The short answer
Libido drops in perimenopause for many reasons at once, not just hormones. On The WarriorBabe Show, Dr. Jolene Brighten points to swinging then falling estrogen, lower progesterone, poor sleep, histamine, pain with sex, insulin resistance, inflammation, stress, body image and relationship strain. Her message: you are not broken.
Hear it answered
Tap play to start right where it's answered. It keeps playing while you browse.
Dr. Brighten on why perimenopause libido loss is multifactorial and estrogen's role
Plays from 40:54 · Ep. 300: Lifting, Under-Eating and Perimenopause: Truths After 40
How belly fat, body image and pregnancy fears pull you out of the mood
Plays from 40:33 · Ep. 279: Early Perimenopause Signs Women Over 40 Should Know
The overlooked link between insulin resistance, inflammation and orgasm
Plays from 41:37 · Ep. 279: Early Perimenopause Signs Women Over 40 Should Know
Why your partner lowering your stress helps desire come back
Plays from 37:37 · Ep. 279: Early Perimenopause Signs Women Over 40 Should Know
The full answer
Dr. Jolene Brighten, a naturopathic endocrinologist and certified menopause specialist, calls perimenopause libido loss very multifactorial. She explains that estrogen drives much of sexual desire, fantasies, lubrication and arousal, and that desire naturally dips after ovulation once progesterone comes online. Testosterone matters too. She notes that roughly half is made by the ovaries, and the adrenal glands make DHEA that converts to testosterone, so it is worth looking at if desire has disappeared.
She also flags what she says gets talked about least:
- Insulin resistance and inflammation are bad for libido and orgasm. She explains that elevated glucose can damage nerves in the clitoris, making orgasm harder.
- Mood shifts. She says around 40% of women see new anxiety or depression with the hormone decline.
- Body changes and belly fat that lead to body image issues, which she names, along with fear of unintended pregnancy, as two big reasons women get out of the mood.
- Pain with sex. If sex hurts and there is no orgasm, desire understandably fades.
Stress and your relationship are part of it as well. Dr. Brighten tells women to ask their partner to lower their stress load and give the kind of love they need, whether that is touch, praise or doing the dishes. When your nervous system is dysregulated, she says, you simply do not receive those signals.
She adds that for some women, things like vaginal estrogen, lube and no pregnancy risk change the picture completely. That is a conversation to have with your doctor, not a fix to guess at. The takeaway from both episodes: it is never just your hormones, and nothing is wrong with you. Lower libido is a signal to look at the whole picture.
From WarriorBabe's coaches (how we write our answers). For education, not medical advice: talk to your doctor about your own health.
Women also ask
More on Hormones & Hormone Health →
Hormones & Hormone Health
How can I balance my hormones naturally after 40?
On The WarriorBabe Show, supporting your hormones after 40 starts with your routine, not willpower. That means consistent strength training, walking instead of punishing cardio, real recovery and lower stress, and eating enough, especially protein at every meal. The episodes frame this as supporting your body, not fixing a broken one. For symptoms or medications, work with your doctor.
Read the answer →
Hormones & Hormone Health
How can I tell if my stress hormones are out of balance?
The show points to these signs: feeling wired and tired at bedtime, being easily startled, waking unrested or with headaches after a full night's sleep, blood sugar crashes and getting sick often. On Ep. 279, Dr. Jolene Brighten says cortisol can be checked with saliva or urine testing, like the DUTCH test, or with blood work.
Read the answer →
Hormones & Hormone Health
What is metabolic flexibility?
Metabolic flexibility is your body's ability to run on fat for energy and then easily switch to burning carbs after a carb-containing meal or during hard effort. On The WarriorBabe Show, Lumen co-founders Michal and Merav link it to healthy mitochondria and to lower risk of obesity, insulin resistance and other chronic disease.
Read the answer →
Hormones & Hormone Health
How much fat should I eat for hormone health?
Nikkiey typically sets women's fat between 55 and 85 grams a day, depending on whether you're cutting or in maintenance. On Ep. 172 she says women going through menopause usually need fat a little higher to support their changing hormones. She also says to actually hit your fat target, because falling short quietly cuts calories.
Read the answer →
Hormones & Hormone Health
Can strength training help with insulin resistance?
Yes. On the show, strength training is one of the main tools for insulin resistance. Nikkiey explains that building muscle improves insulin sensitivity, and Dr. Morgan Nolte says muscle is the main reservoir for the glucose you eat, so more muscle means less glucose spilling over into fat tissue and a lower insulin response.
Read the answer →
Hormones & Hormone Health
Can stress stop me from losing belly fat?
Yes, according to Nikkiey. On The WarriorBabe Show she explains that chronic stress keeps cortisol elevated, which she says increases fat storage around the midsection and drives cravings for comfort foods. Even with solid macros and training, a body stuck in survival mode can hold on to fat, so managing stress becomes part of the plan.
Read the answer →
Watch or listen in full
More on this topic →
55 minLifting, Under-Eating and Perimenopause: Truths After 40
Episode 300 · Oct 6, 2025
1 hr 1 minEarly Perimenopause Signs Women Over 40 Should Know
With Dr. Jolene Brighten