I’m a 53-year-old woman and I recently lost my libido overnight. I woke up and it had gone. I used to have a very good sex life, though I do get some vaginal pain during and after sex. What has happened to me?
Dr Philippa Kaye answers: A sudden loss of libido can often be triggered by the menopause.
The mid-life condition leads to a loss of sex hormones. Most women will go through it in their 50s – though it can happen earlier or later.
It’s common for this fall in sex hormones to lower libido. Moreover, certain forms of menopause can lead to vaginal dryness. Sex can then become painful and, as a result, less appealing.
The good news is that there are a number of steps people can take to tackle this problem.
Many women who take hormone replacement therapy (HRT), the most common menopause treatment, report that it can improve their libido.
This isn’t necessarily because the drug itself boosts libido – rather, it can combat other symptoms such as hot flushes and poor sleep that reduce sexual desire.
Vaginal oestrogen – creams and tablets applied directly to the vagina – are very effective at combating dryness. This in itself can help boost libido.
Menopause leads to a loss of sex hormones, which commonly results in a lower libido. Most women will go through it in their 50s – though it can happen earlier or later (picture posed by models)
A GP should be able to prescribe these menopause treatments.
For some women whose low sexual desire persists despite HRT, testosterone therapy may be an option. This is a male hormone but women produce it, too.
However, levels fall with age, leading to low sex drive. It can be difficult to get hold of testosterone on the NHS because it is not a licensed treatment for women in the UK.
Some GPs can prescribe it, but others have to refer patients to specialist menopause clinics or gynaecologists.
Many patients opt to pay for testosterone at a private clinic.
Pharmaceuticals are not the only option when it comes to treating menopause-related low libido. Research shows that regular exercise; good sleep habits; limiting alcohol intake and smoking; and eating a balanced diet all improve sex drive.
It’s also important to consider other causes beyond the menopause. It’s possible that a sudden loss of libido could be due to stress, anxiety or depression.
These problems can be triggered by life pressures such as work demands, caring responsibilities or relationship difficulties, or occur on their own.
A GP can refer patients with these issues for talking therapy, or psychosexual therapy, which can help improve sex drive.
There are also medicines that trigger low libido. These include (perhaps ironically) antidepressants as well as blood pressure tablets.
Loss of libido can be triggered by life pressures such as work demands, caring responsibilities or relationship difficulties, or other causes of anxiety, stress or depression
I constantly have to get up in the night to go to the toilet. I don’t drink water before bed, but this doesn’t help. What should I do?
Dr Philippa Kaye answers: Needing to go to the toilet in the night is common. Typically, avoiding drinking water before bed won’t tackle the problem. But there are other effective measures.
Known by doctor as nocturia, waking in the night to pee becomes more of a problem in later life. Most older adults will wake once or twice in the night but, for some, this can get worse and worse, until they are going almost every hour.
Understandably, this can be distressing and disrupts sleep.
There are a few steps that everyone with nocturia can take to reduce the frequency. As well as avoiding fluids two to fours hours before bed, patients are often told to steer clear of tea, coffee, fizzy drinks and alcohol as these all irritate the bladder, triggering the need to pee.
However, for others, treatment will depend on the cause.
GP, author and broadcaster Dr Philippa Kaye
For many, nocturia can occur due to fluid that builds up in the legs during the day. Patients would normally have noticeable swelling in their legs if this is the cause. This always merits a GP appointment, as it can be a sign of potentially serious heart problems.
Patients are typically advised to elevate their legs in the two hours before bed, as well as go for regular walks in the day, to stimulate the leg muscles and stop fluid from accumulating.
For men, nocturia can be caused by an enlarged prostate, as the walnut-sized gland can continue to grow in later life. Other symptoms would usually include difficulty peeing and the sensation of not being able to fully clear the bladder.
There are medicines that patients can take to help with an enlarged prostate. In severe cases, surgery may be required.
In rare cases, a change in bowel habits can be a sign of cancer. This is why patients who experience this issue should always tell their GP.
Nocturia can also be a sign of poor sleep quality – as the body produces less urine at night and should normally be able to ignore the need to pee.
If you wake up a lot at night you will be more aware of the need to go. This can be tackled by going to bed and waking up at fixed times, avoiding screens before bed, and ensuring the bedroom is cool and dark.
The NHS can also offer patients sessions with a bladder training specialist. This is a practitioner who can provide exercises and tips to improve bladder control.
Any patient who experiences pain while peeing or sees blood in their urine should see their GP immediately to rule out the risk of cancer.
- Write to Dr Philippa Kaye at Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: health@mailonsunday.co.uk – include contact details. Dr Kaye cannot enter into personal correspondence. Replies should be taken in a general context. Consult your own GP with any health worries.
