How Perimenopause Affects Sex Drive

This editorial series, S-E-X, is brought to you by the Fort Worth Moms Blog and Andrea Palmer, MD FACOG with Fenom Women’s CareOur friends at Women’s Health Services sponsored and crafted this blog post for the S-E-X editorial series, and explained how perimenopause affects the sex drive. All 15 original articles from the S-E-X series can be found on our website.

You can’t fall asleep most nights, you’re exhausted at work, you feel irritable and depressed, and you have absolutely no sex drive. What gives? Should you chalk this up to job burnout? Family stress? Financial issues?

It could actually be from something completely normal and natural: perimenopause.

s-e-x series by dr. palmer and fenom 800 x 800

Perimenopause, also called menopausal transition, occurs several years before menopause. It’s the period when your ovaries gradually make less estrogen. The average length of perimenopause is four years, but this stage can last just a few months or continue for 10 years for some women. Women usually start perimenopause in their 40s, but it can also begin in their mid-30s or earlier.

Irregular periods are often the first noticeable sign of perimenopause. Other symptoms include:

  • hot flashes
  • sleep problems
  • fatigue
  • vaginal and bladder problems
  • mood changes
  • loss of sex drive

How Does Perimenopause Affect Sex?

Going through perimenopause doesn’t mean your libido will go away completely, but it will likely decrease considerably. And if you had difficulties with sex in your relationship before perimenopause, these issues may worsen.

Okay, So Why Do I Have a Lower Sex Drive?

During perimenopause, your body goes through several changes, which can cause your libido to decrease. These include hormonal causes and emotional causes. Hormonal causes include lack of ovulation, decrease in progesterone, lower estrogen levels, and testosterone imbalance.

Ovulation might not occur every month and progesterone levels drop, and so your body might not react with the same sexual desire. Estrogen levels also decrease, which can lead to vaginal dryness, thinning of vaginal walls, and vaginal atrophy, which can make vaginal intercourse painful. Estrogen also plays an important role for normal sexual response and orgasm, and so you might not feel the same pleasure from physical touch and intercourse. Testosterone levels can also become imbalanced during perimenopause, which decreases sex drive and reduces vaginal lubrication.

Emotional causes, such as mood swings, depression, fatigue, and exhaustion, can also affect your desire for intimacy and sexual intercourse. Hot flashes can also prevent you from having a good night’s sleep, and being physically exhausted can decrease your sex drive.

So What Can I Do?

You should talk with your doctor to request tests to find out if you’re experiencing perimenopause. Some available methods to help increase libido include estrogen, testosterone, testosterone creams, Vitamin E, and personal lubricants.

Communication with your partner is also important during perimenopause. It’s important to let your partner know what to expect and what you’re going through. Talk about other ways to be intimate and to keep your relationship healthy and strong. The support of your partner can make coping with the changes easier and redefine your relationship.

Womens Health Services sponsoredAll Women’s Health Services physicians are board-certified. The doctors are skilled in managing all aspects of women’s health care, including normal and high-risk pregnancy, gynecologic surgery, incontinence treatment, annual exams, and contraceptive and hormone therapy. They are dedicated to taking care of female patients from adolescence through menopause. Their goal is to provide quality care with high patient satisfaction.


  1. It’s important to know that if your doctor puts you in birth control pills as a solution to lack of hormones from perimenopause that this can be a serious sex drive killer. No one seems to acknowledge what birth control can do to sex drive.


Please enter your comment!
Please enter your name here