Women Report a ‘Horny Menopause’—Experts Reveal Why Sex Drive Soars (Or Drops) After 50
Find out how to tell if you might have a 'sex surge' or lagging libido—and what you can do about it
Social media is filled with forums talking about menopause and sex-drive changes. Some women are lamenting the loss of their libido, while others are talking about a surprising “sex surge” with hashtags like #HornyMenopause and #HornyOnHRT. But how and why might our sex drive go in such wildly opposite directions during this phase of life? Why do some of us get a “sexy menopause” and others miss out? We spoke with experts to find out.
Why sex drive shifts gears during menopause
The obvious, initial answer is changes in hormone levels. “Hormones in midlife are, by nature, unpredictable,” says Easy Perimenopause author Jennifer Woodward, MS, who conducts hormone testing with women as a Functional Diagnostic Nutrition Practitioner. “Estrogen, progesterone and testosterone can shift at different speeds, which is why some women might feel an increase in libido and some women feel like their libido has completely tanked.”
But sexual interest can be a fickle thing. “Sex drive is a very complicated body function, and it has many variables,” says internal medicine expert Meena Malhotra, MD, founder of Heal N Care Medical Wellness Center. “Several things all need to be in place for libido to be right.”
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8 factors that can affect sex drive in menopause
Sometimes midlife shifts are… satisfying. One Reddit user revealed, “I finished menopause about six years ago and I am so horny I can hardly contain myself. Everything works slightly differently than it did when I was younger, but my level of desire has not diminished in the slightest.”
Let’s take a closer look at the main things that can derail (or enhance) sex drive in midlife.
Testosterone
Testosterone dips can lead to fewer sexual thoughts or less sensitivity to stimulation. Dr. Malhotra says, “Low testosterone will be the biggest marker for the libido driving down.”
Woodward advises, “Getting your testosterone levels checked regularly can be a reliable way to predict libido in midlife.” In her practice, she sees, “A woman often feels her best when her free testosterone lands in the upper third of the functional range: around 2.0 to 4.0 pg/mL.”
Estrogen
Social psychologist Carol Tavris PhD, co-author of Estrogen Matters with Avrum Bluming, MD, finds estrogen is a major influence on interest in sex and sexual pleasure. “Estrogen doesn’t just slowly decline at menopause; it plummets to as low as one percent of what it was,” she says. “Estrogen is what keeps every organ and tissue in our bodies and brains functioning at their best.”
Tavris explains, “Many women who begin hormone replacement therapy (HRT) and report increased libido are doing so because estrogen is restoring a better night’s sleep (no hot flashes and racing heart), preventing metabolic problems that can cause weight gain around the middle, reducing brain fog, reducing depression and, in terms of sexual pleasure, reducing or eliminating the frequency of UTIs and alleviating the vaginal dryness that causes pain during intercourse.”
Progesterone
When this hormone declines, it can disrupt sleep and trigger mood swings that prevent us from feeling “in the mood” and may even create distance with our partner. It’s important to note, doctors recommend that if a woman still has her uterus, she should take progesterone whenever she takes estrogen during menopause to reduce the risk of uterine cancer.
Fatigue
It’s not all hormonal. “Another leading reason for a ‘decrease in libido’ for women is sheer fatigue,” adds Tavris. Many women in menopause are in the “sandwich generation”—feeling the squeeze to take care of their own children while also caring for aging parents. “Taking a pill, even one with estrogen, can’t eliminate those pressures.”
Chronic conditions
Dr. Malhotra says as many women age, they also develop chronic diseases and symptoms that can play a role in sex drive. “If you are not feeling good because of low energy, or you have a thyroid issue or a heart issue, these things will decrease libido.” She says, “Considering the high rates of chronic disease, more frequently women will see their libido going down, than going up.”
Stress
Next, add daily stressors into the mix. “There is no bigger libido killer than stress,” says Woodward. She advises, “If free testosterone levels are optimal, but libido is not there, a woman should make sure she is getting enough calories and protein, sleeping well and managing her stress levels effectively.”
Unfair societal expectations can be one of these stressors. What are we talking about? Tavris explains, “The persistent ageism in our society that devalues older women and demands that we banish every extra wrinkle, blemish and pound” can be a massive libido-killer.
Anna Cabeca, DO, an ob-gyn and sexual health educator, says, “I hear from so many women, ‘I love my husband. I just never want to initiate sex. It’s the last thing on my to-do list.” She recommends, “Decreasing the stress hormone cortisol is key to increasing the love hormone oxytocin.”
Social factors
There can be some upsides here too. Dr. Malhotra says there are freedoms that come with menopausal sex. “You’re not afraid of pregnancy anymore. You may be more settled in life and work and know your partner better. You know what you want and don’t want sexually.”
Case in point: One Reddit user who is 48 and taking HRT and testosterone for perimenopause said, “I’m in the healthiest relationship I’ve ever had and sex with my partner is also the best I’ve ever had. Funny how that works, eh?” She added, “I realize this may not last, so I’m enjoying it while I got it!”
Confidence
Woodward also sees plenty of women thriving sexually in menopause. She says, “Midlife is the time in a woman’s life where she has become more confident and sure of herself. She may start to feel like she can own her power and her sexuality. Instead of looking at sex as a burden or nuisance, she might finally allow herself to feel pleasure and freedom from a satisfying sexual experience.”
Can you predict what will happen to your sex drive during menopause?
You may be wondering if you’re lined up for a “horny menopause” or not. Who exactly becomes a “cougar” and embraces her outer “menopot” to become an inner sexpot? Can science really predict these things? Not exactly. But there are some clues. Getting your hormones checked and staying healthy overall, including stress and sleep levels, can improve your chances of a so-called midlife sex surge.
The takeaways on sex drive during menopause
A “horny menopause” may be worth striving for, since healthy sex organs, hormone levels and even a value of intimacy may contribute to longevity, finds research from the Journal of Applied Gerontology. Dr. Cabeca says, “I always say sexual self-health is necessary for optimal health.”
Looking to the future, be gentle with yourself and know you’re worthy of pleasure at any age. If you’re concerned about sex drive changes in menopause, consult a healthcare provider to have your hormones tested and try to lower stress levels and improve sleep. Many women live a third or even half of their entire life in menopause, so they deserve all the joy they desire.
To women who are beating themselves up over sex drive losses, Tavris says ask yourself, “Who is telling me what ‘normal’ libido is, and why should I pay attention to someone bragging on social media?”
“Never forget that sexuality involves mind and body,” Tavris says. “I read a story by one woman who decided to try Viagra, thinking ‘Hey, it helps my husband, why not me?’ And she reported having the most incredible night of passionate sex in her life. The next morning she realized the ‘little blue pill’ she had taken was… Aleve!”
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