PCOS and sex drive: How does it affect your libido?

Libido isn’t talked about nearly enough when it comes to PCOS. When it is discussed, the conversation often focuses exclusively on low sex drive, leaving many women feeling confused or alone if their experience is different.

The truth is that PCOS can affect libido in different – and sometimes completely opposite – ways. Some women experience low desire, others notice increased libido, and many find their sex drive fluctuates unpredictably. All of these experiences are valid and more common than you might think. 

In this blog, we’ll explore how PCOS impacts sex drive, what causes these changes, and what you can do to support a healthy libido while managing your symptoms.

Can PCOS affect your sex drive? 

Yes, PCOS can significantly impact sexual desire and arousal. Studies suggest women with PCOS are more likely to report reduced desire and arousal difficulties compared with women without PCOS.

Libido with PCOS is influenced by a complex mix of factors: 

• Hormones: Androgens (like testosterone), oestrogen, and progesterone all play roles in sexual desire. PCOS-related hormonal imbalances can affect these levels in different ways.
• Ovulation patterns: Women who ovulate often experience a libido peak around ovulation when oestrogen levels are highest. Irregular or absent ovulation can disrupt this rhythm.
• Mental health and stress: Anxiety, depression, and stress all impact sexual desire.
• Body image and confidence:  research also shows that body image concerns related to weight and facial hair growth can affect sexual function in women with PCOS.
• Medications and supplements: Hormonal contraception and certain medications can influence libido.

There’s no single ‘PCOS libido’ experience – it widely varies from person to person and can even change over time for the same individual.

Hormones, ovulation, and libido in PCOS

Understanding the hormonal picture can help make sense of libido changes with PCOS.

Testosterone and sexual desire

While we often think of testosterone as a male hormone, it plays a crucial role in female sexual desire, too. Women with PCOS often have elevated androgens, which can increase libido in some cases – though the correlation isn’t always straightforward.

The role of ovulation

In people who ovulate regularly, sexual desire typically peaks around ovulation, when oestrogen levels are at their highest. This biological rhythm evolved to increase the likelihood of conception during the fertile window. 

With PCOS, irregular or absent ovulation means this libido pattern may not occur, leading to either consistently low desire or unpredictable fluctuations.

Hormonal fluctuations

Even in women who do ovulate, hormonal levels may be more erratic than in those without the condition. This can mean libido feels inconsistent – high some weeks, low others, or varying month to month in ways that feel confusing or unpredictable.

Progesterone and oestrogen balance

After ovulation, progesterone rises and can have a dampening effect on libido. When ovulation is irregular, this balance between oestrogen and progesterone becomes disrupted, potentially affecting sexual desire in unexpected ways.

PCOS and low libido

Low libido is the most commonly discussed experience in PCOS conversations, though it’s important to note that it’s not expected or inevitable – many women with PCOS don’t experience reduced desire at all.

For those who notice a lower sex drive, several factors may contribute:

• Hormonal imbalances: Disrupted ratios of testosterone, oestrogen, and progesterone can reduce sexual desire.
• Fatigue and insulin resistance: Chronic tiredness and blood sugar imbalances leave little energy for intimacy.
• Stress, anxiety, or depression: Mental health struggles can significantly impact sexual desire.
• Body image concerns: Feeling disconnected from or unhappy with your body can make intimacy feel difficult. 
• Pain during sex: Research shows that some women with PCOS may experience vaginal dryness or pelvic discomfort, which can understandably reduce desire for sexual activity. 
• Hormonal contraception or medications: The pill and certain PCOS medications can lower libido as a side effect.
• Hormonal imbalance symptoms: Other PCOS symptoms and hormonal imbalance symptoms, like mood swings and irregular periods, can compound the impact on sexual desire. 

Remember, low libido is not a personal failing. It often has identifiable, addressable causes that deserve attention and support.

PCOS and high libido

An increased sexual desire can feel confusing or isolating when most PCOS content focuses on low sex drive. Some women describe feeling like their experience doesn’t fit the narrative, or they notice a disconnect between high desire and other challenges like irregular cycles or fertility struggles. 

High libido with PCOS is completely normal and valid. Just as PCOS presents differently in different bodies, so does its impact on sexual desire.

When libido fluctuates – having both high and low sex drive

For many women with PCOS, libido isn’t consistently high or low – it fluctuates, sometimes dramatically. 

• Cyclical changes:  If you ovulate regularly, you might experience intense desire during some months and almost nothing during others, depending on your hormonal patterns that cycle. 
• Non-cyclical fluctuations: Stress levels, blood sugar level stability, sleep quality, and mental load can all shift desire week to week, independent of your menstrual cycle. 
• Why PCOS makes libido unpredictable: The hormone irregularity that defines PCOS means that the biochemical triggers for sexual desire are themselves inconsistent. This can make libido feel confusing or unreliable.

Fluctuation is normal. Understanding that your changing desire has physiological roots – rather than being a personal failing or relationship issues – can help reduce frustration and open up better communication with partners.

PCOS, mental health, and sex drive

Libido is both a physical and emotional experience, and mental health plays a significant role in sexual desire.

• Anxiety and low mood: These common experiences with PCOS can reduce interest in intimacy and make connections feel more difficult.
• Reduced self-esteem: Body image concerns, symptom management, and the emotional load of PCOS can affect how you feel about yourself and your desirability. 
• Fertility pressures: If you’re trying to conceive (TTC), sex can start to feel like a medical task rather than an intimate connection, which can impact natural desire.
• Relationship dynamics: PCOS symptoms and their management can affect relationship dynamics. Open communication with partners about what you’re experiencing – physically and emotionally – can help maintain intimacy even when libido fluctuates. 

Addressing mental health alongside physical symptoms is essential for supporting overall wellbeing, including sexual desire.

What can help support a healthy libido with PCOS?

Supporting libido with PCOS often involves addressing multiple factors at once. Here are practical approaches that can help: 

Support ovulation and hormonal balance

PCOS supplements like Inofolic Alpha and Inofolic Alpha Plus (for women in bigger bodies) can support ovulation, cycle regularity and hormonal balance, which may positively impact sexual desire.

Manage insulin resistance and energy levels

Stabilising blood sugar and addressing fatigue through diet, movement, and targeted supplements can improve overall vitality, including libido.

Address stress and sleep

Chronic stress and poor sleep can impact hormones and desire. Prioritising rest and finding stress management techniques that work for you can make a real difference.

Talk openly with partners or healthcare providers

Communication reduces isolation and opens up possibilities for support, whether that’s adjusting expectations during low-libido periods or exploring solutions together.

Review medications or contraception

If you suspect your contraception or other medications are affecting your sex drive, discuss alternatives with your healthcare provider. Sometimes adjustments can make a significant difference.

Remember – supporting libido is about creating the conditions for desire to emerge naturally, not forcing it or judging yourself when it fluctuates.

When to speak to a healthcare professional

Moving forward with body respect

PCOS affects libido in diverse and individual ways. Whether you experience low desire, high desire, or fluctuating patterns, your experience is valid and more common than mainstream conversations suggest. 

Managing PCOS holistically – including supporting natural ovulation and hormonal balance – can positively impact many symptoms, including sexual desire.

Supplements like Inofolic Alpha and Alpha Plus provide targeted nutritional support for women with PCOS, containing myo-inositol, alpha-lactalbumin, folic acid and other supportive micronutrients. This blend helps to support hormonal balance and overall wellbeing.

Be patient with yourself and your body as you navigate these changes. Understanding the reasons behind libido fluctuations can reduce frustration and help you approach intimacy with more compassion and less pressure.

Frequently Asked Questions

Can you have a high libido and still have PCOS?

Absolutely. While low libido is often discussed in PCOS contexts, elevated androgens can actually increase sexual desire in some women. PCOS presents differently in different bodies, and high or normal libido is a completely valid experience with the condition.

Can supplements help libido with PCOS?

PCOS supplements that support hormonal balance and ovulation, such as those containing myo-inositol, may indirectly support libido by addressing underlying hormonal imbalances. While supplements aren’t specifically marketed for libido, improving overall PCOS symptoms – including insulin resistance, energy levels, and cycle regularity – can positively impact sexual desire.

Does the pill affect sex drive if you have PCOS?

Yes, hormonal contraception can affect libido in women with or without PCOS. The pill can reduce testosterone levels, which may lower sex drive in some women. If you suspect the pill is affecting your libido, discuss alternatives with your healthcare provider.

Can PCOS cause vaginal dryness?

Yes, PCOS can be associated with vaginal dryness, though it’s not one of the most commonly discussed symptoms. Hormonal imbalances, particularly lower oestrogen levels or irregular cycles, can affect vaginal lubrication. If you’re experiencing dryness or discomfort during sex, speak with your healthcare provider about solutions.

Is it normal for libido to change throughout the month?

Yes, it’s completely normal for libido to fluctuate throughout the menstrual cycle, typically peaking around ovulation when oestrogen is highest. With PCOS, these patterns may be less predictable due to irregular ovulation, but cyclical changes in desire are a normal part of hormonal function.

References 

Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nature Reviews Endocrinology. 2014;10(5):270-284. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4233312/

Teede HJ, Misso ML, Costello MF, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. International Journal of Gynecology & Obstetrics. 2023. Available at: https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.13911

Wåhlin-Jacobsen S, Kristensen E, Pedersen AT, et al. Is there a correlation between androgens and sexual desire in women? Journal of Sexual Medicine. 2015;12(2):358-373. Available at: https://pubmed.ncbi.nlm.nih.gov/25475395/