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Libido and PMS
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Summary
Libido naturally ebbs and flows across the menstrual cycle. During the luteal phase, lower oestrogen and testosterone – plus common PMS and PMDD symptoms like fatigue, anxiety, headaches, and vaginal dryness – can dampen desire or make sex uncomfortable. Some people notice spikes linked to relief or sensitivity changes. This guide explains the hormonal drivers behind changes in sex drive before your period, other influences including stress, medication, mental health, pregnancy, age, and trauma, why there is no single normal, and practical ways to respond to changes in libido during PMS and PMDD.
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🌿 Key takeaways
Libido, sex drive, and PMS: what to know
- There is no such thing as a normal sex drive – what matters is understanding your own patterns across your cycle
- During the luteal phase, lower oestrogen and testosterone can reduce libido, while PMS symptoms like fatigue, bloating, and anxiety make sex feel less appealing
- Some people experience increased desire before their period due to sensitivity changes, hormonal shifts at the start of the next cycle, or the pain-relieving effects of sex
- Stress, medication, mental health, age, and trauma can all influence sex drive independently of PMS
- Practical steps including communication, lubrication, and adjusting positions can help, and clinical support is available when needed
- Pain during sex is never something to normalise – if it persists, speak to a healthcare professional
What is a typical sex drive?
There is no such thing as a normal sex drive. How much we want to have sex depends on many things, including lifestyle, health, stress levels, the psychology of a relationship, and much more. The only normal that matters is your own. No one should ever make us feel like we are having too little or too much sex – our bodies, our choice.
When we notice a change in our libido, it can feel worrying. Libido and sex drive both describe our desire for sex, and healthcare providers are increasingly recognising the importance of libido as an indicator of general health and quality of life. Our libido is known to fluctuate throughout the menstrual cycle – specifically, it tends to increase just before ovulation. But what happens to libido during PMS and PMDD?
🌿 Good to know: Tracking your libido alongside your PMS symptoms across a few cycles can help you identify your own patterns and understand what is normal for you. Use The Evelyn Premenstrual Health Tracker to get started.
Low sex drive and PMS
Around one in three people experience low sex drive at some point. For people with PMS and PMDD, hormone fluctuations and physical symptoms can interfere significantly with the desire to have sex.
The hormonal picture in the luteal phase
During the luteal phase – the second half of the menstrual cycle – hormones shift in ways that directly affect libido.
- Oestrogen is known to increase libido – it raises sexual desire, increases sensitivity in the breasts and nipples, and promotes vaginal lubrication. In the luteal phase, oestrogen levels are predominantly low, which can reduce or eliminate these feelings.
- Testosterone also has a positive effect on libido and is at its highest around ovulation. It drops during the luteal phase, which can reduce sexual desire in the weeks leading up to a period.
- Progesterone rises in the first half of the luteal phase. It does not directly reduce libido, but the PMS and PMDD symptoms it is associated with – including fatigue, headaches, bloating, depression, and anxiety – often do.
🧠 In simple terms: Without high enough levels of oestrogen, the body may not produce enough natural lubrication or arousal signals. Combined with the fatigue, mood changes, and physical discomfort of PMS, it is completely understandable if sex feels like the last thing on your mind before your period.
How PMS symptoms affect libido
Beyond hormones, the physical and emotional symptoms of PMS and PMDD can make sex feel difficult, uncomfortable, or unappealing.
- Breast tenderness and bloating can make being touched or intimate painful
- Changes in discharge and vaginal dryness can make penetrative sex less comfortable
- Fatigue and disrupted sleep often lead people to prioritise rest over intimacy
- Low mood, anxiety, and withdrawal can make emotional and physical intimacy feel harder to access
- Skin changes and bloating can affect body confidence and reduce the desire to be intimate
⚠️ Worth noting: A reduction in sex drive during the luteal phase is a normal and common experience. It does not mean something is wrong with you or your relationship. Recognising the hormonal pattern is the first step in responding to it with kindness toward yourself.
High sex drive and PMS
On the other hand, some people notice an increased sex drive during PMS or in the days just before their period. This can happen for a number of reasons.
Hormones
While oestrogen is predominantly low during the luteal phase, it begins to rise again as the next cycle starts. For some people, this hormonal uptick in the final days before their period may trigger an increase in desire. Additionally, testosterone is at its highest around ovulation and in the early luteal phase, which may mean libido remains elevated for some people in the first half of the second phase of their cycle.
Sensitivity changes
For some people, the bloating associated with PMS can actually put pressure on the G-spot and vulva, making them feel more sensitive and increasing arousal or enjoyment of sex. This is not universal, but it is a recognised experience for some people with PMS.
Symptom relief
Sex can actually help relieve some PMS and PMDD symptoms, which may increase the desire for it. Multiple studies have found that sex is an effective pain relief mechanism. One study found that PMS-related headaches specifically can be eased by sexual activity, most likely through the release of endorphins. For some people, the positive association between sex and symptom relief may increase their desire for it in the luteal phase.
🧪 What the science says: Research suggests that sexual activity can trigger the release of endorphins, oxytocin, and dopamine – chemicals that can reduce pain perception, improve mood, and ease tension. For some people with PMS, this makes sex a genuinely helpful way to manage symptoms before a period.
Other reasons for a change in sex drive
A change in libido can be caused by many things beyond the menstrual cycle. The following is not an exhaustive list, but covers some of the most common factors.
Causes of decreased sex drive
Medication
Research has found that up to 43% of people experience a reduction in libido when taking hormonal contraception, compared to 12% of those on non-hormonal contraception. Many people taking SSRIs also report decreased libido as a side effect. Always speak to your GP if you think medication is affecting your sex drive.
Mental health and stress
Depression and anxiety not linked to PMS can lower libido and impede sexual function. High stress levels can also prevent the body from producing enough natural moisture, making sex less comfortable and therefore less desirable.
Pregnancy and family life
Pregnancy changes hormone levels and body image in ways that can reduce desire. After a baby arrives, disrupted sleep and the demands of a newborn can leave little room for intimacy. Even without pregnancy, chronic fatigue can significantly reduce sex drive.
Past trauma
Survivors of sexual assault or people with past trauma may find it difficult to be intimate and as a result desire sex less. Certain injuries or surgeries can also affect libido through discomfort or pain.
Age
Between the mid-30s and early 60s, adrenal androgen production reduces by about two-thirds. The main androgen is testosterone, and lower levels are thought to reduce libido. With age, vaginas also tend to produce less natural lubricant, potentially making sex less comfortable.
Causes of increased sex drive
New relationships
At the beginning of a relationship, the excitement of discovery and novelty often increases desire and arousal.
Self-confidence
When we feel good about ourselves, we are more likely to feel confident being intimate. Working on self-confidence and a positive body image can improve sexual response.
Exercise
Research suggests exercise can increase libido by stimulating the sympathetic nervous system, releasing hormones and enzymes that increase sexual desire, improving mood and reducing stress, and supporting positive body image.
Pregnancy
While pregnancy reduces libido for some, it can increase it for others – particularly in the second trimester.
HRT
People taking hormone replacement therapy (HRT) for perimenopause or menopause may find an increase in sexual desire as oestrogen (and sometimes testosterone) levels rise as a result of treatment.
Age and experience
One study found that women between 30 and 34 reported feeling more sexually active during this period – as greater confidence, experience, and self-knowledge can increase desire even as hormone levels shift.
Pain during PMS and sex
In the UK, around 7.5% of women report pain during sex, also known as dyspareunia. There are many reasons why sex might be painful, including sexually transmitted infections or underlying conditions such as:
PMS symptoms can also contribute to pain during sex. Vaginal dryness, breast tenderness, headaches, cramps, and joint and muscle aches can all make intimacy uncomfortable. Additionally, just before a period, the cervix sits lower and closer to the vaginal wall, which can make penetration more uncomfortable.
⚠️ Important: Painful sex is never something to normalise. PMS-related discomfort during sex should ease once your period arrives. If pain persists or becomes severe at any time in your cycle, please speak to a healthcare professional to rule out underlying conditions.
What can I do if I am concerned about my PMS and libido?
It is really important to know your body – what normal looks and feels like for you, what you find enjoyable, and how to fulfil your desires and needs. When something changes, start by being kind to yourself and avoiding self-blame or shame. There is no wrong or right amount of sex, and it is completely normal to want a lot of it, none at all, or for that to change across your cycle.
IAPMD (International Association for Premenstrual Disorders) suggest a number of practical approaches for people with PMS or PMDD who want to address low sex drive.
Communicate your needs
Start with open communication with your partner about what is going on with your body and what feels good or not. When everyone understands what is happening, needs and desires can be met more thoughtfully and with greater care.
Ease tension
Try including pain relief or relaxation before intimacy. A massage, a long hot bath, or aromatherapy with essential oils can help relieve physical and psychological tension. Some people find diffusers, room sprays, or bath oils help them feel more ready to be intimate.
Focus on what feels good
Think about what turns you on or off, and try connecting with your body by focusing on sensations that feel good. If PMS-related vaginal dryness is an issue, use lubrication. Avoid scented lubes that can disrupt vaginal pH, and be aware that silicone-based lubricants are not always compatible with silicone toys. Try different positions that reduce impact on the cervix or increase G-spot stimulation in the luteal phase. Keeping a note of what works best at different points in your cycle can help you build a rhythm that supports your changing needs.
🗓️ Track your cycle: Noting your libido changes alongside PMS symptoms in The Evelyn Premenstrual Health Tracker can help you anticipate your own patterns and communicate more clearly with partners and healthcare providers.
Seek medical support
If you want to explore clinical options, speaking to a healthcare professional is a great first step. They may ask about your medical history, current medication, and whether you have any existing conditions. They might suggest a pelvic floor examination or blood test. Depending on what they find, possible options could include changing medication, pelvic floor therapy, or talking therapy to help unpack feelings around libido changes and enhance intimacy.
Final thoughts
There is no such thing as normal when it comes to sex drive or PMS. Everybody is different, and the best thing you can do is get to know your own patterns and what makes you feel good. If your libido changes worry you or affect your quality of life, you are not alone and there is support available.
If you want to read more about understanding and working with your sex drive, we recommend Come As You Are by Emily Nagoski – a brilliant, accessible book about how desire actually works.
When to speak to a healthcare professional about libido and PMS
- Your libido change is significantly affecting your quality of life or relationships
- You are experiencing pain during or after sex that does not resolve after your period
- You think your medication may be affecting your desire for sex
- Your PMS or PMDD symptoms feel unmanageable and are affecting your relationships and intimacy
Disclaimer: This content is for informational purposes only and is not intended as medical advice. Always speak to a qualified healthcare professional about any health concerns.
