Sex... Is it me or the perimenopause?

[Need2knowbasis]

Hi,
Age 48, separated a few years young kids. In pretty good shape, on Tinder and Bumble, no real problem attracting men BUT...

I can't seem to get 'into' kissing or sex. I'm not really there in the moment, I'm observing, feeling kinda numb. I have great freedom as my kids are at their Dads at least one night most weekends. I could have lovers but I'd rather not bother. Last night an attractive sexy man who I don't want a relationship with but is very keen on me drove me home after a party... we kissed.... I wasn't bothered. He was a nuisance... they all are :-(

I do want love in my life. It's been 18mths since I was serious about someone. We were only together a few months and it ended traumatically...
I dated someone for a few months this summer and I was warming to him sexually but he kinda ghosted.... I actually think he was dishonest about being open to a relationship.

Sex is important to me. I don't to lose it. And I real want to fall in love for the rest of my life. There is a sex problem here, but I also feel like I'm 'seeing through' these guys too easily... may be being judgemental. It also doesn't help that I live in a smallish town. The men here aren't really my kind of people? Not many attractive single men my age

I don't want to see celibate and alone. Is this my age and hormones or a trauma response? I'm on the pill as HRT, doc says its enough for me for now. Can I get the sexual and romantic energy back? Or is this just what happens to some women. Very sad about it.

@ElephantLover Testosterone is important for both sexes, but estrogen is important and often overlooked competent to female sex drive. If that works alone without the addition of testosterone then that's great.

How long should you give the hrt before asking for testosterone? I've lost all libido and will shortly get a prescription for hrt.

@EarthSight - totally agree. For me Estrogen alone has worked wonders (alongside Progesterone) so I haven't yet thought of testosterone.

@CourtneeLuv - it look me just a week to start feeling different and 4-6 weeks until I felt like my old self again. It's been 2.5 months now and I can't believe i had shut the door on sex last year!

Ok thank you

I was horny before HRT , and horny with it
im also single 🙂

it could be peri meno
but it could also be some stuff going on in your head , stuff that’s valid and needs thinking through ?

There are lots of menopause checklists out there to help you to identify which symptoms affect you right now. Look up Louise Newson and get her app called 'Balance'. Transdermal HRT is extremely safe and I would urge you to get onto this right away, particularly as hormone depletion is telling on your bone condition. HRT protects heart, brain, bone and particularly in my case, joint health. Testosterone is much harder to come by, GPs are often poorly trained and because it is off license, refuse to prescribe it. You can be referred to your local menopause clinic (very long waiting list) and they are more likely to prescribe it. I've found the benefits of all 3 hormones have improved the quality of my life in such a way that I feel pretty much normal. Usually to get testosterone, your oestrogen level has to be properly balanced first. Do your research, don't take no for an answer and check out the NICE guidelines if you run into difficulty. Hope this helps.

My GP in N Ireland will not prescribe Testosterone. She says we cant get it in NI. End of discussion. I was on a waiting list at a clinic in England but there is a massive waiting list!!!!!

Sadly, women and women's health issues are treated abysmally. It's interesting like a previous poster mentioned, the pill is given out like sweeties, but my goodness, a bit of gel and progesterone causes all kinds of uproar. My question to any doctor is if they refuse HRT (and so many still do based on extremely old and flawed research and therefore so many women are left to suffer needlessly), how will they address your hormone deficiency? They are happy to address other hormone deficiencies such as type 2 diabetes with a load of drugs etc. How will they address the zillion other health issues that kill us women off because of menopause and hormone depletion. I'm lucky to have an amazing GP who has supported me in this since I was 45 (I'm 62 now). Thousands of women are not so lucky. I will support anyone on this inevitable female journey. And as far as HRT being messy, putting on a patch or rubbing in some gel is hardly a big deal!!

Stamp, thanks for posting, that's very informative.

Oh my good God. You need body identical HRT not synthetic contraceptive pill. In any case I dont believe the combination pill is advised for late 40s. Body identical simply means it is chemically identical to the hormones your own body produces. oestrogen comes as patches/gels/spray and is taken with body identical progesterone capsules in order to protect the womb lining, though some evidence is beginning to gather that progesterone plays a role in the whole body. There is also a body identical oestrogen tablets though there is a slight increase in clotting risk with that and no increased risk with transdermal. Unlike the contraceptive pill. You could also get the Mirena coil which also protects the womb lining and provides contraception but it's not body identical. There are other synthetic progestin tablets too as some people can't tolerate body identical progesterone.

I can't see how the contraceptive pill would do anything for bone density.

My libido has definitely come back a bit. GPs in ireland do prescribe testosterone for libido but I am ok for now.

Should have said the mini pill is ok for contraception purposes and can be taken with HRT.

OP, please change your ill informed G.P, ask to see a Dr at your practice that specialises in menopause. Also read up on, and print out the NICE guidelines to take with you to your next appointment. It states that Hrt should be prescribed on vasometer symptoms alone and if you're having hot flushes that is enough of an indication for you to be given hrt. You may well feel very different when your estrogen levels are restored but if not testosterone can be added for libido.
Be aware though that many Doctors refuse to prescribe testosterone so you may have to request a referral to a Menopause clinic, though as a previous poster mentioned there is a long wait.

Is it possible you're just not feeling the emotional connection with these guys that you need to be interested in sex? I know I'm not interested physically unless I feel a real emotional connection.

I'm also perimenopausal but, for me, the difficulties are from the antidepressant I started a few months ago.

@LakeIsle48 you can easily get a private prescription for testosterone in England. Try the Harper Clinic for example. All appointments can be done via Zoom etc.

@CourtneeLuv How patient are you? I'd give it a minimum of 2 - 3 months, maybe a bit longer.

There's a lot of misinformation on this thread

In any case I dont believe the combination pill is advised for late 40s.

You can continue to take COCP until 50, once in good health & getting regular blood pressure checks.

I can't see how the contraceptive pill would do anything for bone density.

COCP does actually prevent bone weakening (that's not to say it is sufficient in place of HRT)

also does not allow any fine tuning of estrogen/progesterone ratio (as far as I'm aware), not in the same way as HRT does.

I'm not sure what this means? Oestrogen & progesterone aren't prescribed in ratio? Or perhaps that poster meant that oestrogen doses can be increased, which is true.

The pill is undoubtedly able to address (or rather, suppress) some perimenopausal issues, but not all. And it has the distinct problem of often affecting libido (it did for me when I took it many years ago).

It seems like firstly, the pill is not working for you OP.

I have no doubt that there are a few issues, including emotional, affecting your relationships / sex drive. You've mentioned wanting love, so it seems like you've more in-depth requirements that sex alone.

It would seem like the Mirena plus oestrogen would work well for you (providing contraception while addressing the progesterone aspect of HRT).

I concur with PP that you should go to a different GP / menopause specialist.

Regarding testosterone usage, this is the BMS advice

thebms.org.uk/publications/tools-for-clinicians/testosterone-replacement-in-menopause/

I haven't started it yet, the gp wants to do a few more tests first.