Menopause gets all of the attention these days. This is good for women as we come to understand and aggressively treat the often debilitating symptoms of menopause. But what about perimenopause? For some women, perimenopause can be more disruptive than menopause due to the wildly fluctuating hormones during this period. One of the possible consequences of what can be a years-long journey is a significant impact on libido. Some women report a complete abscence of sexual desire. Let’s take a closer look at perimenopause and how to cope and manage a loss of libido.
What is Perimenopause?
Perimenopause is the transitional stage leading up to menopause when a woman's body begins to produce less estrogen, testosterone, and progesterone. Ovulation may become erratic and then stop. This phase can start several years before menopause, typically in a woman’s 40s, but it may begin in the late 30s for some and can last up to 10 years.
Perimenopause ends when a woman has gone 12 consecutive months without a menstrual period, signaling the onset of menopause. Some women sail through perimenopause with few symptoms, but others endure years-long hormonal fluctuations. Here are some of the typical symptoms of perimenopause:
Irregular periods or skipping periods
Mood changes, including depression and anxiety
Changes in sexual desire (some women have a decline in sexual desire, and others may experience an increase)
Weight gain that can be a challenge to control
Trouble concentrating and problems with memory
Headaches
Night sweats
Hot flashes
Vaginal dryness
Trouble sleeping
Joint and muscle aches
PMS-like symptoms
Perimenopause and Libido
Libido is complicated enough even without the changes perimenopause brings. For example, how was your sex life before perimenopause? Is your relationship with your partner strong? Have you had a strong sex drive throughout your life or the opposite? What about sexual trauma or religious or cultural influences? Here are some of the ways perimenopause and declining hormones affect libido:
A higher estrogen level typically means a higher level of sexual desire. As estrogen levels decline during perimenopause, libido can decrease with it.
We now know that testosterone plays a significant role in sexual desire for women. Testosterone levels drop naturally between the ages of 18 and 40 and accelerate during perimenopause.
Depression and anxiety can negatively affect sexual desire.
Weight gain can affect self-esteem and confidence, which can affect libido
Fatigue decreases interest in sex.
Vaginal dryness makes penetration painful.
Arousal becomes challenging, if not impossible.
Difficulty reaching orgasm
Fatigue can impact sexual desire.
How to Treat and Cope with Loss of Libido During Perimenopause
If you have a partner, the first step is to have an open discussion about what perimenopause is and your symptoms. If you are with a man, he may have no idea about why you have fluctuating moods and a lack of interest in sex. Having these discussions sets the stage for adapting your approach to sexual intimacy. Meanwhile, consider these options to cope with a lack of libido during perimenopause.
Adjust and Adapt
Sexual intimacy takes many forms, and you and your partner may need to adjust your expectations. You may prefer other forms of intimacy, such as massage, cuddling, or masturbation. Give your perimenopause treatments time to work. Help your partner realize that your lack of interest in sex is not personal.
Hormone Therapy
Hormone replacement therapy is a logical consideration for treating symptoms of perimenopause, but due to fluctuating levels, it can take patience and trial and error. At Optimal Hormone Health, we use an approach to perimenopause that includes labs, individual goals, and a holistic approach to wellness and symptom management. We may recommend a method of hormone replacement that is more appropriate for changing hormone levels.
Lubrication and CO2RE Intma Laser
Vaginal lubrication and or estrogen can be used to address vaginal dryness and painful penetration. Our CO2RE Intima is a non-surgical laser treatment that stimulates collagen production to address the following:
Vaginal Dryness
Painful Intercourse
Stress Incontinence- such as leaking while coughing, laughing, etc.
Loss of vaginal tone & elasticity
Low Dose Antidepressant
For some women who have significant symptoms of depression and or anxiety, a low-dose anti-depressant can help. Specifically, selective serotonin reuptake inhibitors (SSRIs) can be helpful. Talk with your primary care provider about the medication best for your situation. However, keep in mind that anti-depressants can have sexual side effects such as reduced sex drive and difficulty reaching orgasm.
Regular Exercise
Fatigue and brain fog can make regular exercise challenging, but if you persist, you will reap the benefits. Regular exercise can help you sleep, manage anxiety, stress, and depression, and improve your self-esteem.
Healthy Diet
A healthy diet will give you energy, help you manage weight, and cope with stress. Focus on eating plenty of vegetables, fruit, and whole grains. Avoid processed foods, dairy, and meat products if possible since they may contribute to inflammation.
Weight Loss
Losing weight has benefits far beyond improving self-image and increasing libido. It can reduce the risk of heart disease, stroke, diabetes, and certain cancers, including breast cancer in postmenopausal women. Improved mobility makes it easier to exercise and improve overall health. You will sleep better, feel better, and have the energy to achieve your goals.
Getting Through Perimenopause
Perimenopause can be a tough time for many women. However, you can mitigate symptoms by taking a proactive and committed approach to treatment and lifestyle changes. Loss of libido is, unfortunately, one of the fallouts of fluctuating hormones, but you can and will eventually recover your sexual desire.
Comments