Libido is simply defined as the urge to have sex. The hormonal imbalances found in peri-menopause, menopause and post-menopause are commonly associated with the decline in sexual drive or libido in women. All the sex hormones play important roles in sexual arousal and responsiveness. As we age, the loss of libido is a common complaint of both men and women. The main deficient hormone culprits are estrogen, progesterone, and testosterone.
Both estrogen and progesterone naturally decrease production during peri-menopause, but progesterone drops precipitously more than estrogen. This can result in estrogen dominance, which effectively can cause low libido in women. This imbalance often causes vaginal dryness, vaginal atrophy or thinning, and decreased clitoral sensitivity. The other consequences of estrogen dominance, including mood swings, weight gain, and fatigue, add to the problem. Too little estrogen can cause similar vaginal problems resulting in vaginal discomfort and painful intercourse.
Reduced ovarian function, caused by hormonal imbalance, aging, or a hysterectomy, lessens the amount of testosterone a woman produces, especially in post menopause. The ovary produces testosterone throughout a woman’s reproductive life. Production of testosterone begins to decrease in most women in her forties and sometimes even sooner. Natural levels of testosterone in a woman in her 40s are half that of when she was in her twenties.
While testosterone is mainly considered a hormone for men, it also serves important purposes for women including mood, cognition, increased bone density, maintenance of lean muscle mass, decreased fat storage, and a sense of well-being among others. In terms of libido, testosterone for women serves to heighten sexual response and intensity of orgasms. As a result, low testosterone can cause a loss of libido as well as other adverse health problems.
It is important to realize that testosterone does not increase libido in every woman. Libido in women is multifaceted and involves much more than just hormones although they are critically important. How a woman feels about her partner, his approach to her, fatigue, physical and other psychological factors also play important roles in a woman’s desire and response.
In addition, each woman’s body responds differently to the same level of testosterone. Studies show that some women are more sensitive to the same level of testosterone and can make do with less. When testosterone deficiency is not an obvious cause of deceased libido, other hormone imbalances or deficiencies or both must be explored including thyroid and adrenal dysfunction. Still, a large percentage of women 40 and older have low testosterone levels and increasing these levels with bio-identical testosterone is a safe and effective way to restore libido in those who are symptomatic.