Loss of libido in menopausal women. Management issues.

Background: Due to a complex interplay of sociocultural factors, past experiences, relationships and hormones, a woman's experience at menopause and beyond is highly individual. A variety of external, often stressful, life events can be occurring at this time in a woman's life, all impacting on her individual symptom profile. Menopause is a natural event in a woman's life cycle and loss of libido may be one of a multitude of symptoms experienced around this time. In fact, the decline in sexual interest commonly precedes the onset of a natural menopause, even though many women do not report their loss of libido until the menopause, when symptoms may be exacerbated.

Objective: To review contributing factors and treatment options available for menopausal women experiencing loss of libido.

Discussion: With increasing awareness, knowledge and discussion about sexual health issues, there are an increasing number of women seeking advice and treatment for low libido. The introduction of the oral contraceptive pill in the '60s; the increasing use of HRT for menopausal symptoms; the availability of drugs such as sildenafil; the recent acknowledgement and definition of the 'female androgen insufficiency syndrome' are all factors which have contributed to the so-called 'sexual revolution' whereby women and their doctors--are able to feel more comfortable discussing their sexual concerns. Nevertheless, many women will not volunteer this information and it is advisable to specifically ask about libido and associated symptoms of mood and well being.