Sexual Health & Desire Assessment — The Menopause Clinic

This questionnaire helps us understand what's changed for you.  There are no wrong answers, and nothing here is too small or too awkward to mention. Desire is shaped by three connected things: biology (hormones, tissue health, medications, sleep), psychology (stress, mood, body image), and context (relationship, time, privacy). This form looks at all three, because treating only one layer often isn't enough. Your answers are confidential and go directly to your clinician.

These words get used interchangeably, but they're different — and the difference matters for treatment. Libido (desire) is the wanting: interest in sex, thinking about it, being open to it. Arousal is the body responding: blood flow, lubrication, physical excitement once something is underway. Some women lose the wanting, but the body still responds fine. Some want to, but the body doesn't cooperate. Some experience both. Each pattern points to a different cause — so answer the next questions with that distinction in mind.

Most women measure themselves against spontaneous desire — wanting that shows up out of nowhere. That's the version movies show, and it doesn't describe most women, including women with deeply satisfying sex lives. Responsive desire arises after something begins — in response to closeness, touch, or arousal. Both are normal. In midlife, responsive desire becomes the more common pattern for nearly everyone. Often the real question isn't 'why don't I want it out of nowhere' — it's whether desire shows up once things start.

Low desire is only a medical problem if it bothers you. This part tells us whose problem we're solving — and that changes the plan.

Sexual response works like a car with both an accelerator and a brake. Hormones work on the accelerator — they can make desire easier to access. But they do not release brakes. If a brake is pressed hard (exhaustion, stress, pain, resentment, certain medications), no amount of accelerator makes the system go. Identifying your brakes is one of the most useful things this form does.

Some very common medications quietly lower desire or blunt arousal and orgasm — antidepressants (SSRIs and SNRIs) are the biggest offenders, and no hormone overrides them. This never means stopping a medication that's working. It means we factor it in honestly.

Hormones do real work: transdermal testosterone has strong evidence for improving desire, arousal, and satisfaction; vaginal estrogen restores the tissue health that makes sex comfortable; and treating sleep and hot flashes clears the fog desire has to fight through. But hormones cannot recreate anticipation in a long relationship, resolve resentment, teach technique, or undo a brace-against-pain reflex. Those layers are real, treatable, and not pharmacology — that's where sex therapy, pelvic floor physical therapy, and evidence-based programs come in. Most successful plans combine layers. Needing more than a prescription is not a failure — it's how this actually works.

Thank you for taking the time with this. Your clinician will review it and reach out to you.