Libido across your cycle, and what contraception does to it

Q: Does libido change across the menstrual cycle?

For many people it does, a little. A study published in Hormones and Behavior collected daily saliva samples and desire ratings across one to two cycles and found that desire, on average, peaked mid-cycle. Higher oestradiol tracked with more desire and higher progesterone with less. Rising progesterone after ovulation statistically accounted for the fall in desire into the luteal phase. The same study could not explain the rise before mid-cycle with any combination of the hormones it measured, and testosterone had no clear effect once oestradiol and progesterone were accounted for. That matters, because a lot of popular writing presents testosterone as the main driver of a mid-cycle "surge". In naturally cycling people, this study did not support that. If you want a refresher on what happens in each phase, see the four phases of the menstrual cycle.

Sexual desire can change across the menstrual cycle, but the pattern is less tidy than most explanations suggest. On average, studies find a modest rise around the middle of the cycle and a fall in the second half. Underneath that average, people differ a great deal: some feel most interested just before or during their period, and some notice no cycle pattern at all.

Hormonal contraception changes this picture for some people and not for others. Large reviews find most users report no change in desire, a minority report less, and some report more. Perimenopause can push desire down, up, or both in the same year. None of these patterns means your body is doing something wrong, and none of them can be predicted for you in advance by an app or a calendar.

Two women lying in bed under white sheets, one laughing. Photo by RDNE Stock project on Pexels.

Does libido change across the menstrual cycle?

For many people it does, a little. A study published in Hormones and Behavior collected daily saliva samples and desire ratings across one to two cycles and found that desire, on average, peaked mid-cycle. Higher oestradiol tracked with more desire and higher progesterone with less. Rising progesterone after ovulation statistically accounted for the fall in desire into the luteal phase.

The same study could not explain the rise before mid-cycle with any combination of the hormones it measured, and testosterone had no clear effect once oestradiol and progesterone were accounted for. That matters, because a lot of popular writing presents testosterone as the main driver of a mid-cycle "surge". In naturally cycling people, this study did not support that.

If you want a refresher on what happens in each phase, see the four phases of the menstrual cycle.

Why your pattern may not match the textbook one

The average effect is small, and averages hide people. A 2023 study in The Journal of Sexual Medicine followed 213 university students through two full cycles with daily reports. Across the whole group there was a small mid-cycle increase in desire. When the researchers looked at individuals, the differences were large: some showed the mid-cycle rise, others had their highest desire around their period, and others had no cycle-linked change.

The same study found that psychological changes, such as mood and stress, predicted desire better than physical symptoms did. The authors suggested that tracking desire daily across several cycles is a more useful way to understand one person's pattern than applying a general rule.

In practice:

No mid-cycle rise is not a sign of a hormone problem or that you did not ovulate.
Higher desire before or during your period is a recognised pattern, not an oddity.
A drop in the luteal phase may have as much to do with tiredness, bloating, or luteal mood changes as with hormones directly.

What hormonal contraception does to desire

Whether hormonal contraception raises or lowers desire is a common question, and the honest answer is that the evidence is mixed and depends on the person and the method.

A review in The Journal of Sexual Medicine concluded that the sexual side effects of hormonal contraceptives are not well studied. It found mixed effects on libido: a small percentage of users reported an increase, a small percentage a decrease, and the majority were unaffected.

The strongest single piece of evidence is a double-blind, placebo-controlled trial at Karolinska University Hospital. It randomised 340 healthy women aged 18 to 35 to a combined pill containing levonorgestrel and ethinylestradiol, or to placebo, for three months. Overall sexual function was similar between groups. Scores for desire, arousal and pleasure were modestly lower on the pill, while orgasm, responsiveness, self-image, the frequency of satisfying sexual episodes, and personal distress did not differ.

Question	What the evidence shows
Does the pill lower desire for most users?	No. The 2012 review found most users unaffected
Can it lower desire for some?	Yes. One trial found small drops in desire, arousal and pleasure on a levonorgestrel pill
Can it raise desire for some?	Yes, a minority report an increase
Does one study cover every method?	No. The trial tested one pill for three months; other pills, the implant, injection and coils were not tested

The NHS lists hormonal contraception, including the pill, patch and implant, among the possible causes of low sex drive. Its listed options include changing to a different type of contraception, and it advises seeing a GP if you think your method is affecting your sex drive.

Two cautions keep this in proportion. First, a change in desire after starting contraception may coincide with other things, such as a new relationship, stress, or a change in mood. Second, stopping contraception without a replacement carries a pregnancy risk. Talking it through with a GP or sexual health clinic lets you switch methods without a gap. For bleeding changes when you start or switch a method, see birth control and bleeding changes.

Perimenopause: desire can go down, or up

Most of the research on perimenopause describes a decline. The Study of Women's Health Across the Nation (SWAN), which followed more than 3,000 women from their 40s, found that sexual desire decreased and pain during sex became more likely by late perimenopause. A later SWAN analysis found that overall sexual function began to decline about 20 months before the final period.

That is not the whole story. The first SWAN analysis also found that masturbation increased in early perimenopause before declining after menopause. Mayo Clinic explains that during perimenopause oestrogen rises and falls, and that sexual arousal and desire may change: some women enjoy sex less, while others enjoy it more.

So a rise in desire in your 40s is within the range of normal experience. The research has not pinned down why it happens for some people, so treat confident hormone explanations with caution. For the cycle changes that often come alongside it, see perimenopause and period changes.

When desire falls around menopause, the NHS notes there are many possible reasons, including relationship difficulties, how you feel about yourself, and physical discomfort. Vaginal dryness and pain during sex are treatable. The NHS also says testosterone gel or cream can help low libido for some people, and may be prescribed by a menopause specialist.

Other reasons desire changes

Cycle hormones are only one influence, and often not the largest. The NHS lists these among the main causes of low sex drive:

Stress, anxiety or depression, and the tiredness that often comes with them
Medicines, including some antidepressants and blood pressure treatments
Pregnancy and a new baby, through hormone changes, stress and lack of sleep
Alcohol, particularly drinking too much
Relationship problems
Physical problems, such as vaginal dryness or pain during sex
Long-term conditions, such as diabetes, heart disease, an underactive thyroid, or cancer

Mayo Clinic also points out that there is no number that defines a low sex drive. Desire naturally rises and falls with life changes, relationships and health. Lower desire than a partner, or lower than you used to have, is not automatically a problem, and a relationship can be strong either way.

What tracking can and cannot tell you

An app cannot tell you why your desire changed, or predict how a contraceptive will affect you. What a few cycles of notes can do is show whether your desire follows a cycle pattern at all, and give you something concrete to discuss with a clinician.

If you want to look for a pattern, these are worth recording:

Desire, as a quick daily rating in your own words or numbers
Mood, stress and energy, since these predicted desire better than physical symptoms in the 2023 study
Cycle day, so you can line entries up across cycles
Contraception changes, with the start date and method name
New medicines, and when you started or stopped them
Pain or dryness during sex, which is a separate, treatable problem

In Flowy, the day log has an Intimacy section (protected, unprotected, withdrawal, solo or other), alongside Feelings, Energy and Mind sections and a free-text Notes field. There is no dedicated desire scale, so a short note such as "desire: high" is the simplest way to record it. Logging sex is not contraception, and nothing in a cycle app can tell you whether a day is safe from pregnancy.

When to talk to a healthcare professional

The NHS suggests seeing a GP if:

Your sex drive does not return to normal after pregnancy
You think a medicine or your contraception may be affecting your sex drive
You are worried about your low sex drive

Mayo Clinic adds that low desire that persists or keeps returning and causes you distress may be a treatable condition, but you do not need to meet a diagnosis to ask for help. Pain during sex, or low desire alongside persistent low mood, is also worth raising.

Frequently asked questions

Is it normal to want sex more just before my period?

Yes. In the 2023 daily-diary study, some participants had their highest desire around their period rather than mid-cycle.

Can the pill permanently lower my sex drive?

The available trials measured effects during use, over months rather than years. There is not good evidence about long-term effects after stopping, so if you notice a change that does not settle, raise it with a GP.

Does high libido mean I am ovulating?

Not reliably. Desire varies too much between people, and from cycle to cycle, to work as an ovulation or fertility sign.

Is a libido surge in perimenopause a warning sign?

Not on its own. Mayo Clinic notes some women enjoy sex more during perimenopause. If it comes with other changes that worry you, talk to a clinician.

The short version

Desire moves with the cycle for some people, and the average pattern is a modest mid-cycle rise with a luteal dip. Your own pattern may be different, reversed, or absent, and that is normal. Hormonal contraception leaves most users unchanged and lowers desire for some, and switching method is a reasonable step to discuss. Perimenopause can move desire in either direction. If a change bothers you, a few cycles of notes and a conversation with a GP will usually tell you more than any general rule.