Best Supplements for Low Libido in Perimenopause
Best supplements for low libido in perimenopause, from maca root to zinc and ashwagandha. Evidence-informed options to support sexual wellbeing.
Why Libido Drops in Perimenopause
Low libido is one of the most common and least discussed symptoms of perimenopause. Falling oestrogen reduces vaginal lubrication and sensitivity, making sex physically uncomfortable, while declining testosterone affects desire directly. At the same time, disrupted sleep, elevated cortisol from chronic stress, and mood changes all dampen the motivation for intimacy. Addressing libido in perimenopause therefore requires looking at multiple contributing factors. Supplements can support some of these pathways, though they work best as part of a broader approach that includes managing stress, prioritising sleep, and, where appropriate, discussing hormone options with a GP.
Maca Root
Maca is a Peruvian root vegetable that has been used traditionally to support energy and fertility. Several small clinical trials specifically in perimenopausal and postmenopausal women have found that maca supplementation at 2 to 3.5 grams per day improved self-reported sexual dysfunction and overall wellbeing scores compared to placebo. It does not appear to work by directly raising oestrogen or testosterone, but may influence hypothalamic regulation of hormone balance. Maca is generally well tolerated and widely available in powder and capsule form. Effects tend to build over four to eight weeks of consistent use.
Ashwagandha
Ashwagandha is an adaptogenic herb with good evidence for reducing cortisol and improving stress resilience, both of which are relevant to libido. High cortisol blunts the production of sex hormones through a mechanism sometimes called the cortisol steal. A 2022 trial in women with self-reported low sexual satisfaction found that ashwagandha supplementation at 300 milligrams twice daily significantly improved arousal, lubrication, orgasm, and satisfaction scores after eight weeks. The proposed mechanism involves cortisol reduction combined with direct support of adrenal hormone pathways. It is one of the more evidence-supported adaptogens for women's sexual health.
Zinc
Zinc is a cofactor in testosterone synthesis, and adequate levels are necessary for maintaining healthy testosterone production in both men and women. In women, testosterone plays a meaningful role in sexual desire, energy, and mood. Deficiency, which is more common than many realise, can quietly suppress these functions. Studies show that supplementing with 25 to 30 milligrams of zinc per day in deficient individuals can restore testosterone to normal ranges over several months. Getting a serum zinc test before supplementing helps confirm whether this is relevant for you. Food sources including oysters, pumpkin seeds, and red meat are also useful.
Tribulus Terrestris
Tribulus terrestris is a plant extract used in traditional medicine systems across Europe and Asia. Some trials in women with low sexual function, including a notable study in premenopausal women with hypoactive sexual desire disorder, found significant improvements in desire, arousal, and satisfaction at doses of around 750 milligrams per day. The evidence is less robust than for ashwagandha or maca, but it is a reasonable option to explore if other approaches have not worked. It is generally considered safe for short-term use, though interactions with diabetes and blood pressure medications mean it is worth checking with a pharmacist or GP first.
Vitamin D
Vitamin D deficiency has been independently associated with low sexual satisfaction and low testosterone levels in women. Receptors for vitamin D are found in reproductive tissues, suggesting a direct physiological role rather than a purely indirect one. Given how common deficiency is in the UK and in northern climates generally, correcting low vitamin D is a sensible baseline step before exploring more targeted libido supplements. A dose of 1,000 to 2,000 IU per day is standard maintenance, with higher doses sometimes needed under GP guidance to correct significant deficiency. Blood testing remains the most reliable way to establish your starting point.
A Realistic Perspective on Supplements and Libido
Supplements can contribute to improved libido in perimenopause, but they are unlikely to fully address the problem on their own when physical or relational factors are also at play. Vaginal dryness causing discomfort during sex often responds better to topical oestrogen or lubricants than to oral supplements. Stress and relationship dynamics matter enormously and are not addressable through a capsule. The best outcomes tend to come from combining targeted supplementation with stress management, regular movement, and open conversations with a partner or healthcare provider. Tracking your symptoms, energy, and mood over time using a tool like PeriPlan can help you identify what is actually moving the needle.
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