“You’re so lucky you just have dogs and not a husband to deal with!” said one of my friends over dinner. I was sitting at an outdoor restaurant with five married women in their fifties, each of them commiserating about the daily challenges they endure with their spouses of more than 25 years. As the only single woman at the table, I listened—half amused, half envious.  

One friend announced that she simply wasn’t attracted to her husband any longer. They loved each other, but his lack of follow-through on home projects contributed to her lack of desire to share a bed with him. “And, he’s so moody!” she told us, rolling her eyes as she swigged her glass of wine. “Like a teenage girl!”  

Another friend rather triumphantly stated, “I’m closed for business in the sex department. I had my heyday. It was a good run! Now, I just don’t even care anymore about that part of my life.”  

She also expressed having no energy at the end of the day, after working a demanding job, and caring for an aging parent. She simply didn’t have much left to give to her marriage. Ironically, she said her husband didn’t seem to care, either. They were otherwise happy living as roommates, sharing household chores, and taking an occasional trip together.  

Fatigue, Low Sex Drive, and Marriage During Menopause

I marveled at how similar all these women's stories sounded: they were tired, lacked sex drive, slept in separate rooms, and some even had husbands who seemed to be on the same dismal page. And, they kept telling me how fortunate I was to be unencumbered by a middle-aged man!

It was an interesting perspective, for sure, as I often think I’d like to be encumbered by a man at this stage of my life. However, as I know from research, what my friends are all experiencing is quite the norm for women: changes in desire and energy are common complaints during and after the menopause transition.  

As The Change Is Personal discussed in “Menopause, Marriage, and the Rise of Divorce After 50”, the “menodivorce” is a growing concern for many midlife adults. Women are finding a renewed sense of independence, priorities, and freedom to shed what no longer serves them. Sometimes, that includes their marriages.  

But, as I listened to my friends—beautiful, successful, smart women—talk about how tired they are of putting in the effort, and how their desire for intimacy “just doesn’t matter much” these days, I couldn’t help but think that hormones might be a huge factor for all of them, including their men.

Why Aren't They Considering Testosterone Therapy?

To the best of my knowledge, none of my friends’ husbands are investing in their own hormonal health and wellness, meaning, they’re mostly oblivious about their own declining testosterone levels. My girlfriends (I know for a fact) are somewhat hesitantly experimenting with hormone patches and pills to replace estradiol and progesterone, but NONE of them are incorporating testosterone therapy into their lives.  

I believe this is solely because most medical providers are not trained experts in hormone therapy, and therefore have never told my friends (or any other women) why they may benefit from testosterone, too. This actually reflects a much bigger issue in the medical community—a gap in female sexual wellness care in which women are limited by what’s available in mainstream healthcare.

And clearly, my friends aren’t listening to me preach about testosterone (or they’re choosing to ignore me because I’m not a medical professional). Even though I research and write about bioidentical hormone replacement therapy (BHRT) every day, and I speak to knowledgeable compounding pharmacists and the Medical Director of Belmar Pharma Solutions, Dr. HotFlash, herself—Angela DeRosa, DO, MBA, CPE—on a regular basis, that doesn’t seem to matter. My friends’ gynecologists are calling the shots, and every time I casually ask, “Did you ask about adding testosterone therapy yet?” they change the subject.

Is There More to It Than “Just Hormones?”

Have middle-aged women who’ve been with the same man for more than 25 years “just gotten over it?” Do they truly no longer want to put in the effort to make their marriages amazing, now that the kids are out of the house, and some of these couples are even retired?  

Would I feel that way, too, if I had stayed married all these years?

I’m not sure I’ll ever know the answers to these questions. But, I do know this: my run isn’t over. I’m not finished with my intimate relationship life. I know I still have a lot to accomplish in the next 46 years (I plan to live to be 103). I also know that a big difference between my married friends and me is that testosterone therapy IS part of my BHRT plan.  

I have energy and a libido, and I'm not tired all the time like they are. I also work full time, take care of two, high-maintenance, rescued German Shepherds (both need daily walks; one needs daily Prozac to keep her anxiety at a manageable level!). Plus, I have an aging parent who lives with me, and occasionally needs assistance. I don’t have a husband to help me with any of it.  

I’m not saying this to be self-righteous, either. I truly believe the biggest advantage I have over my friends is optimized hormones. Aside from not being married, the ONLY other difference I can see is that my optimized hormones really are making a significant impact on how I feel about intimate relationships.  

Perhaps my friends and their husbands could benefit from oxytocin—the love hormone—that makes you feel all warm and fuzzy toward your significant other. Or maybe it’s more than “just their hormones” being too low. Maybe that’s what “normal” couples go through after 25 years of day-in-day-out married life. However, it's hard for me to accept that as the most viable answer to the menodivorce trend.  

At the end of the day, as a self-acknowledged hopeless romantic who works in the world of compounded hormone therapy, I’m wondering:  

What if a conversation about personalized BHRT is worth having before simply accepting “this is just how it is” in midlife?

What if access to more encompassing hormone care could help my friends (and other women) feel a spark in their relationships again?

What Does a Pharmacist Think About This?

As one of Belmar Pharmacy’s very knowledgeable compounding pharmacists put it when I posed these same questions to her, “As a woman, why wouldn’t you try one last thing that could help revive your marriage and help you feel better overall? Don’t these women want to reclaim their own power over their physical and emotional well-being?”

So, I pose these questions to you, too, and challenge you to take the steps toward your unique idea of a happy, healthy life. If your provider doesn’t understand hormones, or dismisses your questions, find a new one.

Don’t become a victim of the consequences of aging. Perhaps the best gift we can give ourselves (and any partners in our lives) is learning to adapt and adjust as we continue to enjoy the privilege of getting older.