One year into her second marriage, television anchor and podcaster Tamsen Fadal asked her husband what he wanted for Christmas. His playful response was, “I just want you, tied up in a big, red bow.” Taking the request to heart, Fadal decided to surprise him. “I found a big red bow, wrapped myself up naked, and there I was,” she recalls.
The following Christmas, when her husband, Ira, expressed a desire for the same whimsical gift, Fadal’s reaction was quite different. “You’re crazy,” she told him in an interview with the Daily Mail. “All I wanted to do was stay in bed and watch Netflix.”
At 51, Fadal was experiencing menopause, which had dramatically impacted her hormones and extinguished her libido. “I really loved my husband,” she shared, “but it wasn’t just ‘not tonight’—I had completely stopped thinking about sex.”
She described the change as a sudden shift, where everything felt muted, as if someone had turned down the volume on her life. This lack of energy affected her ability to exercise and even impacted her passion for her beloved career in the newsroom.
Fadal is also the author of the New York Times bestseller, “How to Menopause: Take Charge of Your Health, Reclaim Your Life, and Feel Even Better Than Before,” where she offers guidance for navigating this life stage.
A 12-time Emmy award-winning journalist and producer and anchor of PIX11 News in NYC, she lives with her TV executive husband Ira Bernstein between New York City and Santa Monica.
Now 55, she is making it her mission to tell the truth about menopause to other midlife women – and to empower them so they don’t have to suffer the way she did.
She is part of a burgeoning, and starry, movement to demystify and destigmatize it. Halle Berry, Naomi Watts, Drew Barrymore, Gwyneth Paltrow and Cameron Diaz have all become champions of menopause awareness and products designed to help ease the symptoms which sometimes accompany it.
At the age of 51, Tamsen Fadal no longer had energy for exercise, or for the career in the newsroom she loved so much
She lives with her TV executive husband Ira Bernstein between New York City and Santa Monica
At the point her libido crashed, Fadal was already taking estrogen and progesterone for her menopause. ‘It had taken me a long time to start on these hormones,’ she said. ‘Even in my early 40s, no-one was talking about the menopause. Maybe there were jokes about “hormones” or “The Change” – which you weren’t allowed to mention.
‘But because I lost my mom to breast cancer when I was 20 and she was 51, it was never a conversation in my family. I’d certainly never heard the word “perimenopause.”‘
Perimenopause, or ‘around menopause,’ is the period when a woman’s hormones start to fluctuate, starting in her 40s, sometimes earlier. A woman is officially in menopause when she goes 12 consecutive months without a period.
‘Even though I worked in news, I had no understanding of menopause at all,’ said Fadal.
In her mid 40s, Fadal started to feel anxious, muddle-headed, constantly waking up at 3am and unable to go back to sleep.
She went to see her doctor, who prescribed her Lexapro, an antidepressant. ‘I later looked back at my notes, which said “patient complaining of weight gain and moodiness,”‘ said Fadal. ‘So many of us have been there: sitting in a doctor’s office, feeling dismissed and handed a prescription for antidepressants, when the real issue is menopause.’
Matters finally came to a head in 2019, when, after weeks of poor sleep and brain fog, Fadal had a debilitating episode in the middle of a broadcast. ‘I felt a hot blast from inside, an epic eruption that superheated the surface of my skin,’ she said. ‘I thought I was going to fall over. In the commercial break, I went and laid down on the cool floor of the bathroom, germs be damned. “What is this?” I thought.’
Fadal went to see her OBGYN. ‘Later, I visited the patient portal to find the words: “in menopause: any questions?” written there,’ she said. ‘And that is how I found out. I was mortified: I didn’t understand – I was only 48. How could this be menopause?’
She started visiting doctors to discuss hormone therapy (HT) with them and was prescribed estrogen and progestogen.
This combination helped Fadal at first. ‘I started sleeping again, the hot flashes resolved and I started feeling like myself,’ she said. ‘But then, two years in, I noticed my drive and libido had gone through the floor.’
Always keen on fitness, Fadal now found herself reluctant to work out. ‘I used to get up super-early to exercise, but during that year I had nothing,’ she said. ‘I felt sluggish and went from a regular gym-goer, to only going once a week – even finding any excuse to get out of that, to stay in bed.’
In her mid 40s, Fadal started to feel anxious, muddle-headed, constantly waking up at 3am and unable to go back to sleep
And so, Fadal decided to seek medical guidance once more. ‘Now what? I thought,’ she said. ‘What’s wrong with me?’
It took a while for Fadal’s new concerns to be taken seriously. Her first doctor – a woman – suggested Fadal see a sex therapist. ‘She made me feel that there was something wrong with me – that it was a psychological disorder to want sex,’ she said. ‘I later discovered this isn’t that uncommon – there is a feeling that (unlike with men) sex is a luxury. Women aren’t talking about it enough, and this has to change.’
Meanwhile, during conversations with doctors and friends, Fadal started to hear mentions of testosterone therapy as part of menopause treatment. ‘I didn’t know much about testosterone,’ she said. ‘I thought, “That’s for guys.” All I could think about was these huge, grunting men, with their sweaty muscles and no hair. I wasn’t even aware that women had testosterone in their bodies: I thought estrogen was in the female column and testosterone in the male column.’
But having Googled and overcome her fears of getting ‘acne, male pattern baldness and an Adam’s apple,’ Fadal came to understand that testosterone is part of a woman’s normal hormonal make-up: vital for drive and libido.
In 2023, at the age of 52, she visited a new doctor who gave her a blood test revealing she had zero testosterone in her body. (Normal testosterone levels for women are typically between 15 and 70 nanograms per deciliter).
‘This doctor was happy to talk to me about testosterone, and she gave it to me in the form of pellets, which were implanted in my hip,’ she said.
The problem was that this method worked perhaps too well – and then not at all. ‘For two months I was crawling all over my husband, attacking him,’ said Fadal. ‘Then my libido just crashed. One night he reached for me in bed, and I said, “Get away from me.”‘
She finally saw a new OBGYN who ‘didn’t treat me like there was something wrong with me and was willing to talk the subject through properly.’
After some trial and error, Fadal found her balance.
She now takes a daily pea-sized dollop of testosterone gel, which she rubs into the back of her leg every morning. ‘I had heard of people overdoing it – if you take too much, side effects can include palpitations or growing new hair, but these have never happened to me,’ she said. ‘My advice is: follow the rules.’
Fadal is a 12-time Emmy award-winning journalist and producer and anchor of PIX11 News in NYC
Fadal is the author of the New York Times bestselling How to Menopause: Take Charge of Your Health, Reclaim Your Life, and Feel Even Better Than Before
For Fadal, testosterone has been a ‘game-changer.’ ‘A few weeks after I started treatment, something in my brain clicked back on,’ she said. ‘My libido and energy came roaring back. These days, I’m more energetic: I want to have sex, and to think about having sex. I went from hating the gym to being back in the gym.’
And she’s certainly active, walking an hour and a half before work every day, strength training in the gym three times a week, plus a session of yoga or Pilates on weekends.
‘All this is great for my mind and body,’ she said. ‘Being on testosterone has certainly helped the definition come back into my arms and my body is much closer to its pre-menopause state. No, I’m not going to be 25 or 35 again but, in some ways, I feel better than I did then. The most important thing is that I’m in control of my body. I’m doing great: I’m back, baby!’
What would she say to midlife women who find themselves in the same position, exhausted, sleeping badly and with no libido?
‘When it comes to your menopause – whether it’s HT in general, or testosterone in particular – the most important thing is to get educated and take control,’ Fadal said. She believes that all women of menopausal age should insist on a proper hormone test from their OBGYN.
‘Don’t accept it when your doctor says they “can’t do it” or they “don’t understand,” she said. ‘Don’t give up. Don’t think there aren’t solutions – because there are.’
