Eps 456: Why You Don’t Want Sex Anymore: Low Libido in Perimenopause Explained with Laurie Minz
Why does your libido disappear in perimenopause, even when you still love your partner and miss feeling connected?
In this episode, I sit down with psychologist, sex therapist, University of Florida professor, and bestselling author Dr. Laurie Mintz to talk honestly about low libido, responsive desire, orgasms, and sexual health after 40.
Many women feel ashamed when they no longer think about sex, look forward to it, or respond the way they once did. They may worry that they are broken, failing their relationship, or destined to lose this part of themselves forever. But desire is more complex than simply feeling spontaneously “in the mood.”
Dr. Laurie explains the difference between spontaneous and responsive desire, why stress and the mental load can change how desire begins, and why responsive desire is never the same as duty sex. It does not mean forcing yourself, pushing through pain, or performing for a partner. It describes allowing desire to grow from connection, touch, safety, and pleasure that you genuinely want.
We also unpack the orgasm gap and why intercourse alone is not the most reliable route to orgasm for most women. Dr. Laurie explains the importance of clitoral stimulation, how blood flow and nerve sensitivity may change with age, and why self-pleasure and vibrators can be valuable tools in perimenopause and menopause.
If psychological and relational strategies are not enough, women still have options. We discuss Addyi, Vyleesi, and off-label topical testosterone, along with when to consult a qualified sexual medicine physician. These are not universal libido boosters, and low desire may also relate to pain, medications, hormones, stress, exhaustion, relationship dynamics, or sex that is not pleasurable.
No woman owes anyone sex. But if you miss your desire, pleasure, confidence, or connection, you deserve better information than “this is just aging.”
In This Episode
00:00 What happened to my libido?
02:29 How losing her own sex drive changed Dr. Laurie’s career
06:16 What women mean when they say they have no libido
07:39 Spontaneous versus responsive desire
10:21 Hormones, testosterone, and the mental load
12:06 Why desire changes in long-term relationships
14:03 Reconnecting with pleasure without creating another obligation
17:19 Why “I don’t want sex” can mean 100 different things
18:50 When to consider medical or hormonal support
21:50 Sexual satisfaction and quality of life
22:55 The orgasm gap and the importance of clitoral stimulation
26:16 What every woman deserves to know about her anatomy
28:05 Vibrators during perimenopause and menopause
30:26 Blood flow, nerve sensitivity, SSRIs, and orgasm changes
38:14 Scheduling intimacy without making it feel like duty
41:07 Dr. Laurie’s books for desire and orgasm
42:52 Self-pleasure and reconnecting with your body
44:45 Psychological versus physical sexual concerns
47:11 Teaching the next generation that sex should be pleasurable
Connect with Dr. Laurie Mintz
Instagram: @drlauriemintz
Books: Becoming Cliterate and A Tired Woman’s Guide to Passionate Sex
Resources: https://mymojo.com
Connect with Bria
Instagram: @bria_period_whisperer
Website: https://theperiodwhisperer.com
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