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Abstract Midlife female sexual function is often conceptualized as a uniform oestrogen-driven decline, yet convergent evidence from neuroendocrinology, intracrinology, vascular physiology, and sensory neuroscience suggests that sexual motivation and genital responsiveness follow asynchronous ageing trajectories regulated by multi-layer biological mechanisms in which oestrogen is only one factor. These divergent trajectories are not captured by existing models, which lack the mechanistic nuance to integrate motivational, cognitive-gating, and genital-tissue pathways into a coherent account of midlife sexual function. We propose the Drive–Capacity Model, a systems-biology framework in which Drive declines early due to neurochemical sensitivity to hormonal volatility, stress physiology, and age-related changes in reward and salience networks, while genital Capacity declines later as epithelial, stromal, and extracellular matrix remodelling gradually accumulates. A proposed cognitive-attentional gating layer, Access - mediated by prefrontal gain regulation and cholinergic–glutamatergic attentional networks–regulates communication between these systems by determining whether erotic cues enter and remain within motivational circuitry. The resulting Drive–Capacity Gap offers a mechanistic explanation for the common clinical presentation in which midlife women report diminished desire or difficulty initiating arousal despite intact lubrication, swelling, and orgasmic capacity. Although large cohort studies such as SWAN have described this dissociation, no prior framework has explained its underlying biology. The Drive–Capacity Model synthesizes previously fragmented findings into a coherent systems-level architecture and delineates diagnostic, therapeutic, and research trajectories grounded in the differential ageing of motivational, cognitive-gating, and tissue pathways. A clearer mechanistic framework is urgently needed to improve clinical assessment and guide more effective, biologically grounded interventions for the millions of midlife women whose sexual-health needs remain insufficiently addressed.