Perimenopause and Testosterone

Testosterone is a key player in your sex drive - it affects interest, arousal, sexual response, lubrication and orgasm. Many women in perimenopause don’t have enough testosterone.

Before menopause, testosterone comes primarily from the ovaries, both directly and indirectly through their production of progesterone. DHEA, a hormone produced from progesterone in the adrenal glands, also partly converts into testosterone. If your adrenals are healthy as you approach menopause, they’ll smoothly take over more of the sex hormone production from your ovaries. If you’re under too much stress, though, the adrenals work overtime, favoring cortisol instead of DHEA production. This can lead to low testosterone levels and low libido.

Some women maintain good levels of testosterone throughout perimenopause and menopause, and have no complaints. Their bodies probably compensate better by making testosterone from the pathways of other steroidal hormones, through more balanced adrenal function, and a healthy metabolism supported by good nutrition.

Supplemental testosterone is available, and it may be an option to discuss with your doctor if you've experienced a significant drop in your sex drive. Equally important in maintaining libido, however, is keeping a check on stress, exercising, eating and sleeping well, and avoiding the build-up of resentment in your relationship.