Detailed definition
Libido, or sexual desire, is a multifactorial state shaped by sex steroid hormones (estrogen and testosterone in women), neurotransmitter systems (dopamine and norepinephrine promote desire; serotonin and prolactin suppress it), psychological state (mood, stress, attention, body image), relational context, and medication exposures (SSRIs, beta-blockers, hormonal contraceptives in some women). Libido naturally declines with age and across the menopause transition. Hormonal contributors include falling ovarian estrogen and testosterone, with the testosterone drop being more abrupt in surgical menopause. Non-hormonal contributors include sleep loss, fatigue, dyspareunia from GSM, depression, body image changes, and the cumulative effect of long-term partnerships. The Decreased Sexual Desire Screener (DSDS) is a brief validated tool to identify clinically significant low desire that may warrant treatment.
Why it matters in menopause
Asking about libido directly opens the door to treatments that women rarely volunteer to discuss. The clinical question is not just "is it there" but "is its absence causing you distress" — many women have lower spontaneous desire and are not bothered, while others are. Distress is what defines HSDD and what guides treatment.
Related terms
Sources
External references: Wikipedia.