I think it's almost always a combination of things. Which is why it's so hard to deal with. If your FSH levels were off the chart - easy, HRT, solved. But they probably won't be. Maybe just slightly off or even, on the surface, okay. Ditto everything else. But together, it's too much.
I think handing over responsibilities, rather than tasks, can be quite difficult but it is also worth the effort. eg, DH is responsible for football now. It has taken us a while for him to understand that this means he can't ask ME if it's 'okay if he takes an extra shift on a Saturday ... ie, asking ME to then handle figuring out logistics for football for DS while simultaneously managing DD's gymnastics. But we are there now - if he wants to take an extra shift, HE has to figure out what will happen with DS. Even if that means that he then tells me that I have to drop DD, fetch DS, get back for DD and then go fetch DS etc, that's fine. But I'm not thinking about it. HE can be the one to give ME a list.
He's also responsible for all sports kit. Sometimes, that means kit isn't necessarily washed on time. But it's no longer my problem and both him and the kids know that they can't ask me WHY something hasn't been done. Again, if I'm doing washing, and there's sports kit in there, I will absolutely do it. But I'm not thinking about it anymore. Ever.
On Mothers day, my treat was not to have to do or think about anything. For the first time, this genuinely did work. From feeding the pets to lunch for DD - I didn't have to think about any of it. (he was always willing to DO it, but I had to tell him what to do. it was relentless).
Sidebar: Dh gets a lot more sex these days....
It's amazing how NOT having to treat him like a child has improved my sex drive.