Loss of libido on Prostap

[Incakewetrust]

Hi,
This is my first time posting on the menopause board so I hope this is ok.

I’m mid 30s and currently on Prostap whilst waiting for a radical hysterectomy due to lifelong gynae issues. For the 3 months I’ve been on it, I’ve been absolutely fine except for irritability and hot flushes.
Today however, I realised it’s been a few weeks since I’ve felt any form of arousal and with it being our anniversary, we were hoping to have an intimate evening.
That however has gone to shit as it genuinely feels like my sex drive has well and truly died a death.

I’m sure I’m not the only one who’s experienced this so I was wondering if anyone has any advice? I know some people swear by different supplements whilst in the menopause so is there something I can take to help revive my libido? I’m not ready to lose this part of my life.

Forgot to add, I’m on a low dose of Tibolone.

Anyone?

Sorry you've had no replies @Incakewetrust
Maybe because this is quite unusual a question.

It's hard to know what to suggest without knowing why you're having a radical hysterectomy in your 30s. Is this an absolute decision and no other option?

I assume they want to stop your ovaries functioning first- but why do this rather than just do the op?

And if they're blocking your estrogen, is the Tibolone to help reduce bone loss with a type of HRT that won't stimulate your womb?

Without knowing why you're having the op, it's really hard to suggest anything.

Post-op you should be on HRT (maybe not Tibolone) and also add testosterone for libido. But I'm assuming this can't be offered at the moment because one criteria is it has to be balanced with estrogen.

What's the plan for the future with HRT after your op?

I’m having the hysterectomy due to endo, other gynae issues and severe PMDD.
The prostap is sort of a trial menopause to see how my mental health will fare whilst I’m in menopause and if all is good, they will remove everything and if not, they’ll leave the ovaries but remove everything else.
So far, so good so they’ll be removing everything.

In all honesty, nobody has talked to me about what HRT will be offered post surgery. I’m due another appt with my consultant in a few weeks so will ask them.

Are you also being advised by a consultant who knows about menopause?

There is an absolute need for HRT if you have your ovaries removed at 35. You need to discuss this in detail because you will need HRT for many years to protect your bones, heart and brain. This is standard medical guidance for early menopause (either surgical or natural.)

You've already got some side effects- loss of libido.

Why are you taking Tibolone? Is this your HRT 'trial' because it is a form of HRT. You can't accurately judge the effects of Prostap when you're also using Tibolone.

https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/tibolone/about-tibolone/

Thank you so much for replying.

The reason for tibolone wasn’t discussed with me, it was just given to me by the consultant and I was told after my first injection that I should only start taking the HRT when I get the first symptoms of menopause. That was genuinely all he said to me.

Tibolone is HRT.

It must be hard to get your head round being prescribed a drug but not told why or the benefits.

It has pros and cons and it's not usually first choice, but it is definitely HRT.

It is supposedly more 'androgenic' meaning it is aligned to male hormones and should in effect increase libido.

In all honesty I’ve felt very unsupported by my consultant so far.
I’m going to be asking a hell of a lot of questions at the next review.

That’s really interesting that tibolone should increase my libido. I’m on quite a low dose so I’ll ask my consultant if it can be raised.
I really appreciate your time and advice! Thank you

There is only one dose of Tibolone- there's not a low or high dose option. So if your Dr said it's 'low dose' that's not quite right. You will see it listed here under e) (half way down the page) as a type of HRT used for women post menopause.

https://www.menopausematters.co.uk/postmeno.php

e. Gonadomimetic
LIVIAL (TIBOLONE) 2.5mg*
gonadomimetic synthetic preparation with weak estrogenic, progestogenic & androgenic properties

Presumably you have been advised that a hysterectomy is not a cure for endo (but you mention other gynae issues.) The endo will be elsewhere, so a hysterectomy won't eradicate that.

Hey @Incakewetrust I’m also on my 3rd month of prostap, to suppress inflammation from my endo / adeno ahead of my final ivf embryo transfer. I’m having awful hot flushes, dry vagina, occasional palpitations and zero sexual desire; so symptoms match with you!

Ok I think you need to be my consultant 😂 I’ve had more information from you than him so far!

I don’t know anyone irl on prostap so haven’t been able to compare symptoms with anyone so thank you! This really helps.
I’ve also been getting palpitations but I assumed it was from my coffee habit 😂

Also good look with your transfer! I hope all goes well 🤞