Perimenopause and Sexual Confidence: Rebuilding It When Hormones Have Taken a Toll
Perimenopause can knock sexual confidence in specific, hormonal ways. Here is how to understand what is happening and start building it back.
Why Sexual Confidence Often Dips During Perimenopause
Sexual confidence during perimenopause can erode from multiple directions at once. Vaginal dryness makes sex physically uncomfortable or painful, which understandably creates avoidance. Declining libido driven by lower oestrogen and testosterone reduces desire. Changes in body image affect how desirable women feel. Sleep deprivation and fatigue leave little energy for intimacy. These are interconnected, hormonal issues, not personal failings. Understanding the cause is the first step toward doing something about it.
The Physical Side: Addressing Comfort During Sex
Vaginal dryness and discomfort during sex are very common in perimenopause and are among the most treatable symptoms. Non-hormonal vaginal moisturisers used regularly (not just during sex) help maintain vaginal tissue health. Lubricants, particularly silicone-based ones, reduce friction effectively. Topical vaginal oestrogen, available on prescription, directly addresses the hormonal changes in the vaginal tissue and has a strong evidence base for improving comfort. This is worth raising with a doctor if dryness is affecting your sex life.
Desire Does Not Always Come Before Arousal
A common model of sexual desire suggests that arousal follows desire: you want sex, so you become aroused. But for many women, particularly during perimenopause, desire is more responsive than spontaneous. Arousal comes first, in response to the right context and stimulation, and desire follows. Waiting to feel spontaneously in the mood before initiating or engaging with intimacy can mean waiting a very long time. Creating the right conditions, without pressure, without rush, with enough comfort, is often more useful than waiting for desire to appear on its own.
Reconnecting With Your Body Outside of Sex
Sexual confidence is partly built through feeling comfortable in your body generally, not just during sex. Physical activities you enjoy, whether that is walking, swimming, or yoga, build a sense of physical capability and agency that carries over. Spending time on self-care that feels good, rather than purely corrective, helps too. Masturbation, on its own terms and without pressure, can be a low-stakes way to stay connected with what feels good for your body as it changes.
Communication With Partners
If you have a partner, being honest about what is changing is far more effective than either pretending everything is fine or withdrawing from intimacy entirely. Most partners, when told clearly what is happening and what would help, want to respond well. This conversation does not need to happen in bed. A calm, straightforward conversation about hormonal changes, what feels good now, and what does not, gives both people useful information and reduces the guesswork that leads to misread signals and distance.
When It Is More Than a Phase
If low sexual confidence or low libido is significantly affecting your quality of life or your relationship, this is a legitimate medical issue worth raising. Testosterone therapy is used by some women in perimenopause and postmenopause to address low libido, and it may be appropriate depending on your overall hormonal picture. A menopause specialist can assess options. Therapy, including psychosexual therapy, is also effective for the psychological dimensions of sexual confidence.
Related reading
Get your personalized daily plan
Track symptoms, match workouts to your day type, and build a routine that adapts with you through every phase of perimenopause.