How Does Your Menstrual Cycle Influence Your Sex Drive?

Some people, who don’t identify as women (such as transgender men and non-binary people) are concerned by the menstrual cycle. Therefore, in this article, we will be using the term ‘people who menstruate’.

For a large number of people who menstruate, sexual arousal seems to vary throughout the menstrual cycle. These variations are partly linked to hormonal fluctuations, but their intensity and the nature of these variations can be extremely different from person to person. Some notice an uptick in their sex drive around the ovulation period, others remark no noticeable change. Stress, pain and hormonal contraception also play an important role in these variations.

Research shows that the menstrual cycle does have an impact on libido, but that it is only one of many influencing factors.

Before we look at the menstrual cycle, we must distinguish between three notions that are often mixed up.

Sexual desire, also known as libido, is a psychobiological urge that’s supplied via two sources: external sensory stimuli, and internal stimuli such as fantasies and sexual thoughts. We can also distinguish between 'spontaneous' sexual desire linked to intrinsic emotional, fantasmic and cognitive stimuli, and ‘reactive’ sexual desire, which is a response to physical stimuli (Cour et al., 2012). Spontaneous desire comes from within: a thought, a fantasy, longing that appears without any particular physical stimulation. Reactive desire can be in response to an external factor: physical contact, a caress, a situation that sparks arousal. It’s an internal sensation that represents itself through a desire to connect sexually, either with another person or with oneself. Libido can fluctuate from high to low to completely absent, regardless of the presence of another person.

Sexual attraction occurs when one finds another person sexually attractive and wants to initiate sexual contact with that person (Clifton, 2025).

Sexual arousal is a physical reaction that responds to imagined or real sexual stimuli. It presents itself through increase in cardiac rhythm, vasodilation leading to erection, swelling of the clitoris and lubrication. Sexual arousal can happen without feeling attracted towards another person

Far from being a fixed reaction, libido is a result of the permanent interaction between physiological, psychological, cognitive, social, and environmental factors. This explains both why libido changes so much from person to person, and why it can also change for the same person over time.

Hormones play a central role in libido. Testosterone plays a stimulating role, although its effects can vary from person to person, whilst oxytocin favours relaxation and emotional bonding after orgasm. Hormonal imbalances linked to menopause and andropause, as well as certain illnesses such as endometriosis, polyendocrine metabolic ovarian syndrome (PMOS), formerly known and polycystic ovary syndrome (PCOS) can also impact libido. A varying sex drive can also be secondary to a symptom or illness that has a direct impact on one’s sex life (Vaginismus, dyspareunia, erectile dysfunction, premature ejaculation).

A reduction in sexual desire can also be a side effect of certain medicines and treatments (antidepressants, anti-androgens, prolactin-stimulating agents). Some hormonal contraceptives alter the hormonal balance, which can affect sexual desire.

Mental health also plays a crucial role. Mental load, stress, anxiety, energy levels, sleep quality, depression, grieving, survivors of sexual assault, all of this can inhibit one’s sex drive. On the other hand, a positive self-image and good mental health contribute to an increased sex drive.

Libido can also be extremely closely linked to the quality of a relationship. A secure, loving relationship that relies on open communication and the ability to express one’s needs can favour a higher libido. Conflicts, emotional scars and the inadequate distribution of the emotional load can limit desire.

Integration into a culture, religious affiliation, and education about emotional, relational and sexual life profoundly influence the way in which sexuality is perceived and experienced. Taboos, guilt or social pressure can inhibit the expression of desire, whilst positive messages promote a fulfilling sex life.

Furthermore, one’s sex drive can be greatly influenced by their environment, setting or general atmosphere. Travel, holidays, professional situation, financial situation, family situation etc.

For a long time, sexual response was represented as a sequence of steps: desire ⇨ arousal ⇨ intercourse ⇨ orgasm.

The diverse range of factors that affect libido drove sexologist Rosemary Basson to propose a circular model of desire, that adds more nuance to the classic, linear version. In this model, desire isn’t always the departure point, it can emerge through intimacy, as a response to stimulation, or to a moment of proximity (Basson, 2002). This is the reactive desire as introduced earlier, but seen here as a process that unfolds over time (rather than one fixed category). This entry into intimacy may be motivated by needs other than sexual desire itself – the desire for closeness, tenderness, or to feel desired – without this calling into question the authenticity of that intimacy. This model is widely cited in the literature, but there is no complete consensus on it: some researchers still question its clinical interpretation, particularly the risk of the concept of reactive desire being reincorporated into a diagnostic framework. Basson herself opposed this perspective, as her model aims to depathologise experiences long considered ‘abnormal’.

Two people in a relationship rarely experience desire at the same rhythm and the same moment: 25 to 40% of people in heterosexual relationships report different libidos to their partner (Davies et al., 1999, Mark & Murray, 2012). One study that followed 133 couples daily over a 30-day period confirms that desire fluctuates naturally for each person, and that these fluctuations, are generally, but not always synchronous in a relationship. This makes occasional desynchronisation a statistically normal phenomenon rather than a sign of a relationship problem (Vowels et al., 2018).

In addition to all these factors, the influence of the menstrual cycle on a person’s sex drive is quite significant.

The hormones involved in the menstrual cycle can influence a person’s sex drive. That being said, the effects of these hormones vary from person to person. Some people notice significant differences from one cycle to another. Others notice almost no difference. These variations are in addition to all the other factors mentioned above.

The menstrual cycle refers to the series of physiological changes that prepare the body for a potential pregnancy. It lasts an average of 28 days, although cycles between 24 and 38 days are also common. They can also be shorter or longer and are not always regular. Menstrual cycles begin at puberty and continue until menopause.

The cycle is regulated by luteinising hormone (LH) and follicle-stimulating hormone (FSH), which are produced by the pituitary gland. These hormones help regulate ovulation and stimulate the ovaries to produce oestrogen and progesterone. In turn, they cause changes in the uterus and breasts as the body prepares for a possible pregnancy.

Everyone who menstruates experiences their menstrual cycle differently. The patterns described here are general observations and cannot reflect every individual's unique body or the wide range of experiences associated with the menstrual cycle.

We can divide the menstrual cycle up into four phases:

At the very beginning of the cycle, oestrogen and progesterone levels fall. If pregnancy did not occur during the previous cycle, the lining of the uterus, known as the endometrium, begins to shed, resulting in a period. Testosterone levels are also generally at their lowest around this time.

For some people, this hormonal low can coincide with a decrease in sexual desire, although this is by no means something everyone experiences.

Under the influence of FSH released by the pituitary gland, several ovarian follicles begin to mature. Usually, only one reaches full maturity, while the others regress. As the follicle develops, it produces increasing amounts of oestrogen, gradually thickening the lining of the uterus and preparing the body for a potential pregnancy. Testosterone levels also tend to rise steadily as ovulation approaches.

This combined increase in oestrogen and testosterone has been linked in some research to a gradual rise in sexual desire in the lead-up to ovulation.

A surge in LH (luteinising hormone) triggers the mature follicle to rupture, releasing the egg into the fallopian tube. Around this time, oestrogen and testosterone levels also reach their highest point in the cycle.

Studies most commonly associate this stage of the cycle with a peak in sexual desire, although this link should be interpreted with caution, as individual experiences can vary considerably, as mentioned above.

After ovulation, the follicle that released the egg develops into the corpus luteum, which produces progesterone. This hormone causes the endometrium to thicken further, reaching its maximum thickness at around day 21 as the body prepares for the possibility of an embryo implanting. If fertilisation does not occur, the corpus luteum breaks down towards the end of this phase, causing both progesterone and oestrogen levels to fall. This hormonal drop triggers the return of menstruation and, for some people, the onset of premenstrual symptoms.

Progesterone is the dominant hormone during this phase and has been associated with a tendency towards lower sexual desire in some people, particularly during the second half of the luteal phase. This is also when premenstrual symptoms may become more noticeable, which we will explore in the next section.

Menstrual health is defined as a state of complete physical, mental and social well-being in relation to the menstrual cycle, rather than simply the absence of disease or illness (Hennegan et al., 2021).

A number of health issues can be associated with the menstrual cycle, including abnormal uterine bleeding, dysmenorrhoea (painful periods) and premenstrual syndrome (PMS). Despite growing awareness, these conditions and symptoms are still often dismissed or overlooked because they are not considered immediately life-threatening. Yet they affect a significant number of people and can have a considerable impact on both their personal and professional lives (Maekawa et al., 2023).

When discussing libido throughout the menstrual cycle, the focus is often placed solely on hormones. But the symptoms that accompany different stages of the cycle can play an equally important role, influencing sexual desire independently of hormonal changes themselves.

In 2014, the global prevalence of premenstrual syndrome (PMS) was estimated at 47.8% (Direkvand-Moghadam et al., 2014), however, it remains difficult to determine exactly how many people experience PMS, as prevalence estimates vary considerably across the literature.

PMS can begin as early as around ten days before a period and usually subsides when menstruation starts or shortly afterwards. It encompasses a wide range of symptoms — estimated at between 150 and 200, although the exact number varies between studies — affecting physical, psychological and behavioural well-being. These symptoms can differ greatly in number, duration and intensity. While some are more common than others, experiences can vary not only from one person to another, but also from one cycle to the next in the same individual (Pajot & Angibaud, 2025).

Some of the most commonly reported symptoms include fatigue, mood changes, irritability, low mood, stress, anxiety, abdominal pain, breast tenderness, back pain, headaches, sleep disturbances, increased appetite, nausea, vomiting, changes in bowel habits, acne and dizziness.

An estimated 5% of people who menstruate are affected by premenstrual dysphoric disorder (PMDD) (INSERM, 2021). PMDD is less common than PMS and is considered its most severe form, causing significant psychological distress on a recurring monthly basis.

Research suggests that PMS and PMDD are not caused by a hormonal imbalance, but rather by an increased sensitivity in the brain to the natural hormonal fluctuations that occur throughout the menstrual cycle. In other words, it is this heightened neurological response to normal physiological changes — rather than having too much or too little of a particular hormone — that may explain why some people experience severe symptoms while others do not (Rubinow & Schmidt, 1995).

PMDD is classified as a depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and is also recognised in the International Classification of Diseases (ICD). Like PMS, PMDD is associated with the luteal phase, the second half of the menstrual cycle, although its symptoms may last longer. They typically begin around ovulation and subside within the first week after menstruation begins.

PMDD can cause physical, psychological and emotional symptoms. The physical symptoms are largely similar to those associated with PMS, but the key difference lies in the severity of the psychological and emotional symptoms. These can include anxiety, depression, irritability, anger, severe mood swings, feelings of hopelessness, a sense of losing control over one's emotions and suicidal thoughts. In some cases, these symptoms can be extremely debilitating, significantly affecting a person's personal, professional and social life.

Taken together, the symptoms associated with PMS and PMDD can have a considerable impact on physical health, mental well-being and sexual desire, whether directly or as a secondary consequence of other symptoms.

Today, several approaches can help manage and reduce the symptoms of PMS and PMDD. Psychological support, regular physical activity, improved sleep, certain forms of hormonal contraception and antidepressant medication may help many people manage their symptoms and improve their overall well-being.

Contrary to a common assumption, hormonal contraception does not automatically reduce sexual desire. Research suggests that its effects vary considerably depending on the individual, the type of contraception used and personal circumstances.

Combined hormonal contraceptives — such as certain pills, the patch and the vaginal ring — contain both oestrogen and progestogen. They increase the liver’s production of sex hormone-binding globulin (SHBG), which in turn reduces the amount of free testosterone circulating in the body. This mechanism is well established (Burrows, Basha & Goldstein, 2012). It might therefore seem logical to assume that lower free testosterone would always lead to lower libido, but the reality is more complex.

A review of 36 studies involving more than 13,000 participants found that 85% of people using combined hormonal contraception reported either no change in libido or an increase, while 15% reported a decrease (Pastor et al., 2013). The effect can also vary depending on the specific contraceptive and the type of progestogen it contains, as some formulations have a more androgenic profile than others and may therefore affect free testosterone differently.

This variation is also influenced by indirect effects that go beyond hormones themselves. Effective contraception may reduce anxiety around the risk of pregnancy, while also helping to ease uterine pain or dysmenorrhoea — both of which can have a direct impact on sexual desire.

The overall effect therefore depends on the balance between several factors and will differ from one person to another. The impact of hormonal contraception on libido is neither uniform nor purely mechanical. If a drop in sexual desire is causing distress, it is worth discussing it with a trusted healthcare professional, who may be able to adjust the treatment or suggest an alternative.

The menstrual cycle can influence sexual desire, but it is never the only factor at play. Understanding how hormones, physical symptoms, emotions and personal circumstances interact — and paying attention to your own patterns — can help you understand your body without feeling the need to fit a particular norm.

Some people notice a stronger sex drive around ovulation. Others may feel more desire during their period, while some notice no change at all throughout the cycle. All of these experiences can be completely normal.

Tracking your cycle, including through dedicated apps, may help you spot recurring patterns, but it should never replace paying attention to how you actually feel.

If a drop in sexual desire becomes distressing, affects your relationship or is accompanied by other significant or disabling symptoms, it may be helpful to speak to a healthcare professional, such as a GP, gynaecologist, psychologist or psychiatrist.