Understanding Low Libido in Menopause
Why it happens, why it’s so common, and what you can do to feel like yourself again
Changes in sexual desire during menopause are incredibly common — but also incredibly misunderstood. Many people blame themselves, feel ashamed, or assume low libido is just something they have to accept as they get older or after breast cancer treatment.
Here’s the truth:
Low libido is common. It’s valid. And there are real, effective options to help.
Your desire isn’t “gone.” It’s responding to changes in your body — and those changes are treatable.
What Is Low Libido?
Libido isn’t just about spontaneous sexual desire — it’s about interest, pleasure, connection, and comfort in your body. During perimenopause and menopause, shifts in hormones, sleep, mood, and physical comfort can all influence how your desire shows up.
Many people notice:
Less interest in sex
Feeling “neutral” about intimacy
Increased anxiety around sex
A disconnect between wanting intimacy and wanting sexual activity
These experiences are very common — and none of them mean anything is wrong with you - or that you can never feel a higher level of desire again.
Why Does Low Libido Happen?
Hormonal Changes in Menopause
Estrogen and testosterone both decline during the menopause transition. These hormones affect not only desire, but also blood flow, lubrication, arousal, and comfort. When they shift, libido often shifts too.
Breast Cancer Treatment
Cancer therapies — especially hormone-blocking treatments like tamoxifen or aromatase inhibitors — can intensify menopausal symptoms, including low libido.
These medications reduce estrogen levels to manage breast cancer treatment and recurrance risk, but the effects on vaginal comfort and desire can be significant.
Many survivors are never told this could happen. Even fewer are offered solutions.
We’re here to change that.
Dryness, Atrophy, and Pain
This is one of the biggest, most overlooked factors.
When sex becomes uncomfortable — or even irritating — desire for it naturally decreases.
Which is why the first step in treating low libido is often to address underlying contributing causes:
Vaginal dryness
Burning or irritation
Vaginal atrophy
Pain during sex or exams
Pelvic floor muscle tension
Once comfort is restored, desire often returns more easily.
Other Contributing Factors
Fatigue
Mood changes
Sleep disruptions
Stress or caregiving burden
Relationship dynamics
Medication side effects
Low libido is rarely caused by just one thing — which is why it’s important to get help from an expert who can help you untangle and address your contributing causes.
What Can Help?
1. Start With Comfort: Moisture, Pain Relief, and Tissue Health
Before focusing on desire, we focus on what affects your body’s ability to want sex.
This may include:
Regular vaginal moisturizers
Lubricants for sexual activity
Low-dose vaginal estrogen (with safe formulations for breast cancer survivors)
Pelvic floor physical therapy if muscles are tight or reactive
Once tissues feel comfortable, many people notice their desire returning naturally.
2. Specialized Vaginal Formulations
If standard treatments don’t provide enough relief, or if you have complex symptoms, compounded options can help support arousal, comfort, and libido.
These may include:
Vaginal DHEA (a localized option that supports tissue health and arousal)
Customized moisturizers or gels designed for your specific symptoms
Combination formulations that target dryness, elasticity, and blood flow
Compounded treatments can be especially helpful for individuals who require additional support with blood flow and arousal, even after the vaginal and vulvar tissue has been healed.
3. Low-Dose Testosterone Therapy
Testosterone plays a role in libido for people of all genders — and low levels can contribute to low desire in menopause.
Low-dose testosterone therapy can:
Increase sexual desire
Improve arousal and responsiveness
Support sexual satisfaction
Boost energy and sense of wellbeing
4. Sex Therapy and Partner Communication
Even when physiology improves, many people benefit from support that helps rebuild connection, confidence, and pleasure.
Sex therapy can help with:
Navigating changes in desire
Reducing anxiety around intimacy
Reconnecting with your body
Improving communication with a partner
Many people find that desire grows when stress decreases and emotional intimacy improves.
Low Libido Is Treatable
Low libido during menopause or after breast cancer treatment isn’t a personal failing — it’s a natural response to changes in your body and life.
And with the right combination of:
Comfort-focused treatments
Personalized hormone or non-hormonal options
Support for arousal and desire
Compassionate, expert care
…you can feel like yourself again.
At Corla Health, we’re here to help you understand what’s happening, explore what’s possible, and find treatments that actually work for your body and your goals.
Because your pleasure, comfort, and desire aren’t luxuries —
they’re part of your health.