Why does libido drop в midlife?

Decreased libido in perimenopause comes from estrogen, testosterone, and vaginal tissue changes. Vaginal estrogen, off-label testosterone, and flibanserin lead the clinical toolkit.

1 min readReviewed May 2026

By Sarah Editor, MA Journalism, Certified Menopause Coach · Medically reviewed by Jane Smith, MD, MD, NAMS-certified · menopause nams

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Last medically reviewed: 5/15/2026 · Last updated: 5/15/2026 · Next review due: May 2027

Disclosure: Jane Smith, MD declares no financial relationship with the telehealth providers featured in this content.

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Decreased libido in perimenopause comes from estrogen, testosterone, and vaginal tissue changes. Vaginal estrogen, off-label testosterone, and flibanserin lead the clinical toolkit.

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