynecologists -- one male, one female -- and both of them basically pooh-poohed me with talk like, "Well, sometimes it comes back." Is there anything I could take over-the-counter that would help make me even vaguely interested?

Answer: I am sorry to hear about the problems you are having. Women's reactions to menopause can vary greatly, but it is not unusual to lose at least some level of sexual drive. The fact that you had strong sexual desire prior to menopause -- and that you now no longer desire sex with any man -- tells me that your current condition is almost certainly due to the drop in hormone levels caused by menopause.

Unfortunately, it is not unusual for doctors to "pooh-pooh" women's concerns in this area. As a professor who trained students at two medical schools, I can tell you that many medical professionals' level of training or understanding about human sexuality is truly abysmal. Most doctors in our country have not had one single course (or even a one-day seminar) in normal sexual functioning. Therefore, they often rely on their own notions, anecdotal evidence and pat answers such as "sometimes it comes back."

In this day and age, with so many excellent treatments for post-menopausal difficulties, there is no reason for you to lack your previous "lustiness" for the rest of your life. While there are no over-the-counter drugs or creams that will do much good (despite claims by their manufacturers to the contrary), there are several prescriptions that would almost certainly help. Hormone replacement therapy (HRT) has been shown to be safe and effective, and can actually prevent many disorders of later years such as osteoporosis and Alzheimer's. I would suggest that you inquire about a form of therapy that combines estrogen with a form of synthetic androgen. Many doctors don't understand that it is really the androgens that influence sexual desire. Also, if some ill-informed doctors tell you this is a bad or dangerous approach, it is because they are recalling old studies using large doses of testosterone. Modern forms of these drugs are safe and effective and are generally free of major side effects. Of course, you don't have to do any of this. Given that you say you could easily live without sex for the rest of your life, you may choose to do just that. There is no value judgment here; many women make this choice. Of course, this can have a strongly negative impact on your relationship. While I am sure you are heavily weighing that possibility, the choice is ultimately yours. You need to decide what will make you the happiest, then shop around for a doctor who will help you achieve just that.
1 2 Next
Print Article