--- title: Libido and sexual function: 42 studies, explained | Niyora description: 42 studies on libido and sexual function and PMS or PMDD, each summarised in plain English: what was tested, who took part, what they found and what it means. url: https://niyora.com/research/topics/symptom-sexual-function/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Libido and sexual function # Libido and sexual function: what the research says 42 studies on libido and sexual function in PMS and PMDD, each explained in plain English. 7 of them use the strongest designs: randomised trials and systematic reviews. Survey study 18 Randomised trial 9 Cohort study 4 Review 3 Case report 2 Non-randomised trial 2 Randomised trial, 2025 Does mood, well-being, and sexual function change across the menstrual cycle? No, there were no meaningful changes in sexual function, mood, or well-being across menstrual cycle phases in healthy young women. Being in a stable relationship predicted better sexual function overall, but cycle phase did not. Systematic review, 2024 Do SSRI antidepressants help treat PMS and PMDD? Yes. SSRIs probably reduce premenstrual symptoms in women with PMS and PMDD based on moderate-certainty evidence from 34 studies. Daily continuous use appears more effective than taking SSRIs only before your period. Randomised trial, 2008 Does the antidepressant escitalopram taken only during the luteal phase reduce PMDD symptoms? Yes. Escitalopram taken at 20 mg daily during the luteal phase only reduced core PMDD symptoms by 90%, much more than placebo. 80% of women had an 80% or greater reduction in irritability compared to 30% on placebo. Randomised trial, 2005 Does fluoxetine improve sexual drive and desire in women with PMDD? Fluoxetine showed a trend toward improving sexual drive compared to placebo, though the difference wasn't statistically significant. This suggests SSRIs might help rather than harm sexual drive in women with PMDD. Cohort study, 2004 Do women with PMS have worse menopausal symptoms? Yes, women with PMS are significantly more likely to experience hot flushes, depression, poor sleep, and low libido during menopause. This large five-year study provides strong evidence for this connection. Randomised trial, 2003 Do SSRIs (antidepressants) help PMDD? Yes, multiple randomized trials show SSRIs significantly improve PMDD symptoms, especially mood and psychological symptoms. Intermittent dosing for 14 days per month works nearly as well as daily dosing. Randomised trial, 1988 Does dydrogesterone help premenstrual symptoms in real-world practice? No, dydrogesterone was no better than placebo. While 52 percent of women on the drug improved versus 44 percent on placebo, this small difference is not clinically meaningful. Survey study, 2026 Are women with PMS more likely to have sexual dysfunction? Yes. Women with PMS and PMDD have increased risk of sexual dysfunction including low libido, inability to reach orgasm, and pain during intercourse. The causes may be shared hormonal and serotonin system problems. Survey study, 2025 How does sexual desire change during the menstrual cycle? Sexual desire typically increases around ovulation when estrogen is highest, but stress, sleep, relationship quality, and PMS or PMDD can weaken this biological pattern. Randomised trial, 2023 Does mindfulness counselling improve sexual function in women with premenstrual syndrome? Yes. Mindfulness counselling significantly improved sexual desire, orgasm, satisfaction, and pain. These improvements appeared right after treatment and remained at one month follow-up. Cohort study, 2023 Does sexual desire change across the menstrual cycle? Sexual desire does change with the menstrual cycle on average, but the pattern varies greatly between women. Some show increased desire mid-cycle while others show no change. Randomised trial, 2022 Does emotion-focused group therapy help women with premenstrual dysphoric disorder? Yes. Emotion-focused group therapy significantly improved pain, self-compassion, sexual function, and reduced couple burnout. The effects were large and consistent across all measured areas. Survey study, 2021 How did the COVID-19 pandemic affect women's menstrual cycles and symptoms? Nearly half of women reported worsening of their PMS symptoms during the pandemic. Many also reported changes in their menstrual bleeding, increased period pain, and missed periods. Cohort study, 2017 Do women with PMS experience more sexual difficulties and sexual distress? Women with PMS are significantly more likely to report sexual difficulties and sexual distress. 77.6% of women with PMS had sexual concerns compared to 27.3% of controls, and 51.7% of PMS women had sexual difficulties compared to 24.5% of controls. Survey study, 2016 Do hormonal contraceptives reduce PMS symptoms? Hormonal contraceptives are linked to lower risk of some PMS symptoms, including cramps, fatigue, and depression, but not others like mood swings and bloating. Survey study, 2016 Does hormonal birth control affect sexual desire across the menstrual cycle? This study of 89 couples found that women on hormonal birth control pills did not show cycle-related changes in sexual desire that naturally cycling women have. Sexual intercourse frequency declined slightly toward the end of pill cycles. Study, 2011 Does sexual interest change at different times of your menstrual cycle? Women reported more sexual activity before ovulation, and sexual interest was connected to mood and energy levels rather than just hormones. Lab study, 2009 Does emotional response to sexual images change during the menstrual cycle? Yes. Women show more positive emotional reactions to images of nude men during the early part of the cycle compared to the later part. Survey study, 2002 Does sexual behavior change across different phases of the menstrual cycle? Sexual behavior varies across cycle phases. Masturbation is highest during the follicular and ovulatory phases for women without a partner, but not for those with a live-in partner. Sexual activity with a partner peaks in the follicular phase for both groups. Randomised trial, 1993 Does oral contraceptive help PMS and affect sexual interest? The oral contraceptive improved mood during the premenstrual phase but decreased sexual interest during the menstrual and postmenstrual phases. The mood improvement was not the cause of the decreased sexual interest. Case report, 2026 Does psychotherapy help with premenstrual increases in sexual desire and thoughts? Yes. Psychotherapy reduced sexual distress in three women with cyclical increases in sexual desire before menstruation. Survey study, 2024 How are PMDD and sexual dysfunction connected? Women with PMDD often experience sexual problems during the premenstrual phase. Some medications treat PMDD and others treat sexual dysfunction, but it's not clear if they help both conditions together. Review, 2023 Does PMDD affect sexual function? There is a likely biological and psychological connection between PMDD and sexual dysfunction, but very few studies have examined this link. More research is needed. Survey study, 2021 How common is PMS in health care workers? Very common at 76% overall. But rates were much higher in younger women: 80% of those ages 20-24, dropping to 58.3% in ages 25-30, and 46.6% in ages 31-40. Survey study, 2021 Does PMS affect sexual function during the menstrual cycle? No, PMS does not affect sexual function. Sexual function was worse during the luteal phase regardless of whether women had PMS. Survey study, 2021 Do premenstrual symptoms affect sexual desire? Sexual desire is linked to some premenstrual symptoms, particularly back pain, painful periods, and mood changes. Sexual desire was not clearly linked to other symptoms like headaches or breast tenderness. Survey study, 2019 Is premenstrual syndrome a risk factor for sexual dysfunction? No. This study of 282 women found no significant relationship between PMS and sexual dysfunction. Age and urinary problems increased sexual dysfunction risk instead. Interview study, 2015 Does hormonal contraception affect mental health and sexual desire? Clear effects were found on sexual desire (decreased) and painful menstruation (reduced). No clear difference was found in psychological symptoms overall, though interviews suggested some women may experience mental changes. Cohort study, 2014 Does tubal ligation affect periods and premenstrual symptoms? Yes. After the surgery, premenstrual symptoms increased significantly, along with heavier periods and more pain during periods. Women under 35 were more likely to experience these changes. Survey study, 2010 Does PMS severity affect quality of life and sexual desire? Yes. Higher PMS severity was linked to more limitations in daily activities and quality of life. Compared to women with no PMS (45.7%), more women with PMS (67.5%) or PMDD (73.3%) reported sexual desire problems. Survey study, 2006 Do women with fibromyalgia have more reproductive problems and sleep problems? Yes. Women with fibromyalgia were significantly more likely to have PMS, period pain, and sleep problems, and were less physically active and reported more sexual dysfunction. Randomised trial, 2001 Do buspirone and nefazodone help premenstrual dysphoria? Buspirone reduced premenstrual irritability and overall symptoms more than placebo. Nefazodone did not work better than placebo. Both had good tolerability with no excess sexual side effects. Review, 1999 Could testosterone help women with PMS? Testosterone might help PMS symptoms according to this review, but it is only listed as a possible use without presenting evidence from studies. Survey study, 1999 Does sexual desire and function change during the menstrual cycle in women with PMS? Yes. Women with premenstrual symptoms reported less sexual desire and less frequent sexual activity before their period than at other times in their cycle. Survey study, 1996 Is sexual arousal different in different phases of the menstrual cycle? Yes. Women reported higher sexual desire and more erotic fantasies in the follicular phase than in the luteal phase, and this difference persisted over time. Non-randomised trial, 1994 Does fluoxetine (an antidepressant) help premenstrual mood symptoms when taken for a long time? Yes, in this study most women improved and about half went into full remission with long-term fluoxetine use, though it was not a controlled comparison. Review, 1992 How do hormones affect sexuality and psychology in women? Androgens and estrogens play important roles in female sexuality, but their effects are less predictable and less well-understood than in men. Environmental and psychosocial factors appear to play a larger role in women's sexuality than in men's. Survey study, 1991 What mental health and social problems do women with PMS have? Most women seeking PMS treatment (67 percent) had a psychiatric disorder, with depression and anxiety being most common. Sexual dysfunction and social problems were also frequent. Non-randomised trial, 1990 Does testosterone affect sexual behavior differently in pill users versus non-users? Birth control pill users and non-users had similar sexual activity overall. Only non-users showed cycle-related drops in testosterone and matched decreases in sexual desire. Testosterone levels did not predict actual sexual activity in either group. Survey study, 1986 Is premenstrual syndrome more common in women with low sexual desire? Yes. Significantly more women with low sexual desire had severe premenstrual syndrome than women without sexual dysfunction. These women also had higher rates of depression. Survey study, 1983 How do women with premenstrual tension differ psychologically? Women with premenstrual tension have lower self-esteem, more negative attitudes to menstruation, and feel less control over their lives than women without it. Case report, 1981 How do hormonal birth control and progesterone affect mood? Hormonal birth control affects mood differently in different women. In some, it causes depression and loss of sexual desire. In others, it has mood-stabilizing effects and can reduce PMS. How progesterone and hormonal birth control affect mood varies from person to person. Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗