The book arrived in record time, was nicely presented and signed by the author. Wonderful read too!
Before Your Appointment
FreeTwo pagesPrintable
Consultation pack
Fill it in · Bring it · Hand it over
Before your appointment.
Desire, menopause, and what to ask. Two pages that organise what you have noticed into the format doctors use, so you do not have to find the words in the room.
Download the printable version →
Free, no email required. Or fill it in below and print the page.
How to use it
It is not a diagnosis. It is a translation.
Most appointments about this go wrong for the same reason: ten minutes is not long enough to explain something you have never had to describe out loud before.
This organises what you have noticed into the structure a clinician is already working from, so the consultation starts several steps further along. Fill it in beforehand, bring it, and hand it over rather than reading it aloud.
The guidance below is Australian. The underlying condition is recognised internationally, but what is approved and how it is prescribed differs by country. If you are elsewhere, the questions still work and the specifics may not.
Page one · Your summary
A. What has changed.
Reduced or absent desire over several months, together with real distress, is what clinicians look for. Distress is the part that matters, and the part most often left unsaid.
My desire has been
For roughly, in months
It bothers me: a little, somewhat, or a great deal
It started: gradually with menopause, after an event, or it has always been this way
B. What I have already considered.
Clinicians are guided to screen these first, because each can drive low desire on its own and hormones will not fix them.
- Relationship difficulties
- Anxiety or low mood
- Body image
- A history of assault or abuse
- Untreated menopausal symptoms, such as sleep, flushes or vaginal dryness
- Medications that can lower desire, including antidepressants and anti anxiety medicines
- Pain with sex
- None of these apply
C. What I am currently taking.
Menopausal hormone therapy: type, dose, since when
Vaginal oestrogen
Other medicines
Supplements
D. What I want from this appointment.
- To understand whether what I am experiencing has a name
- To know what treatment options exist
- To discuss whether a trial of testosterone is appropriate for me
- A referral to someone who specialises in this, if you do not
Page two · The conversation
What the Australian consensus says.
Around one in six women in and after menopause meet the criteria for a recognised condition of low desire with distress.
The Australasian Menopause Society position, published in April 2026, supports one treatment for it: a female specific, regulator approved, non oral testosterone product, for postmenopausal women.
Prescribing is based on symptoms and distress, never on a blood level. No number defines deficiency, and a normal result does not rule the condition out.
Five questions to ask.
Based on what I have described, do I meet the criteria for hypoactive sexual desire dysfunction?
What contributing factors would you want to rule out or address first?
Is a trial of testosterone appropriate for me, and if not, why not?
What baseline tests would you run before starting? The consensus suggests total testosterone and sex hormone binding globulin, mainly to exclude an unexpectedly high starting level. A free androgen index is not recommended.
What would a fair trial look like, and when would we decide it has not worked?
If you start
What a fair trial looks like.
From the consensus. Write the dates in as you go.
Three weeksA level checked to confirm you are in range, not above it.
Date
Four to six weeksAny effect usually begins to emerge.
Date
Twelve weeksA formal review of whether it is helping.
Date
Six monthsIf there is no meaningful improvement, stop.
Date
OngoingSix monthly review if you continue.
Date
Worth knowing
What the evidence does not support.
The consensus does not support testosterone for low mood, fatigue, brain fog, muscle, bone, or general wellbeing.
If those are your main concerns, this is not the treatment for them, and a good doctor will say so. It also advises against male gels, compounded creams, oral testosterone and pellets.
If you meet resistance
Two things to say.
If you are told it is normal at your age
"I understand it is common. It is also distressing me, and I would like to know what options exist. If you are not comfortable prescribing, could you refer me to someone who is?"
If you are told the practice does not do this
"The Australasian Menopause Society published guidance on this in April 2026. Could we look at it together, or could you refer me to a menopause specialist?"
Educational material for discussion with your own doctor. Not medical advice, and not a recommendation to start any treatment. Source: Australasian Menopause Society information sheet for health professionals, Davis, April 2026.
Related
If this is the conversation you are having.
Find your stagePerimenopause, menopause and postmenopause need different things.
What perimenopause doesThe mechanism, and why the pattern goes unnamed for years.
It is not just drynessThe symptoms that never settle on their own.
The Midlife courseEight modules covering comfort, desire and treatment. $297.
Before your appointment
Take it with you.
Two pages, free, and no email required. Print it, fill it in, and hand it over.
Download the printable version → Or see all eight free tools →
Education first · Not medical advice