The article and the advice here is thanks to the rather wonderful Professor John Studd. Professor Studd is an expert in this field and I am proud he has agreed to let me publish his advice directly here for readers. 

I do hope you find it useful and if you have any comments, something to add, your personal experiences or need to ask a question, then just pop that into the comments section at the end and I’ll get back to you as soon as I can.

Libido and Menopause

Depression and loss of your libido

So, you may be asking yourself “what has your libido got to do with depression?” The answer is quite a lot actually; because they are interconnected by the changes in your hormone levels and personal circumstances.

Now, this may sound strange, but I always ask my clients about their libido. If the couple is happy and having regular intercourse, no further questions are needed and they should carry on enjoying themselves. If not, there will probably follow some very personal questions:

  • Are you having orgasms?
  • If yes, do you have orgasms easily?
  • I would even ask whether orgasms occur with no partner around (the so-called “solos”)?

And usually, these questions are asked and answered without any embarrassment from either side. In fact, often my clients are pleased to have a reason to discuss such private matters with a neutral practitioner as understandably, it’s not the easiest thing to talk about with friends and family.

Your libido

I see the libido as a barometer of how well people feel and by “people” I am of course, referring to women. I have no interest in men, well unless they play rugby or sing at the opera! Your Libido is a measure of your physical, emotional, hormonal and relationship characteristics as a woman. The good news ladies is, a loss of libido can be easily treated along with other menopausal problems including depression, with the appropriate hormones so don’t despair, you could be re-enacting the movie, 9 ½ weeks before you know it! Am I showing my age here, should I be saying “50 Shades of Grey”?

So what can cause a loss of libido?

There are many factors that can cause a loss of libido, stress at work, relationship problems, alcohol intake, getting older and a major cause is depression.

Depression can cause a loss of your libido and in turn, a loss of all other emotional and physical pleasures in life and, if given the wrong treatment can make things worse. For example, if you’re depressed and are given antidepressants, often there is an immediate loss of libido as well as frequent weight gain, which, as you can imagine, is very difficult to correct whilst still taking antidepressants. The danger is, that if the antidepressants don’t work because you have Reproductive Depression of a hormonal origin, you will then be given another antidepressant and then another one and your sex life becomes a thing of the past sometimes leading to further tensions in your relationship and a vicious circle that is hard to break begins.

What I find frustrating is, if you’ve been suffering from cyclical depression and have failed to respond to repeated psychiatric interventions, you will often be incorrectly labelled as suffering from Bipolar Disorder. Now you’re in real trouble, with a new batch of personality and libido destroying drugs that will be prescribed as well as hospital admission for what should actually be an easily treatable condition. In my opinion, Psychiatrists have little understanding of the importance of hormones in the treatment of depression in women.

As well as this, many women going through the menopause suffer from vaginal and vulva dryness which leads to discomfort during sex followed by a wish to avoid sexual intercourse at all costs. This is due to the vaginal atrophy of estrogen deficiency. Apart from causing discomfort and burning during intercourse, it can also lead to bladder problems and recurrent cystitis after almost every episode of intercourse. These problems can strain the relationship and provide further indications to give estrogens.

Your libido is a complex coordination of your heart, head and hormones…”

I often make the point in my lectures that your libido is a complex coordination of your heart, head and hormones and if they’re all working together, you can feel fantastic, if not, then there are ways you can get help.

Your heart

If you no longer like your partner because of his behaviour or lack of attention/attraction that is a problem of the heart that doctors, unfortunately, cannot help you with. It might be worth talking things through with your partner and seeing if you can work things out. For help and advice, you may find it useful to contact the relationship support charity Relate

Your head

If your head is cautious because of your background and beliefs about the whole concept of sexuality and sexual pleasure that is a problem that may need appropriate counselling.

Your hormones

Now, this is where I can help. If it is a hormonal problem, this can be treated easily with the appropriate therapy which I go into in more detail below. Treating menopausal symptoms can boost your sex drive indirectly by improving your general well-being and energy levels.

Transdermal testosterone implants

Transdermal testosterone implants are inserted through your skin into the fat of the abdomen or buttock and this treatment has been available for about forty years. This treatment works well but currently, there is a problem, in that manufacture ceased for two years following a decision by the company’s accountants, not doctors. However, they are now slowly being drip-fed into the market at ten times the original cost I might add. I have a supply of 200mg pellets that I have to cut in half but at the time of writing, we expect to obtain next month testosterone pellets of the correct 100mg dose from a new supplier.   However, we have been promised this monthly over the last two years – so we shall wait and see.


Understandably, not everyone, particularly younger women, wants the minor surgical procedure of an implant so it is important to have some more acceptable method of administering this hormone through the skin. Initially, this was done with a patch, the ‘Intrinsa preparation’ containing a low testosterone dose which improved sexuality creating two extra sexual episodes per month! However, the Food & Drugs Administration (FDA) did not think this was an adequate improvement but, nevertheless gave the product a license. Unfortunately, the public also seemed to think this modest improvement in libido was not adequate and as it did not produce an adequate profitable market share the company withdrew it in October 2012. Fortunately, estrogen patches are available in the appropriate doses and are actually quite popular, they work well but there is a problem of skin irritation and staining. The preparation Estradot with the smallest surface almost avoids this local problem.

Transdermal testosterone cream or gels

The best preparation now is, without a doubt, transdermal testosterone cream or gels. However, at the time of writing, these gels are only licensed for men. Therefore it is usual to use approximately one-tenth of the male dose daily making a single tube (the daily male dose) last for about ten days. This works well but usually gives a concentration level slightly above the normal range. I am not at all concerned by this, but no doubt this way, the gels are more effective than the Intrinsa patch. This Testim or Testogel will be given in combination with the oestradiol gel or Oestrogel. This combination is my first choice hormonal therapy for virtually all patients who need HRT for their menopausal symptoms, their depression, their libido or their low bone density.

Thus the combination of transdermal oestradiol and transdermal testosterone is a very effective treatment for loss of libido and the many types of depression that occur in women. They will also over the years correct and prevent osteoporosis if used long enough. The treatment is also very safe and we must ask ourselves why is it not used more often for depression in women or for libido problems? And also for the long term for the almost total avoidance of osteoporotic fractures.

I hope you have enjoyed reading this and that it has reassured you that a loss of your libido can be easily treated and you can have many more years of enjoying sexual intercourse no matter what age you are.


Original article by Professor John Studd, DSc, MD, FRCOG,

Consultant Gynaecologist, The London PMS & Menopause Clinic,

46 Wimpole Street, W1G 8SD

T: 0207 486 0497



See full article here:



Article Edited by Kathryn Colas,

February 2015.