Increased Sex Drive during Menopause



  • 15%-20% of menopausal women report an increase in libido.
  • Midlife women with increased emotional awareness and good communication skills can express well their sexual desires toward their partners.
  • Testosterone therapy boosts menopausal women’s libido by addressing hormonal imbalances that contribute to decreased sexual desire.

While 40%-50% of menopausal women complain of decrease in sex drive, about 15%-20% report an increase in libido. This surge comes from hormonal changes, particularly the relative balance of testosterone, which become more noticeable as estrogen and progesterone levels decline.


Also, some women experience increased vaginal lubrication during estrogen surges. This makes intercourse more comfortable and enhances libido. Furthermore, psychological and emotional factors contribute to its rise. Here are the detailed explanation:


Psychosocial Factors


Decreased caretaking responsibilities and lower chances of getting pregnant give women more time to focus on intimate relationships with their partners. 

The Journal of Sex Research study found reduced child care demands lower stress levels in midlife women. This contributes to increased sexual desire and satisfaction. Additionally, AARP's survey noted that 33% of women over 50 reported greater privacy for intimate activities after their children left home for studies or work. 

This reduced motherly duties open renewed emotional availability and energy for midlife couples. 

Moreover, menopause gives freedom to women from pregnancy scare. The published Journal of Sexual Medicine study found some postmenopausal women increased sexual satisfaction because of the absence of pregnancy-related concerns. Without the need for contraceptives, which have side effects, women are relaxed and willing to engage in sexual activity.

Improved Self Esteem

While most midlife women worry about their wrinkling skin and saggy shoulders, others develop self-acceptance and self-worth that enhance their body confidence. Dr. Suzanne Hall, MD (an Obstetrics and Gynecology physician from Metro Detroit) noted that when women feel good about their bodies, they feel more comfortable in the bedroom. Also, some women find themselves more confident of their bodies as they age. 

Also, emotional awareness has an important role. A study in Menopause: The Journal of The North American Menopause Society revealed that women with higher levels of emotional intelligence and communication skills had more fulfilling sex lives. 

Emotional awareness allows women to understand and express their desires, improving intimacy and connection with partners. Additionally, a survey by AARP showed that 61% of postmenopausal women (with improved sexual satisfaction) linked it to emotional well-being and communication. Openness and communication are the keys.

Hormonal Treatments

Hormonal replacement therapy (particularly testosterone therapy) boosts menopausal women’s libido by addressing hormonal imbalances that contribute to decreased sexual desire. Naturally, women have smaller amounts of testosterone but it decreases as we age, affecting the balance of sexual desire, arousal, and overall well-being. 

A meta-analysis published in The Lancet Diabetes & Endocrinology (2019) reviewed 36 randomized controlled trials involving over 8,000 women. The study showed testosterone therapy significantly improved sexual function. Also, it noted that women who received testosterone therapy reported better energy levels and mood stability, contributing to a more active libido. 

However, this treatment is not recommended for all menopausal women. It requires careful monitoring and individualized assessment by healthcare providers. 

The North American Menopause Society (NAMS) suggests that testosterone therapy is only applicable to postmenopausal women with hypoactive sexual desire disorder (HSDD) and should be given in physiological doses tailored to female hormone levels. Acne, increased facial or body hair growth, voice deepening, and negative effects on cholesterol levels and liver function are the potential side effects of testosterone therapy. 

Additionally, the Endocrine Society warns against overuse of compounded testosterone formulations with inconsistent dosing as it increases under- and over-treatment, leading to potential long-term health risks. 

Thus, women should consult with their healthcare providers to determine whether testosterone therapy is appropriate and ensure it is used safely and effectively to support libido without unwanted side effects.

Sources

High Libido in Women During Perimenopause

Testosterone Prescriptions for Women Soar

Menopause Topics: Sexual Health

North American Menopause Society










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