I recently attended the British Menopause Society’s annual conference. One of the lecturers was a sex therapist

and what she said clicked for me. She said, something along the lines of.. desire is not like hunger. It does not appear without a stimulus… In other words, you don’t just “get turned on” by nothing the way we suddenly realise we are hungry because of a lack of food.

Although hormones like Estrogen and Testosterone are important, there has to also be the following:

1. A stimulus: hugging, kissing, affectionate words or something to start you revving and

2. The right setting. And setting is a broad term – It’s not just a cosy bed in the candlelight although that helps, but it’s also where you are in your head and what your stress levels are. If you are lying there worrying about the cobwebs you can see on the ceiling or wondering how long it is going to take because you are hearing the garbage truck down the road and you haven’t yet put out the bins then you won’t be so tuned into the foot rub or kisses he or she is giving you. If you are not sleeping because of hot flushes you will be too tired … Or if you are late for work. … you get the drift. And the truth is that the perimenopause and menopause happens for most of us at the busiest time of our lives. We have busy careers. We have stroppy teenagers. We have elderly parents who now also need our help. So the loss of “libido” that I hear people complaining about is not ALWAYS down to a reduction in hormones although of course that can underpin everything. Sometimes it is more complex….and as for Testosterone:

Almost every woman thinks she needs Testosterone treatment to “perk up” her sex life. Yes, women do need some Testosterone. Our ovaries do produce some Testosterone and sometimes as our ovaries start to wind down our Testosterone levels can fall a little. But our adrenal glands also make Testosterone. It is true that in SOME women Testosterone therapy can help…Especially in women who have had their ovaries surgically removed. But Testosterone can help ONLY if you have enough Estrogen on board to keep the vagina nice and lubricated. If everything down below is dry and painful because of a lack of Estrogen then Testosterone might just frustrate you! If you get the HRT right and try to fix the sleep and stress and find the time to have some non pressurized fun then often that is enough. Only then if things in the bedroom are still waning would I then consider Testosterone.– and the way you take it is important. I hear of doctors here giving Testosterone shots. Please think twice before taking these. Testosterone via the skin in a gel form is much safer. We give it to women in the peri and menopause in a much lower dose than what is given to Men.  You are also less likely to get side effects from overshooting a female’s normal Testosterone level to give you male side effects like a deeper voice and hair growth! By the way, even men should be careful about Testosterone injections. I have one patient who got a clot in the lung from these injections! (Not from me)

Anyway, if you are interested in following Dr Karen Gurney (sex therapist) she is on Instagram @thesexdoctor. She has lots of advice for people not just about Sex and The Menopause but about all aspects of our Sex lives! If you need help with HRT or stress then come to see us!