Let’s set the record straight: As Dr. Kelly Casperson likes to say – “you are not broken”. If your desire has changed, if you’re feeling disconnected from your sexuality, or if you’re wondering where your libido ran off to—this isn’t a personal failure. It’s a signal. And it’s normal.
But unfortunately, women are rarely taught that.
The Problem Isn’t You—It’s the Messaging
From a young age, women are taught that our sexuality should look a certain way: spontaneous, effortless, perfectly timed. And if it doesn’t? We must be broken, cold, or “not trying hard enough.”
In reality, female desire is complex, influenced by hormones, relationship dynamics, body image, mental health, stress levels, past experiences, and how safe or seen we feel in our own skin.
Libido Isn’t Just a Switch
We’re often told that libido is either “on” or “off”—but that’s not how it works. Female desire is more like a responsive system than a spontaneous urge. That means desire often follows arousal, not the other way around.
In other words: you might not feel in the mood until things are already happening—and that’s normal.
What Happens in Midlife?
During perimenopause and menopause, hormonal changes (especially declines in estrogen and testosterone) can impact:
- Arousal
- Lubrication
- Sensitivity
- Overall interest in sex
Add in poor sleep, joint pain, body image issues, stress, and an overloaded schedule—and it’s no wonder desire takes a hit.
What Helps?
- Talk about it. With your partner. With your provider. With someone who won’t dismiss you.
- Treat the physical. Vaginal estrogen, hormone therapy, or even testosterone may help.
- Get curious. What feels good now? (Desire in midlife may look different than it used to—and that’s okay.)
- Use your brain. Erotica, fantasy, communication, and novelty all play a role in building desire.
- Ditch the shame. You are not broken. You are changing. And that deserves compassion, not judgment.
The Bottom Line
Desire isn’t something you “should” feel—it’s something that can be nurtured, supported, and reimagined. If you’re struggling, it doesn’t mean something is wrong with you. It just means it’s time to take a different approach.
Your pleasure matters. You matter. And you are definitely not broken.
👉 Desire doesn’t disappear—it just changes. You’re not broken. You just need someone who understands the full picture. Let’s talk about what’s next.
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.
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