Where Did My Sex Drive Go? What Women Should Know About Low Libido
By Michelle Clay, FNP
“I could honestly never have sex again and be perfectly fine.”
I hear some version of this from women all the time. I’ve even felt this way myself.
Maybe you used to enjoy sex. Maybe you used to initiate it. Maybe intimacy felt like a normal part of your relationship.
And now?
You just...don't care.
For many women, the change happens gradually. For others, it feels like someone flipped a switch.
And while libido naturally varies from person to person, a noticeable loss of sexual desire—especially when it bothers you—is worth paying attention to.
Low Libido Isn't Always Just About Your Relationship
One of the biggest misconceptions about low libido is that it automatically means something is wrong with your relationship.
Sometimes relationship issues absolutely play a role.
But sexual desire is influenced by much more than attraction.
Hormone changes, medications, stress, poor sleep, depression, anxiety, pain with intercourse, vaginal dryness and certain health conditions can all affect sexual desire.
And during perimenopause and menopause, hormonal changes can become an important part of that picture.
What About Testosterone?
Women have testosterone too.
Although our levels are much lower than men's, testosterone plays a prominent role in female sexual function.
As women age, androgen levels change, but here's where I think we need to be careful:
A testosterone level alone doesn't diagnose the cause of low libido.
I don't look at a woman's lab result and say, “Your testosterone is low. That's the problem.”
I want to know what's happening in the rest of her life and health.
Did her libido change suddenly?
Is sex painful?
Has she started a new medication?
How is her relationship?
How is she sleeping?
Is she experiencing other symptoms of perimenopause or menopause?
Most importantly: Does the loss of desire bother her?
That last question matters.
When Low Desire Becomes HSDD
There's actually a medical term for persistent low sexual desire that causes significant personal distress: Hypoactive Sexual Desire Disorder, or HSDD.
And I think simply knowing that can be validating for women.
You aren't required to want sex a certain number of times per week. There's no magic number that makes your libido “normal.”
If your level of desire has changed but you're perfectly content with it, it may not be a problem at all.
But if you've lost your desire and you want it back, that's different.
Testosterone Isn't Automatically the Answer
I prescribe testosterone for some women, but I don't believe every woman with low libido needs it.
Treatment depends on what's actually contributing to the problem.
Sometimes we need to address vaginal discomfort.
Sometimes medications are contributing.
Sometimes sleep, stress or relationship factors are significant.
And for appropriately selected women—particularly after menopause—testosterone therapy may be one option worth discussing.
The goal isn't to chase a particular testosterone number.
The goal is to understand why your sexual desire changed and determine whether there's something we can do about it.
Has Your Sex Drive Changed?
If you've noticed a significant decrease in sexual desire and you're wondering whether it could be more than “just getting older,” I've created a short HSDD Assessment to help you evaluate your symptoms.
It only takes a couple of minutes.
👉 Take the FREE HSDD Assessment
About the Author
Michelle Clay, APRN, FNP-C
Michelle Clay is a Family Nurse Practitioner and founder of Balanced Health, a Kentucky-based telehealth practice specializing in women's hormone health, thyroid optimization, insulin resistance, and weight-loss resistance.