Less desire for sex in women can rarely be traced back to one cause. Often hormones, stress, sleep, relationship and health play together. On the hormonal side you usually look at three values: testosterone, oestradiol and SHBG.
I notice that women live with this for a long time before they discuss it. That is understandable, because libido feels personal and the cause is not always easy to pinpoint.
Below you read which hormones can play a role, what the causes can also be, which values give insight and when testing is useful.
What role do hormones play in libido?
Hormones are one of the factors that influence your desire for sex, but rarely the only one. Testosterone plays a role in your desire in women too, oestrogen helps with blood flow and the comfort of the mucous membrane. A low SHBG or a changing balance around menopause can help shape the picture.
The hormones that usually say the most about this:
- Testosterone, which plays a part in your desire in women too
- Oestradiol, which helps with blood flow and comfort
- SHBG, which determines how much testosterone is freely available
No single value explains libido on its own. A result is at most a piece of the puzzle alongside your story and your lifestyle.
What else can play a part?
Alongside hormones, many other things influence your desire for sex. Stress, fatigue, poor sleep, medication use and your relationship often weigh at least as heavily. So it is rarely useful to look only at your hormones.
Factors that often play a part:
- Ongoing stress or a high mental load
- Fatigue and poor sleep
- Certain medicines, including some antidepressants
- How you feel in your relationship and your body
Do you mainly feel structurally tired and worn out? Then it can be useful to look at your general health first before looking at your hormones.
Libido and menopause
Around perimenopause and menopause the balance between oestrogen and testosterone changes, and that can affect your desire and comfort. A falling oestrogen can make the mucous membrane drier, which can make sex less pleasant. That is a common, recognisable change.
Do you recognise this alongside hot flushes or a changing cycle? Then read our pillar on perimenopause, symptoms and solutions. If a low oestrogen mainly plays a part, read about oestrogen deficiency, symptoms and what you can do.
Are you unsure whether your complaints belong to your cycle? Then read our pillar on irregular periods and which hormones to test.
When is a hormone test useful?
A hormone test is mainly useful when less desire for sex goes together with other hormonal complaints, such as a changing cycle, hot flushes or fatigue. With libido alone, without other signals, the picture is often broader than a hormone value.
Consider a check if you recognise this:
- Less desire together with a changing or erratic cycle
- Hot flushes, night sweats or a drier mucous membrane
- Ongoing fatigue alongside your libido complaints
The Hormones Women panel measures testosterone, oestradiol and SHBG among others in one draw. You always discuss an abnormal result with your GP, who can place the whole picture, including the non-hormonal side.
What can you do yourself?
Because libido has so many sides, it often helps to look broadly. Attention to sleep, stress and your relationship can make as much difference as a hormone value. What works for you differs greatly per person.
Steps that can help:
- Attention to enough and regular sleep
- Making room for relaxation and less stress
- Opening the conversation with your partner or a professional
If the complaints persist or trouble you, discuss them with your GP. More is possible than many women think, and you do not have to keep sitting with it alone.
Frequently asked questions
Which hormone drives desire for sex in women?
Testosterone plays a role in your desire in women too, and oestrogen helps with blood flow and comfort. But libido depends on much more than hormones alone, such as stress, sleep and your relationship.
Can menopause affect my libido?
Yes, it can. Around menopause the balance between oestrogen and testosterone changes, and a drier mucous membrane can make sex less pleasant. This is a common change you can discuss with your GP.
Does a testosterone pill help in women?
That is not a standard treatment and depends on your situation. Whether a treatment is useful is decided together with a doctor, because the effect and the trade-off differ per person.
References
- Santoro N. Perimenopause: From Research to Practice. J Womens Health (Larchmt). 2016;25(4):332-339.
- NHG. NHG-Standaard De overgang. Dutch College of General Practitioners. Available via richtlijnen.nhg.org.
- Thuisarts.nl. I have less desire for sex. Dutch College of General Practitioners. Available via thuisarts.nl.
Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
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