Perimenopause Sex Drive: Your Natural Solution Guide for 2026

Perimenopause sex drive fluctuations affect 40% of women, with sexual desire dissatisfaction negatively impacting 70% of relationships [28][28]. These statistics reveal the widespread nature of hormonal changes during this transition phase.

Estrogen and testosterone decline create measurable impacts on sexual function during perimenopause [28]. Yet research confirms nine in ten women maintain sexual desire after entering this phase [28]. The hormonal imbalances driving these changes respond to targeted interventions.

Natural solutions address the root causes of decreased libido. Hormone-supporting supplements work alongside lifestyle modifications to restore sexual wellness. Simply Progesterone provides USP-grade progesterone support, while DHEA Oil delivers precursors for both estrogen and testosterone production.

This guide presents science-backed approaches to reclaim sexual vitality in 2026. Whether experiencing gradual changes or sudden shifts, these methods address the underlying hormonal disruptions that reduce desire.

Got questions? Ask the author in the comments section at the bottom of this page.

What is Perimenopause and How It Affects Libido

The menopausal transition starts years before your final period ends. Perimenopause typically begins in your 40s, marking a significant hormonal shift as the ovaries decrease estrogen and progesterone production [28].

Understanding hormonal shifts

Ovarian hormone production declines during perimenopause, creating erratic menstrual cycles [28]. This transition averages three to four years, though duration varies from months to a decade [28].

Hormone fluctuations follow unpredictable patterns rather than steady declines. Estrogen levels rise and fall irregularly, creating what researchers describe as a hormonal rollercoaster effect [28]. These erratic patterns distinguish perimenopause from the predictable cycles of reproductive years [28].

Physical and emotional symptoms vary dramatically between women [28]. Some experience minimal changes beyond irregular periods, while others face more significant disruptions...

Why estrogen and testosterone matter

Estrogen maintains reproductive system function and sexual response [28]. Declining levels cause vaginal tissue changes, including thinning, dryness, and reduced elasticity, a condition known as vaginal atrophy [28].

Testosterone impacts female libido significantly, despite lower production levels compared to men [28]. This hormone regulates sexual desire and arousal in women. Both estrogen and testosterone decline during perimenopause, affecting sexual motivation [11].

Research demonstrates that estrogen therapies producing periovulatory circulating estradiol levels increase sexual desire in postmenopausal women [11]. Testosterone at supraphysiological levels enhances low-dose estrogen therapy effectiveness for boosting sexual desire [11]. The herbs found in Testosterone Matrix Daily Support support two primary functions: reducing Sex Hormone Binding Globulin, SHBG, and increasing free testosterone levels.

Common sexual symptoms during perimenopause

Sexual function changes occur frequently during this transition. Specific symptoms include:

Decreased sexual desire: One in ten perimenopausal women experiences low libido, compared to 3% of menopausal women [28]
Vaginal dryness: Lower estrogen causes tissue thinning and drying, making intercourse uncomfortable [28] [28]
Difficulty with arousal: Hormonal fluctuations affect arousal speed and ease [28]
Discomfort during sex: Vaginal atrophy creates penetration pain [28]
Changes in sexual satisfaction: Women report altered orgasm intensity and frequency [28]

Research contradicts the belief that perimenopause universally reduces sex drive. Studies confirm that nine in ten women still experience sexual desire after entering perimenopause [28].

Vaginal dryness represents the most significant barrier to healthy sexual function during this transition. Addressing this symptom improves sexual satisfaction considerably [28].

Regular sexual activity helps maintain sexual function and reduces symptoms. Women engaging in frequent sexual activity show fewer genitourinary syndrome of menopause (GSM) symptoms - the collection of genital, sexual, and urinary symptoms associated with decreased estrogen [28].

Recognizing the Signs of Low Sex Drive in Perimenopause

Decreased interest in sex often connects directly to hormonal shifts during perimenopause. Estrogen and testosterone fluctuations create identifiable patterns of change affecting both physical and emotional responses.

Emotional and psychological indicators

Perimenopausal women experience depression at higher rates than their premenopausal counterparts, substantially reducing sexual activity interest [28]. Mood swings make intimacy less appealing during this transition phase.

Fatigue triggers anxiety symptoms, including sweating, nausea, and muscle tension [28]. This anxiety-fatigue combination creates challenging conditions for maintaining sexual interest.

Irritability becomes easily triggered, potentially leading to partner arguments [28]. Memory problems and brain fog compound these emotional responses, creating distance that diminishes the desire for intimacy.

Physical symptoms like dryness and discomfort

Vaginal dryness represents the most frequent physical indicator of decreased libido. Vaginal tissues become thinner, drier, and inflammation-prone as estrogen declines [28]. Vaginal atrophy makes intercourse painful for many women.

Physical changes include:

Decreased vaginal lubrication during sexual activity [28]
Burning or discomfort with intercourse [28]
Shortening and tightening of the vaginal canal [28]
Genital itching or burning sensations [28]
Light bleeding after intercourse [28]

Vulva tissues become thin, dry, and irritated, making daily activities uncomfortable [28]. Some women experience irritation simply from underwear contact [28].

Urinary incontinence affects over one-third of perimenopausal women [28]. Recurrent urinary tract infections correlate with greater sexual dysfunction [28]. Pelvic floor muscle issues create additional challenges with orgasm and libido [28].

Impact on relationships and self-esteem

Emotional and physical symptoms profoundly affect relationship dynamics. Partners may interpret decreased sexual interest as personal rejection, feeling less attractive, or being isolated [39]. Irritability gets misattributed to relationship problems, creating additional strain [39].

Sexual desire disorder prevalence exceeds 50% among perimenopausal women across cultures [40]. Pain during sex, reduced pleasure, and poorer body image characterize this transition compared to pre-menopausal women [40].

Estrogen changes trigger weight gain and abdominal fat increases [40]. Lower body image predicts reduced sexual satisfaction, subsequently affecting relationship quality [40].

Women describe feeling "not in their own bodies anymore" during perimenopause [41]. This identity shift, combined with physical discomfort, creates complex emotional responses toward intimacy.

Research contradicts the belief that perimenopause universally reduces sex drive [28]. Nine in ten women maintain sexual desire after entering perimenopause [28].

Early recognition allows proactive intervention rather than silent suffering - a historically common pattern among women experiencing these changes [41]...

The Role of Hormones in Sexual Desire

Sexual desire connects directly to hormonal fluctuations. These biochemical influences explain changes in libido during perimenopause and reveal targeted solution pathways.

Estrogen, progesterone, and testosterone explained

Hormone regulation of sexual desire requires a precise balance between key hormones. Estrogen, produced primarily in the ovaries, correlates directly with sexual desire levels through urinary estrogen metabolites (E1G) [42]. Estrogen maintains vaginal lubrication, tissue elasticity, and sensitivity.

Progesterone functions as the balancing hormone, working opposite to estrogen. Studies identify progesterone to be a negative predictor of sexual desire [10]. Higher progesterone levels suppress libido, which explains decreased interest during the luteal phase.

Testosterone regulates sexual desire and arousal despite smaller production quantities in women. Research confirms a positive relationship between urinary testosterone levels and sexual desire [42]. Testosterone decline during perimenopause reduces sexual motivation significantly.

How hormone imbalance affects arousal

Perimenopause creates unpredictable hormone fluctuations rather than a steady decline. Women experience significant decreases in sexual desire during late perimenopause transition and early postmenopause [42].

Hormone-arousal relationships work through multiple mechanisms:

Physical changes: Declining estrogen creates thinner, drier vaginal tissue, causing sexual discomfort
Neurological effects: Hormones influence brain centers controlling sexual arousal
Psychological impacts: Fluctuations affect mood, stress, and sleep quality

Follicle-stimulating hormone (FSH) levels show a negative correlation with sexual desire [42]. Hot flashes, fatigue, depression, anxiety, and sleep problems reduce sexual desire through cascade effects [42].

Natural hormone support options

Hormone therapy research demonstrates stronger sexual desire in treated women versus untreated [42]. Estrogen therapy producing periovulatory estriol levels increases postmenopausal sexual desire [11].

Black cohosh and red clover contain plant hormones mimicking estrogen [12]. Scientific evidence remains limited.

Dong Quai, ginseng, and saw palmetto support hormone balance and sexual function. Saw palmetto inhibits testosterone-to-DHT conversion, preserving testosterone levels [13].

Health Natura provides targeted perimenopause solutions. Estrogen oil Estriol delivers localized estrogen support. DHEA Oil supports both estrogen and testosterone production.

Endogenous and exogenous estrogen sources consistently support sexual desire [42]. Understanding these relationships enables informed decisions about increasing sex drive during perimenopause.

How Diet and Nutrition Influence Sex Drive

Nutritional choices directly impact hormone balance and sexual desire during perimenopause. Mediterranean diet patterns show measurable improvements in sexual function across all menopausal stages [3]. Plant-rich eating approaches provide antioxidants while limiting saturated fats and refined carbohydrates.

Foods that support hormone balance

Fatty fish deliver omega-3 fatty acids, vitamin D, selenium, and iodine. These nutrients optimize estrogen metabolism and prevent excessive storage during perimenopause [6]. Salmon provides the most concentrated source of these essential compounds.

Leafy greens contain phytonutrients that support hormonal balance in women with hormone-related conditions [6]. Spinach offers the highest concentration of these bioactive compounds.

Avocados provide monounsaturated fats essential for hormone production [6]. Two tablespoons of flaxseeds daily deliver lignans that help balance estrogen levels [6]. Lentils and chickpeas support blood sugar regulation and gut health—critical functions for hormonal stability [6].

Vitamin D and iron deficiencies create established risk factors for sexual dysfunction [3]. Iron-deficiency anemia causes fatigue that directly mediates sexual dysfunction [3].

Phytoestrogens and libido (BioActive Menopause Support)

Maritime pine bark, Trigonella foenum-graecum, and Foeniculum vulgare show significant sexual function improvements in clinical studies [14]. Soy consumption at 86g daily provides 55-60mg isoflavones—doses that reduce hot flashes and improve libido [7].

Asian populations consuming these isoflavone levels experience 10-25% hot flash incidence compared to 60-90% in Western countries [7]. Plant-based interventions with daily soy demonstrate measurable libido improvements alongside hot flash reduction [7].

BioActive Menopause Support contains targeted phytoestrogens to address libido concerns naturally...

What to avoid: sugar, alcohol, caffeine

Processed foods and sugar increase inflammation while disrupting hormonal balance [6]. Sugary beverages create inflammation linked to hormone imbalance [6].

Alcohol consumption disrupts hormones, accelerates brain aging, and elevates insulin levels [15]. Excessive alcohol contributes to gut health deterioration and hormone imbalances [6].

Caffeine worsens anxiety, hot flashes, and sleep disturbances—factors that diminish sexual desire [16]. Age-related declines in sugar tolerance require limiting simple carbohydrates to manage blood sugar and insulin [15].

Nutrient-rich, plant-focused eating significantly improves perimenopause sex drive through hormone-balancing support, reduced inflammation, and targeted nutrient correction...

Lifestyle Habits That Naturally Improve Libido

Daily habits directly influence perimenopause sex drive fluctuations. Simple modifications produce measurable improvements in libido with minimal side effects.

Exercise and blood flow

Physical activity ranks among the most effective natural methods to improve libido during perimenopause. Aerobic exercise and strength training enhance body image, elevate mood, and directly boost sex drive [17].

Exercise stimulates endorphin production and affects the sympathetic nervous system, positively influencing sexual function [1]. Women who exercise more frequently report higher degrees of sexual desire [1]. Research demonstrates chances of reduced sexual desire decrease by 80.2% with every unit increase in weekly exercise frequency [1].

Women who maintained regular physical activity after menopause showed significant differences in their sexual relationships compared to sedentary women [1]. Those whose sexual relations decreased after menopause averaged 3.9 exercise sessions weekly, whereas women who maintained or increased sexual activity averaged 4.6 sessions [1].

Stress reduction techniques

High stress levels directly inhibit desire through elevated cortisol, which suppresses sex hormones. Effective coping mechanisms for work, financial, and daily stressors substantially enhance sex drive [17].

Meditation, yoga, journaling, and deep-breathing exercises reduce stress and anxiety [18]. These mindfulness activities lower cortisol levels and create mental space for desire to emerge [19]. These practices improve overall emotional well-being, a foundation for healthy sexual function.

Sleep hygiene and circadian rhythm

Quality sleep represents a critical factor affecting perimenopause sex drive. Sleep deprivation directly associates with reduced sexual desire and arousal in women [20].

Consistent sleep patterns regulate your circadian rhythm—your body's internal clock governing hormone secretion [21]. Adults require 7-9 hours of quality sleep nightly, with consistency being key [22].

Sleep-sex optimization includes:

Consistent sleep schedule, even on weekends
Cool (60-67°F), dark bedroom environment
Limited screen time before bed to boost melatonin
Morning sunlight to reset the internal clock
Avoiding caffeine, alcohol, and heavy meals near bedtime

Circadian rhythm appears to be a novel therapeutic target for sexual dysfunction, with disrupted sleep patterns creating vulnerability to various health issues that affect libido [8].

Safe Use of Supplements and Oils

Quality supplements require careful selection for perimenopause sex drive concerns. Not all products meet the same standards for purity and potency.

How to choose quality products

Third-party verification marks like "USP" or "NSF" indicate independent testing for quality standards [9]. These certifications confirm the product contains stated ingredients without harmful contaminants.

Third-party testing verifies correct ingredient doses and screens for heavy metals or adulterants [23]. Quality control remains essential for effective results.

Using Health Natura Estrogen oil Estriol

Health Natura Estrogen Oil - Each bottle contains approximately 800 drops with 0.5 mg bioidentical estriol per drop. Apply 5-10 drops to skin twice daily [24]. Massage into thinner-skinned areas, such as the inner arms or thighs, for optimal absorption.

Consult healthcare professionals before starting hormone products to determine appropriate dosage [24]. Regular monitoring ensures safe, effective use.

Combining supplements safely

Start with one supplement at a time. Introducing multiple products simultaneously makes it difficult to identify individual responses.

Stop any supplement immediately if unusual symptoms occur and consult your doctor [9]. Natural doesn't guarantee safety for everyone.

Lifestyle changes like proper nutrition and exercise often provide more benefits than supplements alone for perimenopause symptoms [9].

When to Seek Professional Help

Natural remedies address many perimenopause sex drive concerns, yet some situations require professional medical guidance. Recognizing these signs ensures you receive appropriate care when needed.

Signs your symptoms need medical attention

Low libido persisting beyond 6 months warrants medical evaluation [25]. Perimenopause symptoms disrupting daily life - including sexual desire - require professional attention [4]. Distress about sexual interest levels indicates the need for clinical guidance [2].

Sudden libido changes may signal underlying health conditions requiring investigation [2]. These shifts differ from gradual hormonal transitions typical of perimenopause.

How to talk to your doctor about libido

Healthcare professionals serve as valuable resources for sexual health concerns [26]. Preparation enhances appointment effectiveness - consider using question builders or notes [25].

Honest symptom reporting enables accurate treatment recommendations [27]. Individual factors determine appropriate interventions. Express how these changes affect relationships and emotional well-being.

Options beyond natural remedies

Medical professionals offer additional treatment pathways when natural approaches prove insufficient. Menopausal hormone therapy represents one option your doctor might suggest [27].

Non-hormonal alternatives include Flibanserin for premenopausal women [28] and Bremelanotide injections [17]. Vaginal dryness responds to prescription treatments like intravaginal DHEA or ospemifene [26].

Testosterone therapy benefits some women with low desire [5], though it lacks specific licensing for women. Cognitive behavioral therapy addresses psychological aspects of sexual health [5].

Professional guidance opens doors to treatments beyond natural remedies...

Conclusion

Perimenopause represents a natural transition phase requiring targeted hormonal support. Dong Quai, black cohosh, and ginseng provide traditional botanical solutions for sexual wellness. Health Natura's Estrogen Oil delivers 0.5 mg bioidentical estriol per drop, while DHEA Oil supports both testosterone and estrogen production pathways.

Mediterranean dietary patterns enhance hormone balance through omega-3 fatty acids and phytoestrogens. Regular exercise is associated with an 80.2% reduction in low-desire risk with increased weekly frequency. Sleep quality and stress reduction directly influence cortisol levels and sexual function.

Nine out of ten women maintain sexual desire after entering perimenopause. The hormonal shifts require adaptation rather than resignation. Natural solutions address the biochemical disruptions causing decreased libido.

Professional guidance offers additional treatment options when natural approaches need enhancement.

Sexual wellness during perimenopause responds to targeted interventions. The right combination of supplements, lifestyle modifications, and professional support can restore intimate vitality.

Key Takeaways

Understanding perimenopause sex drive changes empowers you to take action with natural, science-backed solutions that can restore intimacy and sexual wellness during this transitional phase.

• Hormonal fluctuations during perimenopause directly impact libido - declining estrogen and testosterone levels cause 40% of women to experience low sex drive, but 90% still maintain sexual desire.

• Natural supplements show promising results for boosting libido - Dong Quai, black cohosh, red clover, and ginseng have research support, while targeted products like Health Natura's Estrogen Oil and DHEA Oil address hormonal imbalances.

• Mediterranean diet and regular exercise significantly improve sexual function - plant-rich eating patterns and consistent physical activity enhance hormone balance, blood flow, and body image while reducing inflammation.

• Quality sleep and stress management are crucial for sexual desire - poor sleep directly reduces libido, while stress elevates cortisol and suppresses sex hormones, making these lifestyle factors essential.

• Professional help should be sought when natural remedies aren't enough - if low libido persists beyond 6 months or significantly impacts your life, healthcare providers can offer hormone therapy and other targeted treatments.

Remember that perimenopause represents a natural transition, not a permanent end to sexual satisfaction. With the right combination of natural approaches, lifestyle modifications, and professional guidance when needed, you can maintain a fulfilling intimate life throughout this phase and beyond.

FAQs

Q1. How can I naturally boost my sex drive during perimenopause? You can increase libido naturally through regular exercise, stress reduction techniques like meditation, maintaining a healthy diet rich in omega-3s and phytoestrogens, getting quality sleep, and trying herbal supplements like ginseng or black cohosh. Lifestyle changes often yield significant improvements in desire.

Q2. Is it normal for sex drive to fluctuate during perimenopause? Yes, it's completely normal. Hormonal changes during perimenopause can cause libido to fluctuate. While about 40% of women report experiencing low sex drive, studies show that 90% of women still maintain sexual desire during this transition, though it may change in nature or frequency.

Q3. Can diet affect my libido during perimenopause? Absolutely. A Mediterranean-style diet rich in vegetables, fruits, whole grains, and healthy fats can support hormone balance and improve sexual function. Foods high in omega-3s, like fatty fish, and those containing phytoestrogens, such as soy and flaxseeds, may be particularly beneficial for libido.

Q4. How does exercise impact sex drive during perimenopause? Regular physical activity can significantly boost libido during perimenopause. Exercise improves blood flow, enhances mood, and helps maintain hormone balance. Studies show that women who exercise more frequently report higher levels of sexual desire and satisfaction.

Q5. When should I seek professional help for low libido during perimenopause? If low libido persists for more than 6 months, significantly disrupts your daily life or relationships, or causes you distress, it's time to consult a healthcare professional. They can rule out underlying health conditions and discuss treatment options beyond natural remedies if needed.

Got questions? Ask the author in the comments section at the bottom of this page.

Dr. Peter Kassner, NMD - Biography

Dr. Peter Kassner, NMD, is the founding CEO of Health Natura, bringing 29 years of painstaking dedication to the field of naturopathic medicine. His journey in natural healing began in 1993 at the age of 17, when he embarked on his first apprenticeship before even completing high school...

Dr. Kassner established his first pain clinic, Clinical Therapeutics, in Tuscaloosa, Alabama, in 1996. This eventually evolved into Health Natura, LLC in 2005, reflecting his expanded mission to make Integrative Medicine accessible to those seeking alternatives to conventional treatments.

Throughout his clinical career, Dr. Kassner developed Unparalleled Expertise in immunology, cancer treatment protocols, endocrinology, acute and chronic infectious disease management, neuro-immunology, endocrine-immunology, thyroid iodine therapy, and Lyme disease interventions. His extensive training includes certifications in clinical massage, cranial sacral therapy, energy medicine, homeopathy, herbology, Chinese herbology, acupuncture, reflexology, EAV energy diagnostics, IV chelation, chemistry, and supplement compounding.

After obtaining both Masters and Doctoral degrees in Naturopathic Medicine, in 2005, dissatisfied with the state of commercial supplements, Dr. Kassner established Health Natura's first laboratory, specializing in Custom Compounding of preservative-free, excipient-free formulations with minimal ingredients. This commitment to purity and efficacy led him to retire from clinical practice in 2012 to focus entirely on Health Natura's supplement program.

Dr. Kassner's approach to naturopathic medicine has been profoundly shaped by his extensive travels throughout Western countries and Asia, where he studied diverse healing traditions. This global perspective informs his unique philosophy: delivering High-Quality, Personalized Wellness Solutions rather than mass-produced alternatives with compromised ingredients...

Today, Dr. Kassner continues to revolutionize the supplement industry through careful formulation and ethical sourcing, making Health Natura a trusted resource for those seeking superior natural health products.

* These statements have not been evaluated by the FDA (Food and Drug Administration). This product is not intended to treat, cure or prevent any disease. Statements of potential therapeutic value are the opinion of Dr. Kassner, ND, and are based on his personal and clinical experience. They should not be construed to endorse, condone or promote the use of any product as a medical treatment for any condition. Consult a medical professional before engaging in any self-care or nutritional supplement regimen to ensure safe and appropriate use.

Dr. Kassner has been active in the field of alternative medicine since 1991.

References

[1] - https://www.joinmidi.com/post/how-to-increase-libido
[2] - https://pmc.ncbi.nlm.nih.gov/articles/PMC6519565/
[3] - https://helloclue.com/articles/menopause/perimenopause-menopause-and-libido-tips-for-people-who-want-to-improve-their-sex-drive
[4] - https://my.clevelandclinic.org/health/diseases/21608-perimenopause
[5] - https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause
[6] - https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
[7] - https://simplyyouclinic.com/2024/05/28/testosterone-and-dhea-a-guide-for-women-in-perimenopause-and-menopause/
[8] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4720522/
[9] - https://menopause.org/press-releases/more-sex-less-pain-and-irritation-for-perimenopausal-and-postmenopausal-women
[10] - https://themenopausecharity.org/information-and-support/conversations-about-menopause/relationships-and-sex/
[11] - https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288
[12] - https://www.acog.org/womens-health/experts-and-stories/the-latest/experiencing-vaginal-dryness-heres-what-you-need-to-know
[13] - https://www.femgevityhealth.com/blog/perimenopause-menopause-and-the-effect-on-personal-relationships
[14] - https://www.psychologytoday.com/us/blog/meet-catch-and-keep/202505/love-in-the-time-of-perimenopause
[15] - https://www.letstalkmenopause.org/our-articles/symptom-spotlight-low-libido
[16] - https://pmc.ncbi.nlm.nih.gov/articles/PMC2834444/
[17] - https://propelltherapy.com/estrogen-and-progesterone-levels-linked-to-libido/
[18] - https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/alternatives-to-hormone-replacement-therapy-hrt/herbal-remedies-and-complementary-medicines-for-menopause-symptoms/
[19] - https://drbrighten.com/perimenopause-supplements/
[20] - https://pmc.ncbi.nlm.nih.gov/articles/PMC8299929/
[21] - https://azgyn.com/blog/hormonal-balance-diet/
[22] - https://pubmed.ncbi.nlm.nih.gov/30156931/
[23] - https://blog.cytoplan.co.uk/phytoestrogens-can-they-help-perimenopause/
[24] - https://carolinatotalwellness.com/blog/index.php/2023/11/14/foods-for-menopause-and-perimenopause/
[25] - https://drbrighten.com/best-diet-during-perimenopause/
[26] - https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/diagnosis-treatment/drc-20374561
[27] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4939225/
[28] - https://completewomenscare.net/low-sex-drive-in-perimenopausal-and-menopausal-women/
[29] - https://ronnifarrismd.com/rediscovering-desire-embracing-libido-changes-as-you-age/
[30] - https://www.sleepfoundation.org/physical-health/sex-sleep
[31] - https://ctcoastalobgyn.com/how-sleep-impacts-hormonal-balance/
[32] - https://www.smsna.org/patients/blog/how-does-sleep-affect-your-sex-life
[33] - https://pmc.ncbi.nlm.nih.gov/articles/PMC8782551/
[34] - https://www.health.harvard.edu/womens-health/menopause-supplements-effective-relief-or-empty-promises
[35] - https://lifestylemedicine.stanford.edu/supplements-for-women-40/
[36] - https://healthnatura.com/blog/estriol-oil-benefits-for-menopause-relief-health-natura/
[37] - https://www.healthdirect.gov.au/loss-of-female-libido
[38] - https://www.bswhealth.com/blog/rediscovering-desire-during-perimenopause
[39] - https://www.uchicagomedicine.org/forefront/womens-health-articles/2019/june/vyleesi-addyi-how-women-can-get-help-for-low-sexual-desire
[40] - https://menopause.org/patient-education/menopause-topics/sexual-health
[41] - https://www.keckmedicine.org/blog/what-is-perimenopause-a-doctor-explains/
[42] - https://www.nhs.uk/conditions/menopause/treatment/

Dec 13th 2025 Dr. Peter Kassner, NMD