Libido during perimenopause: what to expect and how to support it

If you’ve noticed shifts in your sex drive as you approach menopause, you’re not alone. Many women experience dips (and sometimes surprising surges) in libido during perimenopause. This transition is driven by fluctuating hormones, but it’s not just biology: stress, relationships, and how you feel about your body all play a role.

The important thing to know is that changes in libido are normal, and there are ways to support your sexual wellbeing.

Table of contents

1. Hormones and sexual desire

2. Emotional and lifestyle factors that play a role

3. Ways to support your libido in perimenopause

4. When to seek extra support

Hormones and sexual desire

Your hormones are powerful messengers that directly influence libido.

• Oestrogen: As oestrogen levels drop, vaginal dryness and thinning of tissues can make sex less comfortable, which can indirectly decrease your libido.

• Testosterone: Often thought of as a “male” hormone, it’s actually crucial for women too. Lower levels of testosterone can reduce sexual interest and arousal.

• Progesterone: Declining levels may change mood and sleep, which also influence how “in the mood” you feel.

Emotional and lifestyle factors that play a role

Libido isn’t just physical: it’s deeply connected to your emotional state. Stress, fatigue, self-esteem, and relationship dynamics can all impact desire. Even practical things like poor sleep (a common perimenopause symptom) can make intimacy feel less appealing.

Ways to support your libido in perimenopause

1. Prioritise vaginal comfort: Moisturisers, lubricants, or local oestrogen treatments (if advised by your doctor) can make intimacy more enjoyable again.

2. Look after your overall health: Exercise, balanced nutrition, and good sleep all support hormone balance and energy, which feeds into sexual wellbeing. Nutrients like vitamin D, B vitamins, and zinc may also help support hormones linked to libido.

3. Nurture emotional connection: For many women, feeling connected, safe, and desired is as important as physical changes. Small acts of intimacy - touch, cuddles, shared laughter - can help.

4. Explore new ways of intimacy: Your sex life doesn’t have to look the same as it did in your twenties. Exploring different types of touch, longer foreplay, or using toys can make intimacy more fulfilling.

When to seek extra support

If low libido is causing distress or affecting your relationship, it’s worth talking to a healthcare professional. Sometimes underlying issues like thyroid problems or medication side effects can play a role. A women’s health doctor can help you explore treatment options, from hormone therapy to lifestyle strategies tailored to you.

Key takeaways

• Libido changes are common in perimenopause due to shifting hormones, but emotional and lifestyle factors matter too.

• Oestrogen, testosterone, and progesterone all influence sexual desire.

• Supporting vaginal comfort, overall health, and emotional intimacy can make a real difference.

• Low libido is nothing to be ashamed of - help is available if it impacts your wellbeing.

References:

Chalise, G. D., Shrestha, S., Thapa, S., Bharati, M., Pradhan, S., & Adhikari, B. (2022). Health Problems experienced by Peri-menopausal Women and their Perception towards Menopause. Journal of Nepal Health Research Council, 20(1), 102–107. https://doi.org/10.33314/jnhrc.v20i01.3891

Tiwari, M., Acharya, N., & Mahakarkar, M. (2025). Navigating the Vaginal Milieu During Perimenopause: A Narrative Review of Physiological Changes and Clinical Implications. Journal of pharmacy & bioallied sciences, 17(Suppl 1), S92–S95. https://doi.org/10.4103/jpbs.jpbs_1493_24

Nguyen, T. T. P., Phan, H. T., Vu, T. M. T., Tran, P. Q., Do, H. T., Vu, L. G., Doan, L. P., Do, H. P., Latkin, C. A., Ho, C. S. H., & Ho, R. C. M. (2022). Physical activity and social support are associated with quality of life in middle-aged women. PloS one, 17(5), e0268135. https://doi.org/10.1371/journal.pone.0268135