The Marion Gluck Clinic

Tackling loss of sex drive during perimenopause

Loss of libido is a common problem affecting up to one in five men and even more women at some point in their life. It’s often linked to professional, personal stress, declining hormones or life-changing events such as pregnancy, childbirth, breastfeeding, perimenopause and menopause.

How hormones affect sex drive

The main causes in the menopausal and the postmenopausal women is the loss of estrogen and testosterone that leads to changes in a woman’s body and sexual drive. Therefore, menopausal and postmenopausal women may notice that they’re not as easily aroused, and they may be less sensitive to touching and stroking. That can lead to less interest in sex. Also, lower levels of estrogen can cause a drop in blood supply to the vagina. That can affect vaginal lubrication, causing the vagina to be too dry for comfortable sex — but there’s help for that – read on! The fluctuating hormones during perimenopause can also affect a woman’s mental health which then, in turn, may cause a decrease in libido.

Tacking loss of sex drive with hormone therapy

As every woman is unique, so are her hormones. Therefore at the Marion Gluck Clinic, we take a holistic approach accessing hormone balance, lifestyle and nutrition to develop a bespoke treatment plan for each client. However, the 2 main ways we tackle sex drive with hormone therapy are:

  • Create Hormone Balance
    As a woman moves through each phase of menopause, hormone levels can fluctuate significantly, however, these vital hormones, such as estrogen, progesterone and testosterone remain important for bones, vaginal and urethral health, skin, brain function and cardiovascular health. It is therefore important to effectively balance and replenish these hormones with bio-identical hormone replacement therapy to maintain a woman’s health, energy, mood, brain function and sex drive.
  • Treat the area locally
    While hormone balance will ensure that you maintain a healthy sex drive you may still need a bit of assistance locally for comfort and arousal. Therefore, we may also prescribe a hormone cream that would be applied to the vagina to increase sensitivity and stimulation.


Clara, a full-time mum, is married to a high flying private-equity trader and is in her mid 40’s. Clara’s concern was not only that her and her husband had stopped having intercourse a couple of years back, but also that she had lost all sexual desire and didn’t quite understand what was happening. She was mildly depressed, excessively tired and lacked stamina. She came to the clinic because she thought it might have been a hormonal problem. After speaking to Clara, we realised that there was no intimacy between her and her husband. Her husband spent 12 or more hours a day at work and perhaps only two or three at home. He usually only had any relationship with the children and his wife on weekends. With a workaholic partner and no intimacy in their relationship, it was no wonder Clara had lost her desire for sex.

She wanted to resume a sexual relationship with him, but after six years was too scared to approach him let alone seduce him. All Clara’s blood tests for various hormone levels came back normal but in a low range. Of course, we could have given her some testosterone supplementation, which might have helped her to be more assertive, confident and might have countered her depression.

Marriage Counsellor:
We advised her to see a marriage counsellor so that she could begin to address the problems in her relationship. From the outside, Clara’s family life looked okay, but from the inside, both partners were becoming increasingly introverted and lonely. Hence, the relationship needed to be sorted out first.

Testosterone Supplementation:
When Clara returned to the clinic a couple of months later, she reported that she and her husband had been to marriage counselling and it was helping. They had resumed a sexual relationship, but Clara admitted it was not particularly gratifying for her. She confided that she had never experienced an orgasm, nor had she ever masturbated. Clara was then prescribed a testosterone cream, to be applied daily. The intention was that it would increase sensitivity so that with the stimulation she could achieve an orgasm.

Book A Consultation Today

Start your journey back to a healthy sex life by booking a consultation with one of our expert doctors today. To book, please call our Patient Care Team on 020 7191 2378, email secretary@mariongluckclinic.com or use our book an appointment form.


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