Low desire is one of the most common concerns I hear from women, especially during perimenopause and menopause. But low libido is not simply a hormone problem, and it is not a personal failure. Desire is shaped by hormones, stress, nervous system regulation, relationship dynamics, sleep, mental health, and overall wellbeing.

In this article, Dr. Evelin Dacker explores the complex roots of low desire in women and discusses evidence-based options that may help support arousal and sexual connection, including PT-141 (Bremelanotide), Addyi (Flibanserin), cannabis, and a more holistic approach to female sexual health and vitality.

Most women have been taught to think of hormones in simplistic categories: natural versus synthetic, safe versus unsafe, good versus bad. But the reality is far more nuanced. In this article, I break down what “bioidentical” hormones actually mean, why so-called natural estrogen was historically made from pregnant mare urine, and why progesterone and progestins are not interchangeable. Because women deserve more honest, evidence-informed conversations about menopause and hormone therapy.