When women talk about menopause and libido, typically the conversation involves a lack or loss of sex drive. Yet some women report an intensely elevated libido or sex drive. Let’s explore this symptom of perimenopause and menopause.

What is increased libido?

An increase in sex drive or libido is a heightened desire to engage in sexual activity. There are degrees of such desire, ranging from a modest to intense increase.

According to the World Health Organization, an overactive sex drive is known hypersexual disorder and is recognized as a compulsive sexual behavior disorder. This is characterized by a loss of control, sexual habits that may lead to potential risks or problems, a compulsion to engage in sexual activities, and obsessive thoughts of sex. Experts estimate that hypersexual disorder affects 3 to 6 percent of the population.

How is increased libido associated with menopause?

Not a great deal of research has been done on this topic. Although some women report a significant increase in sexual desire, the trend is more in the opposite direction. An upswing in sexual desire may be associated with a decline in estrogen accompanied by an increase in testosterone level.

In research that examined a subset of the Seattle Midlife Women’s Health Study, experts compared data from women in early reproductive, early and late menopausal stages, and postmenopause. Data was derived from urine samples tested for estrone glucuronide, testosterone, and follicle-stimulating hormone (FSH). 

The authors found that women experience a significant decrease in their sex drive during the late menopausal and early postmenopausal stages. Women who had elevated levels of estrone glucuronide and testosterone reported significantly higher sexual desire levels, but those with higher FSH had significantly lower sexual desire.

Women who had higher stress levels, hot flashes, fatigue, anxiety, sleep problems, and depressed mood also reported significantly lower sexual desire. Women who were taking hormone therapy, however, reported higher libido. Greater sexual desire was also associated with getting more exercise and greater alcohol use. Having a partner, however, was associated with lower libido.

Hormones may not be the only factor, however. According to OBGYN Dr. Suzanne Hall, as women enter perimenopause and menopause “what affects our libido the most dramatically are psychosocial factors.” These include less parenting demands, more time to participate in “wish list” pursuits, and, as Dr. Hall notes, “research shows improved sexual functioning and increased libido in new relationships” among women who may be starting such relationships. 

How to manage increased libido naturally

Having an increased libido or sex drive may or may not be a concern and is a highly personal situation. For women who are in perimenopause and who can still get pregnant, it’s important to practice effective birth control if pregnancy is not desired.

When to see your doctor

Women who may be experiencing heightened sexual desire that is disrupting their emotional, mental, or physical health and/or if it is damaging their relationships should seek help from a qualified sex therapist or counselor, preferably one who has worked with menopausal women.

Bottom line

Increased libido or sex drive in perimenopause and menopause may or may not be a concern for women.