Low Libido After 40: Causes, GSM & Treatment Options

If you’re over 40 and your interest in sex isn’t what it used to be, you’re not alone. Changes in sexual desire are common as we move through midlife, and they can affect both women and men.

While some changes in libido are a normal part of ageing, a persistent or sudden drop in sexual desire can sometimes signal an underlying hormonal, physical, emotional or relationship issue.

The good news? Low libido doesn’t have to be something you simply accept. Understanding what’s happening is the first step toward finding solutions that can help you feel more comfortable, confident and connected.

At U Renew, we believe intimate wellness is about more than treating symptoms. It’s about helping you feel informed, supported and confident in your body at every stage of life.

What Is Libido?

Libido is your natural interest in sexual activity or intimacy. There is no single “normal” level of sexual desire. Some people have a high sex drive, while others have a lower sex drive. Your own libido can also change throughout your life.

What matters is whether the change is noticeable for you and whether it causes distress, affects your relationship or interferes with your quality of life.

A decrease in desire doesn't automatically mean something is wrong. However, if you find yourself thinking, “This isn't like me,” it may be worth exploring why.

Why Does Libido Change After 40?

There isn't usually one single reason for low libido. Midlife brings physical and emotional changes that can all influence sexual desire.

Hormonal Changes

Hormones play an important role in sexual desire.

For women, perimenopause and menopause bring changes in oestrogen and other hormones. Declining oestrogen can contribute to vaginal dryness, discomfort during sex, changes in arousal and genitourinary symptoms. When sex becomes uncomfortable, it's understandable that desire may decrease.

Men can also experience hormonal changes with age. Testosterone levels may decline gradually, and lower testosterone can be associated with reduced sexual desire in some men.

Stress and Busy Lives

Life after 40 can be incredibly demanding. Work, parenting, caregiving, financial concerns and relationship challenges can leave little energy for intimacy.

When your brain is constantly in “to-do list” mode, switching into a relaxed, intimate state can be difficult.

Poor Sleep and Fatigue

Sleep problems become increasingly common during midlife. Menopause-related night sweats, stress and other factors can interfere with sleep.

When you're exhausted, sex may naturally move down your priority list.

Medications and Health Conditions

Certain medications can affect sexual desire or sexual function. Health conditions such as diabetes, cardiovascular disease, thyroid disorders and depression can also influence libido.

If your libido changed significantly after starting a medication or following a new health diagnosis, talk with your healthcare provider.

Body Image and Confidence

Our relationship with our bodies can change as we age. Weight changes, hormonal changes, skin changes and changes to intimate areas may affect confidence and how comfortable we feel being intimate.

For some women, feeling self-conscious about their abdomen, skin texture or the appearance of their intimate areas can make it harder to relax and enjoy intimacy.

Although body image isn't the only factor in sexual desire, feeling more comfortable in your body can be an important part of intimate wellness.

Depending on your individual concerns and goals, aesthetic treatments may be worth discussing with a qualified provider.

Options offered at U Renew include:

• Microneedling: A treatment that stimulates the skin's natural repair processes and may improve skin texture and appearance.

• EMSCULPT NEO®: A non-invasive body-contouring treatment that combines muscle stimulation with radiofrequency energy to support muscle development and reduce fat in treated areas.

• Labia puffing: An aesthetic treatment intended to restore volume to the labia majora, potentially helping address concerns about changes in appearance.

These treatments are not direct treatments for low libido. However, for women whose intimate wellness concerns include body image or appearance-related confidence, discussing appropriate options may be one part of a broader approach to feeling comfortable in their bodies.

The goal is not to meet someone else's standard of beauty. It's to help you make informed decisions about what makes you feel confident and comfortable.

Relationship and Emotional Factors

Sexual desire doesn't exist in isolation. Relationship conflict, unresolved resentment, a lack of emotional connection, anxiety or depression can all affect libido.

Sometimes, the issue isn't that you've lost your desire for sex. Other parts of your life or relationship may be making it difficult to access that desire.

Is Low Libido After 40 Normal?

It can be, but that doesn't mean you have to live with it if it's bothering you.

There is no magic age at which your sex drive is supposed to decrease. Some people notice significant changes in their 40s, while others maintain an active and satisfying intimate life well into their 50s, 60s and beyond.

The important question isn't, “Is this normal for someone my age?”

A better question is:

“Is this a change that concerns me or affects my quality of life?”

If your answer is yes, it's worth talking about.

When Should You Seek Help?

Consider speaking with Dr. Aluko if:

• Your libido has decreased significantly or suddenly.

• You no longer feel interested in intimacy and the change bothers you.

• Sex has become painful or uncomfortable.

• You are experiencing vaginal dryness, irritation or other menopausal symptoms.

• You have erectile difficulties or other sexual-function changes.

• You are experiencing significant fatigue, mood changes or sleep problems.

• You suspect your medication may be affecting your libido.

• Changes in sexual desire are affecting your relationship.

• You simply feel that something has changed and you don't know why.

You don't need to wait until the problem becomes severe before asking for help.

Understanding GSM: When Menopause Affects Intimate Health

For many women, low libido is connected to another problem: sex has become uncomfortable or painful.

During and after menopause, declining estrogen can contribute to changes in vaginal and urinary tissues. These symptoms are commonly grouped under the term genitourinary syndrome of menopause (GSM).

GSM can include:

• Vaginal dryness and irritation.

• Burning or discomfort.

• Pain during sexual activity.

• Urinary urgency or other urinary symptoms.

• Changes that make intimacy less comfortable.

When intimacy hurts, avoiding sex can become a completely understandable response. Treating the underlying discomfort may help make intimacy more comfortable and, for some women, support a return of sexual desire.

MonaLisa Touch®: A Non-Hormonal Option to Discuss

Women experiencing GSM have several potential treatment options, including vaginal moisturizers, lubricants and, when appropriate, prescription treatments such as vaginal oestrogen.

However, not every woman wants to use hormones. Some prefer to explore non-hormonal approaches because of personal preferences, medical considerations or concerns about hormone therapy.

MonaLisa Touch® is a fractional CO₂ laser treatment designed to address certain vaginal symptoms associated with menopause. It may be an option to discuss with a qualified healthcare provider for women who prefer to explore non-hormonal treatments.

It's important to understand that laser treatment is not appropriate for everyone, and evidence regarding its effectiveness and long-term safety for GSM remains limited. It should not be presented as a guaranteed solution or a replacement for established treatments without an individualized assessment.

At U Renew, women can discuss their symptoms, medical history and treatment preferences with a healthcare professional to determine which options may be appropriate for them.

Emsella® and Pelvic Floor Health

Pelvic floor health is another important aspect of intimate wellness.

The pelvic floor muscles support the bladder and other pelvic organs and play a role in urinary control and sexual function. Changes in muscle strength or coordination may contribute to urinary leakage and other pelvic floor concerns.

BTL EMSELLA® is a non-invasive treatment that uses high-intensity focused electromagnetic energy to stimulate pelvic floor muscle contractions. It is designed to support pelvic floor muscle function and is commonly offered for concerns such as urinary incontinence.

Muscle contractions may also influence circulation in the pelvic region, but improvements in sexual desire or sexual function should not be assumed or guaranteed.

For women experiencing urinary leakage, pelvic floor concerns or changes in intimate wellness, an assessment can help determine whether EMSELLA®, pelvic floor physiotherapy or another approach is appropriate.

What Can You Do About Low Libido?

The right approach depends on what's causing the change. A healthcare provider can help you identify contributing factors and discuss suitable options.

Address Lifestyle Factors

Improving sleep, managing stress, exercising regularly and addressing overall health can support sexual wellbeing.

Making time for relaxation, affection and connection without the expectation of sex can also help reduce pressure around intimacy.

Review Your Medications and Health

If a medication or health condition may be contributing to low libido, your healthcare provider can help determine the next steps. Never stop a prescribed medication without medical advice.

Explore Hormonal and Non-Hormonal Options

Depending on your symptoms and medical history, your provider may discuss hormonal treatments, non-hormonal approaches or treatments for specific menopausal symptoms.

For women who prefer not to use hormones, options may include lubricants, vaginal moisturizers and, in selected cases, treatments such as MonaLisa Touch®. The most appropriate choice depends on the symptoms being treated, the available evidence and individual circumstances.

Consider Pelvic Floor Health

If urinary leakage, pelvic discomfort or other pelvic floor symptoms are affecting your confidence or intimate life, ask about an assessment.

Depending on the findings, pelvic floor physiotherapy or a treatment such as EMSELLA® may be worth discussing.

Support Your Body Confidence

If changes in your appearance are affecting how you feel about yourself, consider discussing your concerns with Dr. Aluko.

Treatments such as microneedling, EMSCULPT NEO® and labia puffing address different aesthetic concerns. They aren't treatments for low libido itself, but they may be relevant to women who want to explore options for their appearance and body confidence.

Address Emotional and Relationship Factors

Counselling, sex therapy or relationship support can be helpful when stress, anxiety, depression or relationship difficulties contribute to low desire.

Sometimes, small changes in communication, expectations and emotional connection can make a meaningful difference.

What About “Normal” Desire?

One of the biggest misconceptions about libido is that there is a specific amount of sex you should want after 40.

There isn't.

Your libido isn't a performance measurement, and there is no required number of times you should want sex each week or month.

What matters is your experience.

If you're happy with your level of desire and it isn't causing distress, you may not need to change anything.

But if you've gone from feeling interested and connected to feeling completely disconnected from intimacy—and you don't understand why—that deserves attention.

You Don't Have to Just Accept It

Getting older doesn't mean your intimate life has to disappear.

For some people, changes in libido are temporary. For others, an underlying issue can be identified and addressed. Improving sexual wellbeing may involve treating physical symptoms, reviewing medications, supporting pelvic floor health, addressing body image concerns or working through emotional and relationship challenges.

There is no single solution that works for everyone, but there are options worth exploring.

The first step is having an honest conversation with Dr. Aluko.

Low libido is common. But feeling like you have to suffer in silence doesn't have to be.

At U Renew, we believe conversations about sexual health, menopause and intimate wellness should be comfortable, respectful and judgment-free.

Whether you're experiencing symptoms of GSM, vaginal discomfort, pelvic floor concerns or changes in body confidence, learning about your options can help you make informed decisions about your care.

Your 40s and beyond can still be a time of confidence, connection and intimacy.

Contact the U Renew team in Stony Plain, Alberta, to learn more about our women's health and intimate wellness services and discuss which options may be suitable for you.

Please contact me for a free consultation

U Renew
Phone: 780-968-6888
Cell/Text: 780-264-2874
hello@urenew.ca

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