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SYMPTOM · PERIMENOPAUSE

Low libido

Less desire, or desire that takes longer to arrive: a drop in libido affects a good many women in perimenopause, often in silence.

WHO IT AFFECTS
Up to 1 in 2 women in perimenopause
AVERAGE DURATION
Can vary a lot from one stage to the next
CAN LAST
Usually improves with a few targeted changes

Why it happens

Falling oestrogen and testosterone levels reduce sensitivity and can make sex less comfortable, especially if there's vaginal dryness. Tiredness, stress and the sleep problems of this stage also play a big part, sometimes more than the hormones themselves.

What tends to weigh most on desire

  • Build-up of tiredness and lack of sleep.
  • Stress and the mental load of daily life.
  • Vaginal dryness, which makes sex less comfortable.
  • Unspoken tension with your partner.

In the moment

  • Take your time, without putting pressure on yourself about the outcome.
  • Use a lubricant if discomfort is holding you back.
  • Talk about how you feel rather than keeping it to yourself.

Day to day

  • Set aside time alone with your partner, with no particular goal.
  • Make sleep and rest a priority: they have a direct effect on desire.
  • Move regularly, it helps circulation and overall energy.

Is low libido getting you down?

A healthcare professional can suggest solutions that suit you, hormonal or not, depending on what works best for you.

For information only. This does not replace a personalised medical assessment.

If several of these symptoms ring true, it's no coincidence.

Menopause isn't just about hot flushes. Symptoms can begin years before your last period and affect sleep, mood, energy, memory, weight and intimate health.

Click on a symptom to find out more.

Brain fog

You search for words, reread the same sentence twice, lose the thread mid-conversation. Nothing to worry about: your brain is simply running slower, with less glucose to fuel it as oestrogen levels fall.

Sleep problems

Asleep in ten minutes yesterday, wide awake at 3 a.m. today, for no reason. Progesterone, which helped you switch off at night, is in shorter supply, and deep sleep takes the hit straight away.

Anxiety

Stress that spikes over an email, a meeting, running ten minutes late. Oestrogen affects serotonin: when it yo-yos, everything feels heavier to carry than before.

Joint pain

Knees that creak as you stand up, hands that feel stiff in the morning. Cartilage loses its best anti-inflammatory ally as oestrogen falls, and you feel as if you are rusting up all over.

Hot flushes

A wave of heat rising from the chest to the face, lasting one to five minutes. Deprived of oestrogen, the thermoregulatory neurons in the hypothalamus narrow the thermal neutral zone: a few tenths of a degree are enough.

Palpitations

Your heart suddenly races, with no effort and no reason. Oestrogen also influences the nervous system that sets your heart rhythm. Alarming in the moment, rarely serious.

Mood swings

You laugh, and thirty seconds later you could cry or tell everyone where to go. Hormones rise and fall faster than before, and your mood follows, without warning.

Weight gain

Your tummy rounds out even though nothing on your plate has changed. Oestrogen redirects fat storage towards the abdomen, and your metabolism runs a little slower than before.

Vaginal dryness

A feeling of dryness, sometimes a little discomfort day to day. Tissues lose their natural moisture as oestrogen falls. It is a common symptom, and still too rarely talked about.

Irregular periods

One cycle shorter, another dragging on, a month skipped altogether. Ovulation becomes less regular as the ovaries slow down. It is often the very first sign of perimenopause.

Night sweats

Waking up drenched in the middle of the night, sheets to change, sleep cut short. It is the same hot flush as during the day, night-time edition, and it wakes you just as surely.

Pain during sex

Discomfort, sometimes real pain, during or after sex. Tissues thin as oestrogen falls, and what never used to be a problem can become sensitive.

Dry skin

Skin that feels tight, marks more easily and seems to have lost some of its bounce. Collagen declines with oestrogen, by up to 30% in the first few years after menopause.

Chronic fatigue

Tiredness that will not lift, even after a good night. Broken sleep, falling hormones: your body runs less efficiently, and you feel it from morning to night.

Hair loss

More hair in your brush, a parting that seems to be widening. Oestrogen used to extend its growth phase. Without it, the cycle shortens and each strand gets finer.