Libido
Decreased libido in midlife stems from multiple sources: estrogen decline, testosterone shifts, relationship dynamics, and side effects of other medications. We cover the full clinical landscape.
Articles
10 articles in this topic.
Vaginal Dryness Treatment Options: An Evidence Guide for Menopause
A clinician-reviewed guide to vaginal dryness treatment options during and after menopause, covering moisturizers, lubricants, hormonal therapies, DHEA, ospemifene, and what current NAMS and ACOG guidance recommends.
Low Libido in Perimenopause: Causes, Evidence-Based Treatment Options
Low libido in perimenopause affects up to 40% of women aged 40-55. Causes span declining estradiol, testosterone shifts, vaginal dryness (GSM), sleep disruption, and SSRIs. This guide synthesizes NAMS, ISSWSH, and ACOG evidence on treatment options.
Testosterone for Women and Libido: What the Evidence Shows in 2026
Testosterone for women with low libido is supported by the 2019 Global Consensus Position Statement for postmenopausal HSDD. Transdermal physiologic dosing reduces sexually satisfying events versus placebo. Here's what the evidence shows and how to discuss it with a clinician.
Pelvic floor dysfunction: the underdiagnosed libido issue
Pelvic floor tightness causes pain with intercourse, which extinguishes desire. Pelvic floor PT often resolves underlying physical barrier before medication.
Libido changes after hysterectomy: ovary-sparing vs total
Removing ovaries causes immediate surgical menopause; uterus-only removal preserves natural hormone production but can still affect libido through other pathways.
Can women take testosterone safely?
Despite no FDA-approved testosterone formulation for women, off-label transdermal testosterone has strong evidence for hypoactive sexual desire disorder в postmenopausal women.
Testosterone for women: realistic side effects timeline
Acne and increased body hair are most common at higher doses. Voice changes and clitoral enlargement are rare but irreversible. Monitoring protocols.
Vaginal estrogen: low-dose, low-systemic, high-impact
Topical estradiol creams, rings, and tablets restore vaginal tissue without significant systemic absorption. First-line for genitourinary syndrome of menopause.
Flibanserin vs bremelanotide: comparing FDA-approved HSDD drugs
Both are FDA-approved for premenopausal HSDD but differ dramatically. Daily oral SSRI-adjacent vs on-demand injection. Side effects, efficacy, and patient fit.
Why does libido drop в midlife?
Decreased libido in perimenopause comes from estrogen, testosterone, and vaginal tissue changes. Vaginal estrogen, off-label testosterone, and flibanserin lead the clinical toolkit.
Other topics
Hot Flashes
Sudden heat sensations during perimenopause and menopause — causes, treatments, and providers.
Brain Fog
Memory, focus, and word-finding difficulty linked to hormone fluctuation — what helps.
Weight Gain
Abdominal weight gain in midlife and the role of GLP-1, HRT, and lifestyle interventions.
Sleep
Hormonal sleep disturbances — night sweats, insomnia, early waking — and treatments.
Mood
Anxiety, depression, and irritability tied to hormonal shifts — clinical perspectives.
Joint Pain
Estrogen decline and joint stiffness — emerging research and treatment options.
Hormonal Acne
Adult acne tied to androgen imbalance — clinical options including spironolactone.