Low libido and vaginal dryness in menopause are not two separate problems. They share the same hormonal root: the decline of DHEA, testosterone, and estrogen that begins in perimenopause and accelerates through menopause. DHEA is a compound the body produces naturally and uses as a building block for the hormones that support both desire and tissue health. When DHEA drops, both tend to go with it.
This is why so many women find that treating one symptom without the other only gets them halfway there — and why the most effective approach addresses both sides at once.
In this article, you will learn:
Why Do Low Libido and Vaginal Dryness Happen Together?
If you have been dealing with both low desire and dryness or discomfort during intimacy, you are not imagining a connection. There is one — and it starts with a hormone most women have never heard of.
DHEA and the hormonal cascade
DHEA (dehydroepiandrosterone) is produced by the adrenal glands and used by the body as a precursor to estrogen and testosterone. It peaks around age 25 and declines steadily after that. By the time a woman reaches perimenopause, her DHEA levels may already be significantly lower than they were in her 20s. By postmenopause, the decline is even more pronounced.
That drop shows up in two places at once.
The first is desire. Testosterone, which the body makes from DHEA, plays a direct role in libido, arousal, and sexual response in women. When testosterone drops, desire often goes with it. This is not a psychological problem. It is a hormonal one.
The second is tissue. The vaginal and vulvar skin is some of the most hormonally sensitive tissue in the body. As estrogen and DHEA decline, this tissue becomes thinner, drier, and less elastic. Intimacy that was once comfortable starts to feel like friction. Sometimes it causes small tears. Sometimes it just aches.
When intimacy hurts, the brain learns to associate it with pain — and desire drops further. The two symptoms feed each other.
Why one solution is not enough
A lubricant helps in the moment but does not address desire or support tissue health over time. An adaptogen supplement supports mood, energy, and libido internally but cannot reach the tissue directly. Both sides of the problem need both kinds of support.
How Desire Changes in Menopause
Low libido is one of the most common complaints I hear in practice — and one of the most undertreated, because it is so often dismissed as psychological or relational rather than hormonal.
The hormones behind desire
Testosterone is not just a male hormone. Women produce it too, primarily in the ovaries and adrenal glands. Before menopause, testosterone supports:
- Libido and sexual arousal
- Energy and motivation
- Muscle mass and physical stamina
- Mood and emotional resilience
- Cognitive sharpness and focus
As testosterone declines through perimenopause — driven in part by the drop in DHEA — women notice changes not just in sexual desire but across all of these areas. The connection is hormonal, not motivational.
Cortisol as a compounding factor
Chronic stress raises cortisol — the body's primary stress hormone. When cortisol stays elevated, the body prioritizes survival over reproduction. Desire is often the first thing to go. This is why women under high stress notice their libido dropping even before menopause begins, and why addressing stress is part of addressing desire.
Your adrenal glands are also your backup system when your ovaries slow down. If they have been depleted by years of chronic stress and poor sleep, they cannot do their job — and the hormonal shortfall becomes even more pronounced.
What Is Maca and What Does the Research Show?
Maca — Lepidium meyenii — is a root vegetable from the high Andes of Peru that has been part of the traditional diet there for centuries, used to support energy, stamina, and vitality.
Maca as an adaptogen
Maca is classified as an adaptogen — a plant that helps the body respond to stress. What interested me clinically when I first studied maca was what it does not appear to do: it does not seem to raise estrogen levels. (1) That matters for women who cannot or choose not to use estrogen.
What it does do is support the adrenal stress response. When the body feels less like it is in crisis mode, energy and desire often have room to return.
What the clinical research shows
- A randomized, placebo-controlled study published in the journal Menopause found that postmenopausal women taking maca reported significantly lower scores for psychological symptoms and sexual dysfunction compared to placebo, without changes in estrogen levels. (1)
- A 2015 randomized trial found that women taking maca had improvements in sexual function compared to placebo, with the strongest effects seen in postmenopausal women. (2)
- A systematic review described the overall evidence as promising but limited by small study sizes. Larger trials are needed. (3)
Maca is not a hormone. It does not replace estrogen or testosterone. It supports the body's own systems — and for many women I work with, that makes a meaningful difference.*
How long does maca take to work?
Most studies ran six to twelve weeks. In clinical experience, women tend to notice changes in energy first, within two to four weeks of daily use. Sexual desire often follows energy — not the other way around.
Why Vaginal Tissue Needs Its Own Support
The desire side of intimacy and the physical comfort side are related — but they require different approaches.
What happens to vaginal tissue in menopause
As estrogen and DHEA decline, the vaginal and vulvar tissues undergo real structural changes. The tissue becomes:
- Thinner and more fragile
- Less elastic
- Drier and more prone to irritation
- More sensitive to friction and tearing
This is not a minor inconvenience. For many women, it is the primary reason they stop enjoying or seeking intimacy. And because it is uncomfortable to talk about, most women are dealing with it far longer than they should be before asking for help.
The difference between daily moisturizing and in-the-moment comfort
These are two distinct needs — and two distinct products.
A daily vulvar moisturizer, used consistently, supports tissue health at the cellular level over time. Applied every morning, it works the way a good facial moisturizer does: not solving a problem in the moment, but building resilience and comfort as a baseline.
An intimate lubricant provides immediate ease and comfort during intimacy. It is not a substitute for daily moisturizing — it is a complement to it.
Using both, rather than one or the other, is the approach I recommend to my patients.
Dr. Anna's Go-To Support for Libido and Intimate Comfort
These are the products I reach for when women come to me with low desire and discomfort during intimacy. They are designed to support the body's own systems, not override them. As always, these are structure/function products — not a replacement for medical care when clinical intervention is indicated.
Mighty Maca Plus
An adaptogenic superfood blend formulated to support energy, stress resilience, and hormonal balance. One scoop of certified organic Peruvian maca (604mg per serving) plus 30 superfoods, greens, and digestive enzymes. This is my daily foundational supplement for hormonal health.*
Start with one scoop in the morning in water, tea, or a smoothie. If you are new to greens, start with half a scoop for the first week.
Velvé — Intimate Lubricant
An aloe-based intimate lubricant formulated for the female pH. Free from glycerin, silicone, parabens, and the ingredients most conventional lubricants rely on. Designed specifically for the comfort and dryness that comes with hormonal shifts in perimenopause and menopause.
Velvé addresses the in-the-moment side of the equation: physical ease and comfort during intimacy.
Julva — Daily Intimate Skin Cream with DHEA
Julva is a different product from Velvé, with a different purpose. Applied daily to the external vulvar skin, Julva delivers DHEA topically to support tissue health, elasticity, and comfort over time. It is not a lubricant — it is a daily moisturizer that works at the tissue level.
Julva every morning. Velvé when you need it. The two work together beautifully. 😉
The Rekindle Bundle
MIGHTY MACA PLUS + VELVÉ
For the first time, both products are available together. Internal support fordesire and energy through Mighty Maca Plus. External support for comfort and ease
through Velvé. Two sides of the same problem addressed together.
Frequently Asked Questions
Why do low libido and vaginal dryness happen at the same time in menopause?
Both symptoms share a common hormonal root: the decline of DHEA, testosterone, and estrogen that begins in perimenopause. DHEA is the building block the body uses for the hormones that support both desire and tissue health. When it drops, both tend to go with it.
Does maca help with libido in menopause?
Small clinical studies suggest maca may support sexual desire and function in postmenopausal women without raising estrogen levels. The evidence is promising but limited — most studies are small and short-term. Maca is considered an adaptogen, not a hormone, and appears to work by supporting the body's stress response.*
Can you use Mighty Maca Plus and Velvé together?
Yes. They address different sides of the same underlying issue. Mighty Maca Plus supports energy, mood, adrenal function, and healthy desire internally. Velvé supports comfort and ease during intimacy externally. They are designed to complement each other.
What is the difference between Julva and Velvé?
Julva is a daily vulvar moisturizer applied every morning to support tissue health over time. It contains DHEA and works at the cellular level. Velvé is an intimate lubricant used during intimacy for immediate comfort and ease. They serve different purposes and can be used alongside each other.
Does maca increase estrogen?
Research so far suggests maca does not raise estrogen levels. It appears to work through a different pathway — supporting adrenal function and stress response rather than directly influencing sex hormone levels. This makes it an option worth discussing with your doctor if you have concerns about estrogen.*
How long does maca take to work?
Most studies ran six to twelve weeks. In clinical experience, women tend to notice changes in energy first, within two to four weeks of daily use. Desire often follows energy, not the other way around.
What causes low libido in menopause besides hormones?
Cortisol plays a significant role. When stress is high and sleep is poor, the body prioritizes survival over desire. Poor sleep, mood changes, painful intimacy, and relationship stress can all suppress desire independently of hormone levels. This is why addressing only hormones often does not fully resolve the problem.
Is maca safe to take every day?
Maca has a long history as a food crop and is generally well tolerated. If you have a hormone-sensitive condition or a thyroid condition, talk with your healthcare provider before starting.*
Final Thoughts
Low libido and vaginal dryness are among the most common — and most undertreated — symptoms of menopause. They are not separate problems. They share a hormonal root, and they respond best to support that addresses both sides.
If you are starting somewhere, I would suggest building from the inside out: daily Mighty Maca Plus for energy, adrenal support, and healthy desire, alongside Velvé for comfort during intimacy and Julva for daily tissue support. These are accessible, daily-use steps you can take while you get more information and, if needed, work with your doctor on a broader hormonal plan.
You do not have to accept this as the new normal. That is not what the research says, and it is not what I have seen in clinical practice for 30 years.
Not sure where to start?
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References
1. Brooks NA et al. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen content. Menopause. 2008.
2. Dording CM et al. A double-blind placebo-controlled trial of maca root as treatment for antidepressant-induced sexual dysfunction in women. Evidence-Based Complementary and Alternative Medicine. 2015.
3. Shin BC et al. Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complementary and Alternative Medicine. 2010.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
