A Nutritionist’s Guide to Low Libido in Perimenopause

Let’s talk about something many of my clients initially find difficult to discuss – changes in sex drive during perimenopause. As a clinical
nutritionist, I’ve sat with countless women who share their concerns about decreased libido, and I appreciate the courage it takes to have
these conversations.

Common Questions about Libido in Perimenopause:

Real questions from real women in our practice:

“Is this a perimenopause thing or is it just me?!”

I hear this question at least once a week. So many women experience changes in their sex drive during perimenopause. You’re part of a large community going through similar changes.

“Is low libido common in perimenopause?”

Changes in sexual desire affect many women (and men) at various points in their life. While perimenopause is not the only cause of changes in libido, it is commonly experienced by women in perimenopause. The hormonal shifts occuring at this time can have a significant impact on our feelings towards sex, intimacy & masturbation.

“Why can’t I orgasm in perimenopause?”

This question is a really important one. While orgasms aren’t the be-all and end-all when it comes to experiencing sexual pleasure, they are a really important part of sex for many of us.

During perimenopause there are a lot of hormonal changes occuring – this can lead to changes in blood flow to the vulva & clitoris, hence affecting tissue sensitivity. This can affect how our bodies respond to sexual stimulation. 

If you’ve noticed changes in your ability to orgasm, talk to us! Herbal medicine and some dietary interventions may be able to help.

“How do I explain low libido to my partner?”

This conversation can feel daunting. Consider sharing what you’re learning about perimenopause and its physical effects. Many couples find that understanding the biological aspects helps them navigate this transition together and find what works for them as a couple. Having open conversations about sex and sexual pleasure is really important.

Understanding What’s Happening with your libido

Sexual desire involves your entire system – physical, emotional, and mental. During perimenopause, you might be juggling intense work demands, family needs (perhaps including both kids and ageing parents), and significant bodily changes. It’s a lot to handle.

Your libido actually tells you important things about your overall health. Changes in sex drive can signal areas that might need attention, from cardiovascular health to emotional well-being.

Physical Changes and Their Effects

The hormonal shifts of perimenopause affect blood flow and tissue health in your genital area. This can lead to sensitivity changes and sometimes discomfort. While challenging, various approaches can support these changes, including specific dietary choices and changing things up in the bedroom to make sex more comfortable and enjoyable for you.

Medical Support Options for Low Libido in Perimenopause

While this guide focuses on nutritional support, testosterone therapy has shown benefits for some women experiencing low libido during perimenopause. This requires thorough testing and a prescription from your healthcare provider. Each woman’s situation is unique, and what works for one person may not suit another. Your GP can help you with this.

Dietary Changes to improving your libido & sexual satisfaction in Perimenopause:

Healthy Fats for Healthy Hormones –

Your body needs healthy fats for hormone production and natural lubrication. Here’s what works:
● Fatty fish like salmon and mackerel (2-3 servings weekly, choose wild caught fish where possible)
● Chia seeds (1-2 tablespoons daily)
● Ground flaxseeds (2 tablespoons daily)
● Walnuts (a handful daily)
● Extra virgin olive oil
● Avocado
● Various nuts and seeds

Foods That Boost Blood Flow –

Better circulation means improved sexual response & pleasure. Include foods such as:
● Berries, citrus, kiwi
● Dark leafy greens
● Watermelon
● Dark chocolate (yes, really – just keep an eye on the sugar content!)
● Pumpkin seeds
● Chickpeas

Supporting Hormones in Perimenopause –

Certain foods stand out when it comes to nurturing hormonal balance during perimenopause. Include:

• Fermented soy foods like tempeh or miso once or twice a week – these contain beneficial compounds called isoflavones that can help ease menopausal symptoms.
• Ground flaxseeds are another powerhouse – aim for 2 tablespoons daily in your smoothie or breakfast, as they contain lignans that support vaginal health and natural lubrication (make sure you grind them fresh, pop them in a sealed container in the fridge for up to one week).
• Fresh apples deserve a special mention, too – research shows eating one daily can improve sexual function thanks to their unique combination of polyphenols and quercetin, which support healthy blood flow and reduce inflammation.

Let’s Talk Lubrication in Perimenopause –

Sometimes, dietary changes aren’t enough, and that’s perfectly fine. Here are products Katie Blakely Wellness trusts and recommends:

Oil-Based Lubricant:

Olive & Bee Lubricant

• Natural ingredients that work
• Feels comfortable
• Vaginal microbiome friendly
• Designed by a pelvic floor physio-therapist
• Can be used as an intimate cream to help with vaginal dryness, meaning that it’s not just useful for sex
• Extremely soothing

Remember: Don’t use with condoms as oil based lubricants can cause condoms to ‘break’ or be inaffective.

Water-Based Lubricant:
Bed Intentions Lubricant

• Safe with condoms
• Gentle ingredients
• Works well for sensitive skin
• Feels amazing – just like your own naturally occuring vaginal lubricant
• Vaginal microbiome friendly

Other Factors That May Be Influencing Your Libido in Perimenopause:

While nutrition can be a big factor influencing your libido, it doesn’t always paint the whole picture. Other considerations for supporting your libido include:

• Finding ways to manage stress that work for you
• Finding joy and purpose in your life
• Getting enough rest (easier said than done, I know)
• Staying hydrated
• Moving your body in ways that feel good (there’s some great research behind exercise supporting libido in women)
• Making sure that the type of sex you’re having is the type of sex that you want to have and that you enjoy – with consent of course (ie. make sure you’re communicating with your partner, exploring new things, getting your needs met – not just meeting someone else’s needs)
• Knowing your own body – enjoying yourself through masturbation and self-exploration, if that’s something that feels good for you
• It’s also important to get a blood test checking iron, thyroid & B vitamin levels

A Final Thought

Your experience with sex and desire during perimenopause is uniquely yours. There’s no standard timeline or “right” level of libido. What matters is how you feel and what you want for your life and relationships.
Supporting your body with good nutrition during this time isn’t about “fixing” anything – it’s about giving yourself what you need to feel your best, whatever that means for you.

More than just one on one:

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