Can You Experience an Increased Libido During Perimenopause?

Why You Might Have a Higher Sex Drive During Menopause

“It's kind of hard to tell if this is more of a cause and effect from just hormones themselves, or if it’s because of other lifestyle, health, and situational factors,” says Anna Camille Moreno, D.O., a board-certified menopause practitioner at Duke University.

There aren’t many published studies on this topic. Nevertheless, Moreno says, “We do know that female hormones play a major role in female sexual function in general.”

During menopause, estrogen levels drop significantly, which contributes to symptoms like vaginal dryness and reduced interest in sex. However, levels of testosterone, which is sometimes referred to as the desire hormone, tend to decline more slowly throughout a woman’s life, beginning in her 20s, and leading to an imbalance of more testosterone than estrogen. “Therefore, there may be relatively more testosterone [as compared to the estrogen] that is available [during menopause], and some women report increase in desire,” Farhi says.

Aside from the levels of testosterone, how that testosterone functions in a perimenopausal woman’s body can also play a role.

Certain testosterone derivatives actually convert to estradiol, which is the most predominant estrogen type in childbearing women, or premenopausal women, explains Moreno. “It's the dramatic drop in estrogen that is related to debilitating symptoms in general,” she says. “So, if a woman is producing testosterone as well as testosterone derivatives that convert to estrogen, a drop in actual estrogen levels is less significant. For this smaller subset of menopausal women, libido tends not to be a problem.”

The Impact of Stress Hormones on Libido

Research suggests that chronic stress can increase levels of the hormone cortisol, which can lead to a decrease in sexual desire. A study published in The Journal of Sexual Medicine in 2013 showed that chronic stress can cause such distraction that it makes sexual arousal difficult.

So conversely, if a woman has less stress in her life—for example, her children are grown and living independently, and she’s retired from her job—her cortisol levels might actually improve or rebound. This can help explain an improvement in desire and sexuality, Farhi says.

The Role of Relationships

“A couple’s relationship after menopause plays an important role for women,” explains Farhi, who adds that the peri- and postmenopausal period may both offer opportunities for more focus on the couple, which in turn leads to more emotional intimacy and a stronger desire for sex.

Yet even if a woman isn’t experiencing sexual issues, a male partner who is dealing with something like erectile dysfunction (ED) can leave her feeling dissatisfied. Keeping open lines of communication with a partner, and encouraging him to get help if he needs it, can boost your sex life in middle age.

In a heterosexual relationship, a male partner addressing his ED with his healthcare provider may be able to resolve the issue, which would improve the female partner’s interest as well, Farhi says. It’s also possible that it would be a turn-on for the female partner to watch her male partner take control of his own sexuality and address it.

The Link Between Overall Health and Sexual Desire in Midlife

Taking steps to maintain a healthy lifestyle in middle age—eating a nutritious diet, staying active, and prioritizing sleep—can improve self-confidence that can in turn boost sexual desire. And some women who have made their health and wellness a priority find themselves feeling pretty darn good in midlife. “For women who enter menopause with optimal physical and mental health and have a transition with minimal symptoms, this can be an exciting new phase,” Farhi says.

Of course, it’s hard to feel sexy if symptoms are making you feel miserable. “If [someone] is having difficulty overall with the menopausal transition due to hot flashes, sleep disruption, and vaginal dryness, then this will impact libido as well,” Farhi says. If this is the case, talking to a doctor may go a long way toward finding relief.

The Personal Connection

Those who have been sexually active for decades can benefit from their earned wisdom. “Women in midlife tend to know what they like and are comfortable conveying that to their partners,” Farhi says. On top of that, she says, they have the time, energy, and opportunity to act on that knowledge. “Or they may have a new partner and be experiencing the heightened excitement of a new romance.”

And there’s the bonus of not having to worry about becoming pregnant, Farhi says.

A Time to Explore

Whether your interest in sex is waxing or waning, you’re not alone, Moreno says. If you feel bothered by changes in lidibo or how they’re affecting your relationship, be sure to discuss them with your doctor. And remember, Farhi says, there’s no “normal” when it comes to sex: “I would encourage my patient to explore her beliefs around sexuality.”

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