Symptoms of Midlife & Menopause

Low Libido

”It’s not that I don’t love my partner, I do. I just don’t want it anymore!”

Many women have come to our office with frustration over their lack of desire. If you have been experiencing changes in your sex drive, you are not alone! Even if you and your partner have a good history of mutual satisfaction, it is common to see changes in libido both during and after menopause.

There are many different physical, psychological, and interpersonal reasons that might be getting in the way of experiencing satisfying sexual experiences. Pain during intercourse, for example, is one of the most prevalent issues that women experience after going through menopause.

true. Women’s Health works with you to find the best techniques to manage low libido.

Over 50% of women experience low libido during menopause.

Why Does Libido Change During Menopause?

There are at least 27 different reasons for low sexual desire, including Hypoactive Sexual Desire Disorder, medications, insecurities, low estrogen or testosterone, depression, painful penetration, vaginal dryness, and anxiety from daily stressors. 

From a scientific standpoint, lower sex drive during and after menopause makes sense. During a woman’s period cycle, the brain releases a chemical signal for the ovaries to release an egg. This same signal, the LH surge, also increases sex drive. Estrogen levels peak around this time as well to help with sexual response. As your cycle starts to shift and estrogen levels drop during menopause, it is natural to experience a dip in sexual desire.

What is the Libido Puzzle?

At true. Women’s Health, we teach and think about sex drive, or libido, using the analogy of a puzzle. Each person has a libido puzzle, men included. There are about thirty pieces to this puzzle, and a certain number must be in place to avoid libido distress. Libido distress occurs when there is dissatisfaction about the amount and/or type of intimacy between partners. If too many pieces of your puzzle are missing, then libido distress will be high, and sex is unlikely to occur. Long-lasting libido distress can place significant stress on your relationship. Understanding your personal libido puzzle can be crucial to your relationship staying healthy.

Five Tips for Reawakening Sexual Desire


Explore Your Personal Libido Puzzle: Knowing your libido puzzle (and your partner’s!) can be crucial to keeping your relationship alive and healthy. Examples of libido puzzle pieces are physical self-image, trust, life satisfaction, hormone balance, energy, and level of physical comfort. Exploring different aspects of your libido puzzle can help you to reinvent communication with your partner and deepen intimacy within your relationship. Dr. Bitner’s Sex Deck Cards gives couples a chance to learn more about their personal puzzles by laying their cards on the table – literally. Couples may be struggling with physical, psychological, or interpersonal challenges impacting their sex lives, and the Sex Deck covers many of these factors to jumpstart conversations about intimacy.


SEEDS®: It is important to remember that our body’s overall health impacts sexual health. Our bodies have non-negotiable needs that must be met to function optimally. SEEDS® – Seven Essential Elements of Daily Success – focuses on the seven essentials that impact your midlife transition. If you supply your body with these basic essentials on a daily basis, you are more likely to alleviate symptoms often associated with menopause, including fluctuations in sexual desire.


MonaLisa Laser Therapy for Painful Sex: Pain during intercourse is one of the most prevalent issues we see women coming to us with. The majority (about 80 percent!) of women develop issues with pain after going through menopause. Despite this, women often struggle with discussing sexual discomfort and dissatisfaction and instead internalize feelings of blame and shame. At true. Women’s Health, we use a device called the MonaLisa Touch to alleviate pain during sex. MonaLisa Laser Therapy is a (mostly) painless light therapy that is one of the most effective non-hormonal treatments for painful sex after menopause. Learn more about saying goodbye to painful sex


Pelvic Floor Physical Therapy: For women who experience pain during sex, the cause can be endometriosis or tight pelvic muscles. Pelvic Floor Dysfunction and pelvic muscle spasms are also common, and a pelvic floor therapist can work with you on your specific issue to improve overall sexual function. We’re happy to have a pelvic floor physical therapist here at true. Kara Fahlen, PT, DPT, FAFS provides care to women of all ages with issues of pain with sex and urinary leakage/urgency.


Counseling:  At true. Women’s Health, when couples schedule a visit to see Dr. Bitner together, the conversation usually turns to sex because it tends to cause the most friction between many couples. Having an objective third-party ask questions allows both partners to express concerns and complaints. It can become much easier to see what small changes can be made to improve sexual experiences for both parties. We have two wonderful therapists on staff that can help.  

It’s never too late to better your sex life and prioritize your pleasure! The only way to solve an issue is to talk about it openly, so don’t hesitate to chat with us about improving your sex life. We are happy to help, and there is no need to suffer! Hormone therapy, lubricants, help with vaginal dryness with the MonaLisa Touch® laser treatment, or just simple advice could be right for you.

Learn About Other Common Symptoms of Midlife + Menopause

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Brain Fog Memory Loss

Mona Lisa and Vaginal Dryness Couple Feature Photo

Treatment for Vaginal Dryness

Which program is right for you?

Complete Wellness

Primary Care +
  • 24/7 Access
  • Midlife + Menopause
  • Hormone Optimization
  • Sexual Health
  • Gynecological Care
  • Same Day/Next Day Appointments
  • Primary Care
  • Functional/Integrative Medicine
  • Free MonaLisa Touch® Consult
  • Care Navigation

Basic Wellness

Healthy Aging
  • 24/7 Access
  • Midlife + Menopause
  • Hormone Optimization
  • Sexual Health
  • Gynecological Care
  • Appointments Within One Week
  • Free MonaLisa Touch® Consult

Cancer Wellness

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  • Cancer Risk Assessments
  • Heart Health
  • Sexual Health
  • Cancer-specific Menopause Care
  • Free MonaLisa Touch® Consult