Perimenopause destroyed my intercourse drive. I believed taking HRT would restore it, nevertheless it did not work. Then a prescription modified my life. Here’s what you will need to inform your physician to pay money for it

One morning in my mid-forties, I woke up and realised something fundamental in my body had changed.

I hadn’t been attracted to anyone in a long time, and the thought of seeing my on-off boyfriend later that day filled me with anxiety.

Overnight, any instinct for physical closeness or intimacy had vanished. It wasn’t a dip or a wobble – it was as if a switch had been flicked both mentally and physically.

I felt numb from the waist down. It was as if my real body had been snatched away while I slept. Yet I’d always had a healthy libido – even if it wasn’t always central to my life.

At the time, I was seeing someone in a way that suited us both – not a meeting of minds so much as a meeting of bodies. Ours was a relationship built on chemistry and physical pleasure rather than commitment and conversation, and it worked.

I was due to see him – our usual routine of dinner, a film and then back to his flat. It should have felt easy, familiar. Instead, I found myself making excuses, quietly dreading it.

Because the idea of undressing, of being physically exposed in that way, suddenly felt completely alien, as if I’d been dropped back into some pre-adolescent version of myself, awkward and disconnected from my own body.

It wasn’t about him. It was as if the entire framework had gone – the instinct, the ease, the sense of wanting. And I didn’t recognise myself in that version at all.

I now know libido is a fragile blend of hormones, imagination and blood flow. Take away one, and the whole system collapses.

I made excuses to avoid date night for a couple of weeks and went to my GP for advice. He was kind, but his first question was whether I was married or in a long-term relationship, as though it only became a priority if it affected a partner.

To my shock, blood tests confirmed I was ‘moderately perimenopausal’ and I was prescribed HRT, a standard combination of oestrogen and progesterone tablets.

As I read about perimenopause, things started to fall into place – no wonder I had been finding it harder to fall asleep naturally at night, often relying on over-the-counter sleep aids. I’d noticed lighter periods and thinning hair too, but I just put these changes down to ageing. After all, I still felt fit and youthful, addicted to my daily 5km runs.

You see, I had no idea symptoms can begin up to ten years before menopause itself. I felt a flicker of anger. Why had no one ever properly explained this before?

There was also a quieter fear: what if the tablets weren’t enough? What if this unfamiliar version of my body was here to stay?

My friends and I assumed we’d go through menopause in our 50s; we weren’t aware it slips in surreptitiously – and before you know it, you’re someone else.

During our 40s, it gradually dawned on us that we rarely giggled over dating app pictures any more, or shared notes about sex. We assumed we were just mellowing out.

My mother and I never discussed ‘the change of life’ – and it wasn’t properly explained during those awkward ‘facts of life’ classes at school either.

A few weeks after I’d started taking the HRT tablets, nothing had changed. And there are only so many excuses you can make. So I did what countless women before me have done: I showed up at my man’s place, played the part and tried to will myself back into something that used to come naturally.

Unbeknown to him, as we lay close, I was wondering quietly if this sorry charade was going to be it for the rest of my life.

Upon learning the tablets weren’t working, my GP referred me to a specialist. I imagined that meant I’d be attending a menopause clinic, which felt very encouraging. Instead, I arrived at St Mary’s Hospital in west London and was directed to the sexual dysfunction clinic.

The waiting room was bleak – plastic chairs, unflattering lights and the kind of embarrassed silence you only get in places where no one wants to make eye contact. There were mostly middle-aged men pretending to read worn copies of magazines. Faded posters about erectile dysfunction curled off the walls; there was nothing about menopause or flagging female libido.

My consultant, a spiky-haired woman in her 40s, was brisk but curious. She listened carefully, though I sensed a flicker of scepticism, as if she wasn’t entirely sure why my numb body warranted this level of concern.

She conceded that my blood tests confirmed I was in perimenopause, but refused to connect it to my sudden loss of sex drive.

When I mentioned that I was fit, healthy and had taken up spin classes, her face lit up. ‘That’s it,’ she said. ‘I would imagine you’ve been overdoing the spinning, and the bike saddle has damaged the nerves. You’ll have to give it up.’

The idea that I’d pedalled my libido to death was almost funny – except it wasn’t. It felt like gaslighting. And, coming from a female consultant, a stark reminder that medical misogyny isn’t always delivered by men.

Ultimately, it was my Botox practitioner who offered to read my blood results and make sense of them. ‘You’re absolutely in perimenopause,’ she said, squeezing my arm affectionately. ‘I really recommend you invest in seeing a private gynaecologist and get proper support.’

I did the research and found one of Harley Street’s most renowned gynaecologists, Professor John Studd, a pioneer of menopause treatment who died in 2021. He was of advanced years when we met in 2018, with a no-nonsense, almost grandfatherly manner. The kind of man you half expected to whisk out an antique fob watch.

He listened to my story and sent me for a bone scan.

The results were alarming. I had unusually advanced osteopenia in my hips – a clear indicator, alongside telltale blood tests, that my sex hormones had dropped significantly. It was also a serious health concern the NHS hadn’t bothered to investigate.

Bone density loss is common as women approach menopause, with data from the NHS showing that around half of women over 50 are affected by low bone density. But it is far less typical to see such advanced changes in someone in their mid-40s, making my diagnosis unusual.

‘You must be of Irish descent,’ Professor Studd said, leafing through my scans, glasses perched on his nose. ‘Premature osteopenia’s common in Irish women.’

‘No, I’m not,’ I replied.

‘Of course you are – ask your mother,’ he barked, with the hint of a smile.

A later DNA test proved him right – my bones and tissues are an 80 per cent Irish-British mix. And it turns out rates of low bone density are relatively high in Ireland, rising sharply from midlife onwards.

Then came the turning point.

‘If you want to restore libido, you need oestrogen, progesterone – and testosterone,’ Professor Studd said, rubbing his hands like a magician.

Unlike the tablets I’d been given, the oestrogen gel he prescribed was absorbed directly through the skin, allowing a steadier dose of hormones to reach the bloodstream. It was explained to me that the new blend of HRT would help prevent possible sleep issues, mood disturbances and hot flushes, but it was the testosterone that would really help strengthen my bones… and my sex drive.

Within 24 hours of applying the testosterone gel, I felt a spark return. It was like a tingling feeling all over my body and a restless night because I felt energised.

Within days I wanted to move more, flirt, create, laugh. It was like remembering a language I’d once spoken fluently but suddenly forgotten.

And yet most women never get the chance. The NHS technically allows testosterone prescriptions for menopause-related loss of libido, but most GPs – including mine – still won’t offer it.

So, we have to pay up to £80 to order a bottle from a private online pharmacy – and hope it’s the real thing. Meanwhile, Viagra can be picked up in supermarkets for the price of a sandwich.

For me, testosterone turned out to be the missing piece. It didn’t turn me into a different woman; it helped give me back a recognisable version of the one I’d been – the version that feels reasonably connected to her own body.

The real test came the next time I went to see my man.

I didn’t exactly fling myself at him the moment the door closed, but there was a lightness again, a sense of confidence. The awkwardness had receded.

The funniest part? He hadn’t really noticed anything had been wrong. My gymnastic performance over those weeks had clearly been more convincing than I’d given myself credit for.

But I knew. The difference was unmistakable, not just in my body, but in my mind. And that, more than anything, was a relief.