Abstract
Libido is a comprehensive and yet elusive word that indicates basic human mental states
— and their biological counterparts— involved in the beginning of sexual behavior.
It has three main roots: biological, motivational-affective and cognitive. All these
dimensions may be variably affected in the post menopause, contributing to a progressive
decrease of sexual drive that parallels the process of aging. Loss of estrogens and,
specifically, of androgens deprives female libido of major biological fuel. The effect
of this loss is pervading, affecting the central nervous system, the sensory organs
that are the major windows to environmental sexual stimuli and the quality of sexual
response, central, peripheral non-genital and genital. Prolactin increase may further
inhibit libido. Arousal disorders, dyspareunia, orgasmic difficulties, dissatisfaction,
both physical and emotional, may contribute to a secondary loss of libido. Depression,
anxiety and chronic stress, may interfere with central and peripheral pathways of
the sexual response, reducing the quality of sexual function mostly in its motivational
root. Relational conflicts and/or marital delusions and partner-specific problems,
erectile deficit first, may contribute to the fading of sexual drive in the post-menopausal
years. Well tailored HRT, including androgens in selected cases, may reduce the biological
causes of loss of libido. A comprehensive treatment requires a balanced evaluation
between biological and pychodynamic factors.
Keywords
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© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
