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Will Pelvic Floor Exercises Help My Libido?
- Carri Dominick
- Aug 3
- 4 min read
Low libido is common for many women in different stages of life. Someone recently asked me if doing pelvic floor therapy and pelvic floor exercises would help their libido. This blog is going to address libido in cis-gendered women only.
I honestly don't think so. There is no research showing this. (There is not a ton of research about many things in pelvic floor therapy, but I haven't seen anything conclusive about libido).
I have a few clients who feel more desire simply because they are paying more attention to that part of their body, but this is not a common experience, which is why I told that person I don't think they should come to pelvic floor therapy to try to improve their libido.
What Can You Do To Improve Libido?
There are some things you can do to improve libido that do have some research behind them.
exercise, of any kind
sunlight, especially in the morning or mid-day
sleep
adventure
try something new with your partner (non-sex related)
scheduling sex
understand the psychological component of desire
medication
for women there is a medication called Addyi approved for those up to age 65
estrogen (systemic) and vaginal estrogen
Understanding Desire
I think many of us are taught that desire should be spontaneous and we should desire sex often. This may be true for some people, and at certain stages of life, but it is common not to have spontaneous desire throughout life.
There is also something called reactive desire, and this is a way to boost libido. If you set the mood, then the desire may come. This is common for people to mainly have this type of desire, and that is perfectly normal.
This is why scheduling sex can be helpful. Society may say that isn't sexy, but for long term monogamous relationships, this can be perfectly normal. You can know it is coming so you can prepare for it physically and mentally.
Don't Skip the Foreplay
For many of my clients, when they don't feel spontaneous desire but want to keep their partner happy, they may just want to get the task overwith, so they skip foreplay. Or sometimes, it is due to a phase of life, like when you have kids at home.
Foreplay is important to give the body and brain time to be aroused. This is especially important for female bodies. Males can often get to full arousal very quickly, but females take, on average, 30-45 minutes to reach full arousal, so don't skip the foreplay. Give the body time for reactive desire to occur. This is also important for females who have pelvic pain with sex. If you are skipping foreplay, then the body isn't fully optimized for sex, and can create more pain.
A Book To Help You Understand Libido
A book I commonly recommend my patients read is called "Come As You Are" by Emily Nagoski. She is a sex educator and has a PhD in this topic.
I have read this book several times and I learned a lot from it.
One example she uses is the analogy of a car's brakes and accelerator. For some people they need to let off the brake. This may mean that the dishes need to be done and the trash taken out and they took a shower. Now their brain can let go of those, let off the brake, and focus on sexual desire and pleasure.
Someone who needs more of the accelerator might need some sexting, kissing, skin-to-skin, talking about what they want to do, in order to push on the accelerator to get their brain and body to have more desire.
The author talks about many more things in the book, but that is one concept that really stuck out to me. I highly recommend reading this book if you are having trouble with your libido.
A Medication for Female Desire
The medication called Addyi has been on the market since 2015. It was first approved for those who are pre- or peri-menopausal. In 2025 it was expanded to be approved for those up to age 65 who have low libido, or in medical terms known as "hypoactive sexual desire disorder."
Estrogen
Estrogen can also be a factor in libido. As estrogen declines in menopause, and in postpartum, that can affect libido because estrogen helps with dopamine. More dopamine can improve libido (hence many things on the list that increase dopamine).
For those in menopause, this might be a conversation with your doctor about menopause hormone therapy. A big caveat here is that menopause hormone therapy is not studied as a way to improve libido, but it may be a consideration along with the rest of your medical history.
Vaginal estrogen is localized estrogen, meaning, it just gets absorbed into the tissues where it is placed, it isn't absorbed throughout the bloodstream and body. For those with vaginal dryness, vaginal estrogen can be a huge help. Less pain = more desire.
Pelvic Floor Therapy and Libido
For those women who have pelvic pain, removing that pain can substantially increase desire. Duh! No one wants to participate in an activity that causes pain. (We are not talking about S&M here, that is a chosen pain).
I see many women in my clinic, and a few men, who have pelvic pain. Pelvic pain is a real downer for libido. For someone with pelvic pain I would definitely recommend pelvic floor therapy to help with libido.
For those people without pelvic pain, there is one small study that shows a positive correlation between pelvic floor muscle training and increased sexual desire, but the author concludes that the "certainty of the evidence is low", which is why I don't recommend pelvic floor therapy to increase libido in the general population. And, I haven't seen any positive correlations in my 20 years of clinical practice.
Conclusion
There are many things you can do to increase your libido, but pelvic floor therapy and pelvic floor exercises don't make it on that list, unless you have pelvic pain. I always recommend to read the book "Come as You Are" as a first step for addressing low libido in women. Then try some of the other things on the list and if you are still having low libido, talk to your doctor and see if medication is right for you.
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