Rediscovering desire during perimenopause

Women's Health

by Baylor Scott & White Health

Oct 1, 2024

From physical changes to mental fog to mood swings, the shifts in your hormones during perimenopause can affect almost every aspect of your life—and that includes your sexual well-being. So, if you feel like something’s off with your libido, it’s not just you. It could be a symptom of perimenopause.

“Sexual desire during perimenopause looks different for everyone,” said Dr. Angela Stoehr, an OBGYN on the medical staff at Baylor Scott & White Medical Center - Centennial. “But changes in the body during this stage cause some women to have a decrease in interest or enjoyment in sex. Other women may experience an increase, ups and downs, or no changes in their sexual desire.”

What is perimenopause?

Perimenopause is a phase leading up to menopause—which is defined as going a full year without a period. During this phase, you experience hormone shifts, including estrogen level fluctuations and decreasing progesterone. These hormonal changes can lead to irregularities with your period and a range of other symptoms.

“The majority of women reach menopause between the ages of 45 and 55, but perimenopause can begin several years before that,” Dr. Stoehr said. “It’s possible to notice perimenopause changes anywhere from a couple of years to up to 10 years before you enter menopause.”

How perimenopause affects libido: Hormonal shifts and emotional impact

If you’re experiencing perimenopause libido changes that are getting in the way of your sex drive, the causes could be multi-layered. Decreasing levels of hormones can directly affect your desire for sex or make it take more time for you to become aroused. But the physical, emotional and mental changes that come with perimenopause could also affect your feelings about sex, too.

Other factors that could lead to a decrease in sexual desire include:

  • Vaginal changes: During perimenopause, your vaginal tissue may become less elastic, or you may experience increased vaginal dryness. This can make having sex less comfortable and less enjoyable.
  • Emotional changes: Some women experience mood swings or increased depression or anxiety during the perimenopause transition, which can reduce desire.
  • Energy level changes: Common perimenopause symptoms like night sweats and sleep disruptions can lead to an increase in fatigue, leaving you feeling too tired for sex.
  • Self-image changes: A changing body and ongoing symptoms during perimenopause can affect confidence and the desire for sex.

7 tips to naturally boost libido during perimenopause

When it comes to boosting libido in perimenopause, you can take steps to take back control of your sexual desire and health. Several lifestyle changes and natural options may serve as low-libido remedies, helping you feel more like yourself.

  1. Combat vaginal dryness: If vaginal changes and discomfort are an issue, consider using a vaginal lubricant during sexual activity or a vaginal moisturizer on a routine basis outside of sex.
  2. Get moving: Exercise is a great way to boost your energy levels and mood, which can support sexual desire.
  3. Support pelvic health: Routine pelvic floor exercises help you strengthen the vaginal muscles and can improve blood flow.
  4. Control the temperature: Reduce the effects of hot flashes by adjusting the temperature, using fans or investing in cooling sheets or a mattress topper to keep things comfortable.
  5. Increase sex frequency: Increasing how often you have sex can actually support sexual desire by stimulating blood flow and keeping your vaginal tissues healthy.
  6. Stop smoking: Smoking may affect your hormone levels and reduce blood flow, which can contribute to issues with libido.
  7. Prioritize sleep: Practicing healthy sleep habits and getting the sleep you need help fight fatigue and give you more energy to spend doing what you enjoy—including sex.

Navigating the emotional and mental changes of perimenopause

Because the emotional and mental aspects of perimenopause can have a big impact on your sex drive, it’s important to find ways to support your mental and emotional wellness in perimenopause. Activities like mindfulness, meditation, yoga or other relaxation techniques may give you a place to address stress and recenter your focus.

Simply talking about these changes lets you better navigate them, too. Talk to close friends or family who may be going through a similar stage. Talk with your partner so you can figure out together what works best for you to boost sexual desire during this next phase of life. And if you need more support, talk with a professional who can guide you through your next steps.

“It’s important to acknowledge that the emotional, mental and sexual changes that you’re experiencing during perimenopause are valid and real,” Dr. Stoehr said. “You aren’t the only one going through this, and you have options to address your symptoms.”

When to speak to your doctor about perimenopause

Focusing on a healthy lifestyle and self-care go a long way in helping you feel your best during perimenopause. But it also helps to have the support of an OBGYN. If perimenopause symptoms are affecting your ability to enjoy any aspect of your day-to-day life—including sexual desire or something else—it deserves a conversation with your doctor.

“An OBGYN can help you understand your treatment options during perimenopause, including a healthy lifestyle and medications such as hormone replacement therapy,” Dr. Stoehr said. “With the right resources, you can make an informed decision about how to best care for your health now and into this next stage of life.”  

Start to conversation about perimenopause by scheduling an appointment with an OBGYN today.

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