About this question
Written by Andrea Leijon, Founder of Temple
There is a biochemical war happening inside many women's bodies during menopause – and most of them don't know it. On one side: the hormones of desire (oestrogen, testosterone, oxytocin). On the other: cortisol, the primary stress hormone. When cortisol is chronically elevated – from work pressure, family demands, the mental load of daily life – the body's capacity to prioritise desire is systematically suppressed. Menopause makes this worse, not just because oestrogen is already falling, but because the hormonal fluctuations of perimenopause are themselves a stress on the system.
Cortisol and testosterone are both steroid hormones made from cholesterol. Some studies link high stress with lower testosterone, but in women the connection is not well established. What is better documented is that long-term stress is linked with lower sexual arousal in women, partly because it pulls attention away from sensation (Hamilton & Meston, 2013). For women in menopause, who are already experiencing a natural decline in testosterone, stress is worth looking at as part of the picture.
"The body that never rests never desires. Cortisol is not the enemy – but it was never designed to be your permanent state."
Acute stress and chronic fatigue operate differently, but they share a common endpoint for desire. Polyvagal theory, developed by Stephen Porges (2011), describes three states of the autonomic nervous system. The ventral vagal state – safety, connection, play – is where desire lives. Chronic stress and fatigue push the system into sympathetic activation (fight or flight) or dorsal vagal shutdown (conservation, numbness). The chronically fatigued woman is often in dorsal vagal territory: not anxious, but flat. Not avoidant, but without the energy that desire requires. Nervous system regulation work – specifically practices that move the system back into ventral vagal – is the most direct intervention available. Breathing, slow movement, time in nature, and physical safety all shift the system. Willpower does not.
The advice to 'reduce stress' is almost universally given and almost universally useless on its own – because it treats stress as an event rather than a physiological state. What moves the needle is building nervous system resilience: training the body to return to ventral vagal more quickly after stress activation. In Temple, we work with this through a combination of somatic practices (body-based, not talk-based) and an understanding of which specific stressors are affecting your system most. The goal is not zero stress. It is a nervous system that recovers.
The research in numbers
Frequently asked questions
Why does stress kill sex drive?
Long-term stress is linked with lower sexual arousal in women (Hamilton & Meston, 2013). The body prioritises survival functions over reproductive ones when under sustained threat.
Can reducing stress improve my sex drive in menopause?
Yes, meaningfully – particularly if chronic stress is a significant factor. The most effective approach combines physiological stress reduction (nervous system regulation practices) with addressing the specific stressors that are most activating your system.
What is the difference between stress and chronic fatigue in terms of sex drive?
Acute stress activates fight-or-flight (sympathetic nervous system), which is incompatible with desire. Chronic fatigue often activates dorsal vagal shutdown – a different nervous system state characterised by flatness and energy conservation. Both suppress desire, but they feel different and respond to different interventions.
My stress is unavoidable right now. Is there anything I can do for my sex drive?
Yes. Nervous system regulation practices – particularly slow, deliberate breathing and non-goal-oriented touch – can shift the body into ventral vagal even within a stressful life. Small doses of safety signal a lot to the nervous system. You do not have to resolve the stress completely to create windows for desire.
Is my low sex drive from stress or from menopause?
Often both – and they compound each other. Menopausal hormonal changes lower the baseline for desire, and chronic stress further depletes it. The combined effect is greater than either alone. Addressing both simultaneously is more effective than treating them sequentially.
Related articles
Sources: Hamilton, L.D. & Meston, C.M. (2013). Chronic stress and sexual function in women. Journal of Sexual Medicine, 10(10), 2443–2454. · Porges, S.W. (2011). The Polyvagal Theory. W.W. Norton. · van der Kolk, B. (2014). The Body Keeps the Score. Viking.