Wala nang gana? Low libido in menopause is common, and it is not your fault

Desire is not just hormones. In midlife several things stack up at once:

• Falling estrogen makes the vagina drier, so sex can hurt. Pain kills desire fast. See vaginal dryness.
• Testosterone falls gradually with age, and suddenly when both ovaries are removed (surgical menopause). Women's Health Concern notes many women do not notice the gradual fall, while others are more sensitive to it.
• Night sweats and poor sleep leave you too tired. See sleep.
• Mood and stress: caring for kids and aging parents, work, money. See mood and anxiety.
• Body image and relationship changes.

It also goes the other way for some women. Filipinas on Reddit have asked whether a higher libido in their 40s is normal (r/AskPinay). Personal reports are not evidence, but they show that changes in either direction are common.

Ask your doctor to look at:

• Thyroid. An underactive thyroid lowers energy and desire. A TSH test is ₱490 per test (Exact Check).
• Anemia. Heavy periods in perimenopause can cause tiredness.
• Depression. Low mood and loss of interest in things you used to enjoy go together. Treating depression can help desire.
• Medication. The NHS lists some antidepressants and blood pressure medicines among medicines that can lower sex drive, and some hormonal contraception can too.
• Diabetes and other long-term illness. The NHS names heart disease, diabetes, an underactive thyroid and cancer as conditions that can affect sex drive.

Prices checked October 2026.

Treating vaginal dryness and pain: Strong evidence for the dryness itself. Low-dose vaginal estrogen rebuilds the tissue (The Menopause Society 2022; NICE 2024). PH options, Rx only: estradiol vaginal tablet (Vagifem), ₱154.50 per tablet (Watsons), and estriol cream (Ovestin), ₱1,009 per 15 g tube (Watsons). See vaginal estrogen.

HRT: Some evidence, mostly indirect. HRT eases hot flashes, night sweats, sleep problems, low mood and vaginal dryness (NHS), which can make sex more comfortable and more appealing. It is not mainly a libido treatment, which is where testosterone comes in. See HRT for menopause.

Testosterone: Some evidence. NICE (2024) says testosterone can be considered for low sexual desire in menopause if HRT alone has not helped. When we checked, we did not find a testosterone product licensed for women on sale in the Philippines. Do not use men's products or compounded creams without specialist advice.

Talking therapy and sex therapy: Some evidence. The NHS suggests relationship counselling when relationship problems are part of the picture, and talking therapies such as CBT when low mood or anxiety is. A small 2024 trial of CBT for sexual concerns in menopausal women reported less sexual distress and better desire, but it was a pilot study.

Non-hormonal hot flash medicines: Not enough evidence for libido. Some SSRIs on our non-hormonal treatments page can lower desire, so ask your doctor.

Supplements (maca, ginseng and others): Not enough evidence. See our honest supplement ratings.

Prices checked October 2026.

See a doctor soon if you have:

• Bleeding after sex, or any bleeding after menopause. Read bleeding after menopause.
• New pain during sex that does not ease.
• Low mood most days for 2 weeks or more, or thoughts of harming yourself. In a crisis call the NCMH Crisis Hotline: 1553 (landline, nationwide), 0919-057-1553 (Smart/TNT), or 0917-899-8727 or 0966-351-4518 (Globe/TM). It is free and open 24/7.

Use the symptom checker, then find a doctor. Our talk to your doctor page has scripts for raising this without embarrassment.