How does sexual desire change during the menstrual cycle?

Objective. To investigate the relationship between fluctuations in the endocrine profile (in particular, estradiol, progesterone, testosterone, and luteinizing hormone) in different phases of the menstrual cycle and changes in female libido, to determine which psychosocial moderators (premenstrual syndrome/premenstrual dysphoric disorder (PMS/PMDD), stress, sleep, cycle regularity, contraception, etc.) influence this relationship. Methods. A systematic review of the literature for the period 2015-2025 was conducted using the PubMed, MEDLINE, Scopus, Web of Science, PsycINFO, and ClinicalTrials.gov databases. The study sample included 48 scientific publications that met the following inclusion criteria: studies with participants of reproductive age; measurement of sexual desire/libido or sexual behavior in relation to the phase of the cycle; measurement of hormones or clear validation of the phase. Results. The results of a systematic review demonstrated pronounced phase dynamics of female libido, most noticeable during the periovulatory period: about 65% of studies recorded an increase in sexual desire at the end of the follicular phase or during ovulation, coinciding with the peak of estradiol (180–250 pg/ml) and a relative decrease in progesterone. Estradiol was positively correlated with libido (r = 0.42–0.58, p 50,000 users) confirms that women with regular and shorter cycles show higher sexual motivation. Conclusions. Current data support the idea of multidimensional control of female libido: endocrine fluctuations (especially estradiol and progesterone) create the biological basis for phase changes in sexual desire, but their influence is moderated by psychosocial factors (PMS/PMDD, stress, sleep, relationships, contraception). When diagnosing sexual desire disorders, it is important to consider the phase of the menstrual cycle and the presence of PMS/PMDD; treatment approaches should be individualized (taking into account hormonal fluctuations, assessing psychosocial triggers, possible use of hormonal or psychotherapeutic correction depending on the etiology).

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