Very low sex drive. Please advise.

[TheRealProfessorYaffle]

Hello, not name changing as frankly this is common and I'm not embarrassed. I'm late forties, peri menopausal, work very close to full time, and having almost nil sex drive this last year. Lovely kind husband who I'm attracted to, does more than his share in the home and is extremely supportive of me, if very gently frustrated and being very respectful and patient. No relationship problems, happy at work, kids not too young so have enough 'me' time. Health generally good, exercise regularly, weight normal. Bit more tired generally this last three years, but put this down to getting old. Blood normal inc thyroid. On hrt. Don't want to add testosterone as I used to have some bad jaw acne and very worried that would trigger it. Anything I can try? Thanks for any advice.

Are you on any type of other medication that could be causing this?

Perhaps a change of hrt? One size does not fit all and you may be able to make some tweaks.Are you on anti depressants by any chance as these can suppress libido.

Many thanks for the replies. Yes, fluoxetine. It works marvellously for me, so I'm very keen to work round that if possible. Equally, the hrt is working except for the sex drive. It feels like a catch 22 between risking my mental health and hormone stability (which are both good) for the sex drive. I'd really like to hope there might be other options.

Has this come on relatively recently? How was your drive before this last year?

Have you had sex in the last year at all? If so, how did you find it? Have you spoken to whoever prescribes your HRT about the possibilities and side effects of testosterone?

I've definitely had a lower sex drive than partner for the last few years (5-6 maybe?) but always had sex at the absolute least fortnightly. Now I will have sex at least three weekly because I love him very much and want him to feel good, but I'm just not that into it. Sometimes I can get into it once actually DTD, but other times less so. I hate to feel that he's picking up on my not really being up for it.

Would rather have a nice chat and a snooze!

Did it coincide with the fluoxetine starting?

I would have a talk with the GP at least. But I completely understand if you're OK on the fluoxetine you won't want to change that.

How is intimacy/affectionate touch going? I've certainly heard men in low sex relationships say they could deal with the lack of sex if the hugs and kissing kept going. As long as your dh understands and is ok that a long hug and kiss isn't going to lead to sex?

Hugging and kissing regularly, intimate and loving talking ditto. I know he'd rather have sex a couple of times a week and don't want to doom him to being regularly a bit disappointed/frustrated, but I also think messing with mental health is a rotten idea. I can't exactly recall an exact change (e.g fluoxetine), it's been more a general decline, but yes, I think the fluoxetine had something to do with it. The hrt didn't make any difference up nor down.

Prozac killed my libido and totally obliterated my ability to orgasm despite it not having that affect when I took it in my early 20s (47 now). I came off it for that reason. That made me as anxious and depressed as the reasons for taking it. I'd speak to your GP.

Sorry to tell you this OP but adding testosterone in is definitely one of the answers. It's also been a game changer for my mental performance at work.

Ok. Will try the testosterone. Sigh. Cystic acne awaits! Thanks for the suggestions all. Will report back in future for anyone else looking for same issue.

There might be better options than fluoxetine. I know it's hard when you find one that works, but it is giving you an undesirable side effect. Might be worth exploring other options there.

Could you try having sex less often than 3x a week? If nearly every time you have it, you don’t really want it, your body will remember and get tenser about it.

I'm pretty sure OP meant she's doing it once every three weeks, not three times a week.

Oh! Ok, that makes sense!

It is a difficult one though. I'm a big believer in use it or lose it sex-drive-wise, and giving the mood a chance to get into you sometimes. But past a certain point, pushing yourself to have sex has a nasty rebound effect where you quite naturally start to dread it and damage gets done to both you and your relationship. Although OP, it sounds like you're having regular enough sex that I don't think pushing yourself to have it more would be helpful.

OP, Is there any particular reason why you're sure that testosterone=cystic acne for you? Have you been on testosterone before?

Testosterone is the only thing that made a difference for me - the rest of my HRT was working well, I’d even had some sex/relationship therapy which did some good but didn’t trigger libido.

No acne; maybe the odd extra chin hair but I suspect I’d have them anyway, DM certainly did at my age.

Even though DH said he’d rather live with me and never have sex again if it came to it, a sex life we both want and enjoy really has added back something special for us.

OP, it will definitely be the Fluoxatine (Prozac) as lack as libido is a well known side effect unfortunately. There are other anti depressants which don't always cause this so it would definitely be worth having a chat with your GP. If you don't want to introduce testosterone you could consider tibilone which is a type of hrt with weak androgenic properties which is often recommended for low sex drive.

I am on testosterone and it has made my skin better. I was very worried about going on it as I had problems with my skin since starting hrt . Now on bio identical hrt plus testesterone. Definitely worth a try . Good luck x