How can libido be increased during perimenopause?

Barbara J. Depree, MD
OBGYN (Obstetrics & Gynecology)
Libido or sexual desire is a complicated issue at most ages/stages of life, so it isn't surprising that it may be more challenging in perimenopause. The primary hormones from the ovary are estrogen and progesterone, which are produced cyclically with changing levels daily throughout the cycle. In perimenopause there are more dramatic shifts in the hormones of estrogen and progesterone, and this may be a contributing factor to a change in lbido. Testosterone in women comes from adrenals and ovaries and is not as variable from day to day. Actually, it is quite stable, peaking about age 25 and slowly falling as we age. We estimate that a 50 year old woman has about 50% of the testosterone she once had at its peak in her mid-20s. While hormones play a role in libido (estrogen and testosterone, probably less so with progesterone), there are many other factors. 

Some contributors to desire problems:
  • Hormones
  • Lack of privacy
  • Past history of disappointing sex
  • Fatigue/illness
  • Medications
  • Relationship discord
  • Absence of emotional intimacy
  • Negative body image
Do any of these sound like you? While it is always important to consider medications and their side effects, and also hormones, most often the relationship is the most important element here. And remember....novelty is important. Try to insert some new elements to this aspect of your relationship. Be creative!

And incorporate mindfulness, keep sex on the list, plan for it and act on it regularly. Waiting for an 'urge' is less and less likely to happen as we get older.  

There are some medications that are used off-label for treatment of libido with mixed results. We are still awaiting FDA approval of some products as well. To date, there are no FDA-approved products to improve women's libido. Stay tuned, we remain optomistic that some day soon that may change.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)

During perimenopause erratic levels of hormones often contribute to a lower libido.


  • First, recognize that a woman’s libido is influenced by many factors beyond hormonal changes including stress and fatigue.
  • Investigate sex therapy.
  • Don’t neglect your biggest sex organ - the brain.
  • Change your routine to add increased desire.
  • Try a local hormone therapy like an estrogen cream.
  • If you’re experiencing vaginal dryness, use an over-the-counter vaginal lubricant or try olive oil to make sex more comfortable.
  • Ask your partner to spice up your sex life with Dr. Mehmet Oz’s (Vice-Chair and Professor of Surgery at Columbia University) National Sex Experiment.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.