Discussions of menopause and libido usually focus on the loss of sex drive later in life. However, some women experience an increase in sexual desire during or after menopause.
Many women continue to enjoy sex as they age. In a 2022 survey by the University of Michigan National Poll on Healthy Aging, 43% of women between the ages of 50 and 80 reported being sexually active within the last year. This included engaging in sexual intercourse, masturbation, sensual touch, or foreplay. In addition, 74% of women who were sexually active reported being satisfied with their sex life.(1)
Menopause can affect women’s libido in different ways. This article will explore why some women may experience an increased desire for sexual intimacy during postmenopause and how they can safely engage in sexual activity, either alone or with a partner, during this phase of life.
Postmenopausal Female Arousal Changes
Sexual arousal is influenced by physiological, emotional, and sociocultural factors, among others. Because libido is multifaceted, women may experience increases, decreases, or no changes in sex drive during menopause.(2) The hormonal, physical, and psychological changes that manifest during this stage of life can all contribute to changes in female arousal after menopause.
How does menopause affect sex drive?
Decreases in sexual desire are frequently reported during menopause. Understanding why libido may wane can help shed light on why some postmenopausal women experience an increase in sex drive, which will be further explored later in this article. The following are ways in which menopause can affect libido:
Hormonal Factors
Changes in libido are influenced by hormones, particularly estrogen, progesterone, and testosterone.(3) Estradiol (a form of estrogen in the body) helps keep vaginal tissue lubricated. During the mid-cycle phase of a woman’s menstrual cycle, estradiol levels are at their highest, while progesterone levels are at their lowest. Many women report an increase in sex drive during this time.(4)
Compared to estrogen, testosterone's role in female sexual desire is not as well understood. However, the hormone does serve as a precursor to estradiol.(3) As hormone levels fluctuate during the menopause transition and periods eventually come to a stop, various physical and psychological changes occur that can impact desire and arousal.
Physical Changes
Declining hormone levels can cause thinning and drying of vaginal tissue. This can lead to uncomfortable vulvovaginal symptoms of genitourinary syndrome of menopause (GSM), which may include the following:(5)
Burning
Itching
Decreased lubrication
Fluctuating hormone levels can also cause changes in the urinary tract, increasing the risk of urinary tract infections (UTIs) and bladder control issues caused by weakened pelvic floor muscles.(5) Some women may feel self-conscious about GSM symptoms, which may affect libido.
Other physical changes, like weight gain, are also common during menopause, a time when visceral fat tends to build up around the midsection. Skin changes may also occur, including the development of wrinkles, reduced elasticity, and sagging. These changes can affect women’s body image and interest in sexual activity.
Hot flashes and night sweats may also contribute to reduced feelings of arousal, especially if women experience continuous fatigue from lack of sleep.
Psychological Changes
Hormone fluctuations can have a substantial psychological effect on women experiencing menopause. Both estrogen and progesterone influence brain chemistry and function. Research suggests that estrogen may have a protective effect against depression. However, the risk of depression significantly increases during perimenopause and the first year of postmenopause. Women are also more vulnerable to anxiety during this time.(6)
Menopause is also associated with other common psychological changes:(2)
Mood swings
Increased stress
Irritability
Sleep disruptions caused by vasomotor symptoms can take a further toll on mood. All of these symptoms can collectively wear on women’s mental health, potentially reducing their interest in sex.
Causes of Increased Libido After Menopause
Hormonal, physical, and psychological changes can all contribute to a dampened libido. Conversely, factors like hormone stabilization, lifestyle changes, and relationship dynamics may explain increased libido after menopause.
Hormonal Stabilization
Hormone levels progressively drop during perimenopause and menopause but eventually stabilize during postmenopause. At this stage, estrogen levels settle at a new low, which has been associated with a reduced risk of depression in postmenopausal women.(6) Improvements in mood may subsequently enhance sex drive. Additionally, supplementing estrogen through bioidentical hormone replacement therapy (HRT) has been shown to boost libido.
Hormonal stabilization may also help relieve other common menopausal symptoms, such as hot flashes and night sweats, which could contribute to an increase in sexual desire.
Freedom from Pregnancy Concerns
Menopause is a life event that marks the end of a woman’s reproductive years. Some women may feel they are able to enjoy their sexuality more freely without having to worry about pregnancy, leading to an increased interest in sex. Many postmenopausal women even describe themselves as being in the prime of their sexuality during this phase of life.(7)
Increased Self-Confidence
The effects of aging on women's self-confidence can vary. While some women may struggle with self-esteem and body image, many others embrace the freedom that comes with aging. This may include developing a deeper sense of self, appreciation for their body, or a better understanding of their sexuality.
Lifestyle Changes
Increases in libido may also be related to lifestyle changes that often come with aging. Some women may no longer be working or raising children by the time they reach postmenopause. With fewer responsibilities and more free time, many may feel inclined to explore their sexuality or deepen intimacy with a partner.
Health-related lifestyle factors can also influence libido. Research has found that increased exercise, lower stress levels, and improved self-perceptions of health are all linked to heightened libido in women during late menopause or early postmenopause.(8)
Relationship Factors
The connection between partner relationships and libido is complex. Some studies suggest that women’s sexual desire may decline in longer marriages, while other research shows a reduced risk of sexual dysfunction.(7)(8)(9)
Better quality spousal relationships have also been linked to improved sexual function in postmenopausal women. Other factors, such as fidelity and whether or not partners live together, can also influence sex drive.(7) For some women, strengthening their relationship with their spouse over time can help boost libido later in life.
Hypersexuality Caused by a Health Condition
While rare, cases of ovarian hyperthecosis (OH) and ovarian stromal hyperthecosis (OSH) have been noted in postmenopausal women.(10)(11) These conditions involve an overproduction of androgens, including testosterone, in the ovaries. In addition to symptoms such as increased facial hair growth and balding of the scalp, some women also report a surge in sexual desire.
Treatment options include the use of hormone suppression drugs or surgical removal of the ovaries (oophorectomy).(10) However, not all women with these conditions experience hypersexuality, and there may be other underlying causes of increased libido.(12)
Managing Increased Sexual Desire
Many women embrace feelings of heightened sexual desire later in life. Open communication with a partner can help women enjoy all aspects of their sexuality. This may involve discussions about what feels pleasurable, the desired frequency of sexual intercourse, or exploring different forms of emotional and physical intimacy.
Because pregnancy can still occur during perimenopause, it’s recommended that women use birth control until the age of 50 for pregnancy prevention. Using condoms during sexual activity is also important for protection against sexually transmitted infections (STIs).(2)
Increased libido can open an exciting new chapter in the sex lives of postmenopausal women. However, in the event that sex drive begins to interfere with day-to-day life or if increased sexual activity is causing health problems, like skin irritation or urinary tract infections (UTIs), women should speak to a doctor for medical advice.
