Hormonal imbalance and low sex drive

“I had NO desire whatsoever for an intimate relationship. All my friends had told me, ‘You’re not going to have any desire in perimenopause.’ So when it came back I was stunned — and so was my husband!” — Pamela, Personal Program Member

Almost all women experience loss of sexual desire at some point in their lives, most commonly during perimenopause. Although the reasons may be as complex as women’s sexuality itself, at Women to Women we most often see the following root causes of decreased sex drive.


The most basic cause of low sex drive in women is hormonal imbalance, which comes in many forms. Progesterone is crucial to libido, and the natural fall in its production during perimenopause can wash away sexual desire all by itself.

Vaginal dryness and thinning of the vaginal wall — two common effects of declining estrogen — can make sex so painful that you dread it.

Fatigue caused by hormonal imbalance or poor nutrition — especially excess caffeine, high carbohydrate intake, or a lack of protein — saps your energy and interest in sex.

Adrenal exhaustion lowers the hormones that fuel sexual response. And for the women who enter menopause medically, usually through hysterectomy, hormonal imbalance is almost a given, at least initially.

Declining ovarian function also lowers a woman’s testosterone levels. While we think of testosterone as a male hormone, there are smaller amounts made by a woman’s ovaries that are vital to healthy sexual response and orgasm — crucial aspects of sexual dysfunction.

Your ovaries’ production of testosterone can be impaired by hormonal imbalance, prescription drugs, disease, or as the result of hysterectomy. (Even for women who have a partial hysterectomy, in which the ovaries are not removed, over 50% experience diminished ovarian function, because removal of the uterus often affects blood supply to the ovaries.)

A woman’s sexuality may also be an issue. For many women their sexual identity is rooted in their attractiveness to men, which is typically based on having a youthful body. As their bodies change at mid-life they may feel undesirable and therefore less interested in sex.

Some women believe that sexual desire is shameful or inappropriate as they get older. Women who’ve been unassertive about their sexuality in the past may now prefer to sacrifice their sex lives rather than become assertive about what’s required to satisfy their sexual needs. And women without partners may be daunted by the prospect of “dating” again.

Many experts believe that relationship issues are the most difficult factor to resolve. By mid-life, most couples have accumulated enough routine and unresolved resentments to squash any spark of intimacy or romance — unless they work to keep it alive. Moreover, perimenopause is naturally a time when you stop accepting unfair treatment from your partner. For many couples, it’s easier to withdraw than to change that unfair treatment.

You can do something about each of these causes — and we urge you to. There is no reason to give up on having a healthy sex life. It’s vital to the life force that supports your mind, body and spirit.
We've had great success solving the underlying issues of hormonal imbalance.