Symptom & Goal

Is Pilates Good for Low Libido During Perimenopause?

Low libido is a frustrating symptom of perimenopause. Learn how Pilates supports pelvic floor health, body confidence, and hormonal balance to help restore your sex drive.

4 min readFebruary 28, 2026

Low Libido in Perimenopause Is Hormonal and Psychological

A reduced sex drive during perimenopause often has multiple causes happening at the same time. Declining oestrogen and testosterone affect physical arousal and lubrication. Poor sleep and fatigue leave little energy for intimacy. Body image concerns and feeling disconnected from your body also play a role. Pilates is interesting in this context because it addresses several of these factors, particularly the physical and psychological ones, in a gentle and accessible way.

The Pelvic Floor Connection

Pilates has a strong emphasis on pelvic floor awareness and activation. In perimenopause, the pelvic floor can weaken as oestrogen levels fall, which contributes to reduced sensation, discomfort during sex, and a disconnection from physical pleasure. Pilates exercises that engage and strengthen the pelvic floor, including the breath patterns that form the foundation of the practice, directly counteract this. A stronger, more aware pelvic floor is linked to improved sexual function and comfort.

Body Confidence and Movement Quality

One of the less obvious but real benefits of Pilates for libido is what it does for how you feel in your body. Pilates emphasises precise, controlled movement, posture, and body awareness. Regular practice tends to build a quiet confidence in physical ability that extends beyond the studio. Feeling strong, capable, and comfortable in your body is an important foundation for sexual desire, particularly when hormonal changes have made the body feel unfamiliar or difficult.

Stress Reduction and Hormonal Effects

Pilates reduces cortisol through focused, deliberate movement and breath control. Cortisol suppresses the production of sex hormones, so bringing it down consistently can have a positive effect on libido over time. The parasympathetic nervous system state that good Pilates practice promotes is also the state in which sexual arousal is possible. Reducing the background hum of stress and anxiety can shift the body into a more receptive mode.

How to Start and What to Expect

If you are new to Pilates, starting with a beginner class or reformer Pilates with an instructor is worthwhile. A good instructor will teach pelvic floor engagement correctly, which is foundational. Aim for two to three sessions per week. Changes in body confidence and pelvic floor strength typically take four to eight weeks of consistent practice to become noticeable. Tracking how you feel generally, including mood and energy, can help you see whether Pilates is making a difference.

When Other Support Is Needed

Pilates can contribute meaningfully to improving low libido, but if the symptom is significant it is worth also speaking to a GP about testosterone therapy, which is increasingly recognised as an effective treatment for low libido in perimenopausal women. A pelvic floor physiotherapist can also work alongside Pilates to address specific physical barriers to sexual comfort. Pilates fits best as one part of a considered, multi-approach response.

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Medical disclaimerThis content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. PeriPlan is not a substitute for professional medical advice. If you are experiencing severe or concerning symptoms, please contact your doctor or emergency services immediately.

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