Best Libido Supplements for Perimenopause: What the Evidence Says
Low libido during perimenopause has real biological causes. Learn which supplements have the strongest evidence for supporting sexual desire and what to know before trying them.
Why Libido Changes During Perimenopause
Low libido during perimenopause is not simply psychological. Declining oestrogen and testosterone both affect sexual desire, arousal, and sensation. Fatigue, poor sleep, mood changes, and vaginal dryness all compound the problem. While no supplement replaces addressing the root hormonal cause (which may require a conversation with a doctor about HRT or testosterone therapy), some have meaningful evidence for supporting libido in this life stage.
Maca Root
Maca is a Peruvian root vegetable that has been studied specifically in peri and postmenopausal women for its effects on sexual dysfunction and desire. Several randomised trials have found that maca improves self-reported sexual function and desire, with modest improvements in mood as a secondary benefit. It does not appear to work through oestrogen-like mechanisms, which makes it of interest for women who cannot use hormonal products. Effects are typically seen after 6 to 8 weeks of daily use. It has a strong, earthy flavour as a powder, which is easier to manage in capsule form.
Ashwagandha
Ashwagandha is an adaptogen, meaning it helps the body manage stress, which is one of the most common libido suppressors in perimenopausal women. Research has found improvements in sexual function, arousal, satisfaction, and orgasm scores in women taking ashwagandha compared to placebo. Its primary mechanism appears to be reducing cortisol and improving stress response, rather than a direct hormonal effect. It also supports sleep quality, which indirectly benefits libido. Ashwagandha is generally well tolerated but should be used with caution if you have thyroid conditions, as it can affect thyroid hormones.
Zinc and Magnesium
Zinc plays a role in testosterone production, and low zinc status is associated with reduced libido in women as well as men. Many women are borderline deficient in zinc, particularly those on plant-heavy diets where phytates can block absorption. A basic zinc supplement, or a product combining zinc and magnesium, can be a good foundation before exploring more targeted supplements. Magnesium also supports testosterone metabolism and reduces the stress and anxiety that can suppress desire. Both are inexpensive and widely available.
Tribulus Terrestris and Fenugreek
Tribulus has some evidence in women for improving sexual desire and satisfaction, with a few trials specific to perimenopausal populations showing positive results. It appears to work partly by supporting androgen (testosterone-related) pathways. Fenugreek extract has also been studied for female libido with some promising results in trials using standardised extracts; it may work in part by supporting free testosterone levels. Both supplements have variable quality across brands, so looking for products that specify the standardised extract and dosage used in research is important.
Important Caveats
Supplements for libido are supportive tools, not solutions, and they work best when the broader picture is also addressed. Chronic poor sleep, relationship stress, unmanaged anxiety, and vaginal discomfort all suppress desire regardless of what supplements you take. If low libido is significantly affecting your quality of life, a menopause specialist can assess whether testosterone therapy is appropriate for you. This is a legitimate medical treatment that is increasingly available for women and has a strong evidence base. Tracking your symptoms over time is one useful way to see whether any change in supplement routine correlates with how you feel.
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