Beyond the Hot Flash: Loss of Libido during Perimenopause

Beyond the Hot Flash: Loss of Libido during Perimenopause

loss of libido in perimenopause

By Rebecca Mendoza, CNP, NCMP

One of the common symptoms of perimenopause is loss of libido, or a lower than normal sex drive. As upsetting as a sudden loss of sexual desire might be, the good news is that it’s a perfectly normal physical response to the hormonal fluctuations of perimenopause. That means that bioidentical hormone therapy can help.

How Hormones Affect Libido during Perimenopause

Progesterone, testosterone and estrogen are the hormones that can cause anything from minor to dramatic changes in your sex drive. Even small fluctuations can affect libido, but the drop-off in progesterone production alone that’s associated with perimenopause can put the brakes on your ability to become aroused and your interest in anything sexual.

Many other things can affect your level of libido, from the attentiveness of your partner to your daily stress levels. For instance, there’s no bioidentical hormone that can make your partner remember to toss the dirty socks in the hamper or buy a thoughtful anniversary gift! Kids at home, financial worries, work problems and anything stressful can affect your libido. But if nothing in your life has changed recently, and you want to desire sex but don’t understand why that feeling isn’t there, it’s a good idea to look at perimenopause as a possibility.

Feeling stressed and irritable can also be caused by hormone fluctuations, which can make determining the real problem tricky. This is why it’s so important to have a health care provider who won’t just try to prescribe something to treat one symptom, but who will listen to your needs and your individual situation to figure out if perimenopause could be the cause.

Often, related symptoms will appear with the lack of sex drive. Vaginal dryness, a sense of less muscle strength in the vagina, and even a less sensitive vagina and clitoris may accompany loss of libido. The drop-off in progesterone production can alter the ratio of hormones, allowing estrogen to far overpower it. This abundance of estrogen is linked to these sexual and vaginal symptoms, along with other things like weight gain, fatigue and mood swings that don’t seem to have any other causes.

Testosterone’s Role in Perimenopause

While testosterone is considered the “male” hormone, the already low testosterone levels in a woman’s body drop off during perimenopause, too. This can contribute to loss of libido which testosterone replacement can help. And even though estrogen may be tipping the scales as the hormone most present, the level could still be far lower than normal, making the sexual side-effects, among others, even worse.

Using a commercial prescription for progesterone or something like Androgel testosterone replacement could be a waste of time and money if fluctuations mean that you need a mixture of hormones to help balance the levels in your body. Bioidentical hormones can be mixed in custom amounts depending on the variety and severity of your symptoms. These custom mixes are known as compounded bioidentical hormones, which are an excellent way to help keep hormones at normal levels and ratios. There is currently no FDA-approved testosterone preparation for women. Androgel, a product for males, is a stronger dose than what women need and too often women are instructed to use a “dab” without knowing the dose they are getting. For this reason, testosterone is best compounded for women in doses of 1-4mg.

Since compounded bioidentical hormones are designed to meet your specific needs, they offer a great benefit over commercial formulas. Custom mixes can be adjusted until you find the right formula to help restore your sex drive and ease the other uncomfortable symptoms of perimenopause.

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