Perimenopause and loss of libido

During perimenopause, changing oestrogen and other hormones may affect arousal, comfort and genital response. Hot flushes, night waking and tiredness can leave less energy for intimacy. Pain or dryness can create worry about sex, which may further reduce desire. Loss of Libido can also occur with depression, Burnout, Hypothyroidism or Type 2 Diabetes, and some medicines can contribute.

There is no single level of desire that everyone should have. The key question is whether the change troubles you, causes pain or affects a relationship. You do not need to accept discomfort as an unavoidable part of ageing.

Note when desire changed, whether sex is painful, any dryness or bleeding, sleep quality, mood, medicines and contraception. A clinician can check for vaginal or hormonal concerns and discuss lubricants, moisturisers, counselling, relationship support or other treatment choices. Avoid fragranced products that irritate sensitive skin.

Talk with a partner about comfort, pace and forms of intimacy without pressure. Allowing more time for arousal and stopping when there is pain can protect comfort and trust.

Arrange an appointment if reduced desire persists, causes distress, follows a medicine change, or comes with pain, marked mood change, unusual discharge or bleeding after sex. Seek prompt care for severe pelvic pain, heavy bleeding, fever or sudden serious illness. Urgent mental-health help is needed for thoughts of self-harm.

Could dryness, pain, mood, medicines or another condition be affecting my desire? Which options are suitable with my medical history? Should I have an examination or blood tests?