Spoiler alert: Your sex drive isn’t broken. It’s just been left out of the conversation. Desire changes in midlife are common, normal, and absolutely treatable—but most women are never told that.
What Happens to Desire in Midlife?
- Hormonal Shifts
Estrogen and testosterone decline, which can affect arousal, lubrication, sensitivity, and desire. - Physical Discomfort
Vaginal dryness and painful sex? Not exactly a turn-on. - Stress, Fatigue, and Mental Load
Libido doesn’t thrive under chronic stress or exhaustion—hello, modern womanhood. - Relationship Dynamics
If intimacy feels disconnected or routine, desire naturally follows.
What’s “Normal”?
There is no one-size-fits-all libido. What matters most is how you feel about it. If changes in desire are bothering you or affecting your relationship, it’s worth addressing.
What You Can Do
- Address physical barriers (vaginal estrogen, lubricants, etc.)
- Explore hormone therapy (including testosterone, if indicated)
- Reduce stress and improve sleep
- Get curious—what do you find pleasurable?
- Work with a doctor who takes sexual health seriously
The Bottom Line
Low desire doesn’t mean you’re broken, frigid, or failing. It means your body, brain, and hormones are changing—and you deserve care that recognizes that.
Your sexuality didn’t expire at 45. It just needs support.
👉 If your sex drive has packed up and left, it might be time to invite your hormones back to the conversation. Want to talk about what’s actually going on? Book a call.
Need support or want to learn more about treatment options? Schedule a free 15-minute call to see how we can work together.
Dr. Aoife O’Sullivan is a family physician, board certified by the American Board of Family Physicians and a menopause specialist, certified by the North American Menopause Society, dedicated to empowering women through their midlife health journeys. She is the founder of Portland Menopause Doc, co-founder of the Portland Menopause Collective, podcaster on The Dusty Muffins, and an expert speaker, frequent podcast guest and active contributor to midlife women’s health research.
Learn more
