I hear this question every now and then, especially from women who are experiencing a higher libido than before. This is entirely possible and "normal": While hormone levels are, in general, declining, the specific levels of estrogen and progesterone are fluctuating erratically from day to day. Testosterone is typically more steady, with less fluctuation from day to day or month to month. That means that the mix of hormones changes. If testosterone is dominant, a woman may experience an enhanced libido (which is why testosterone is sometimes considered as a part of therapy to restore sexual function).
I got an enthusiastic message from a woman who's experiencing this "upside" of perimenopause:
"I’m 46 years old, with some normal perimenopausal symptoms like inability to stay asleep, and irregular heavy periods.
"Unlike most, however, I’m quite thrilled with peri-menopause at the moment, because I feel incredibly energetic and my libido is other-worldly. I’m wet all the time. When my husband approaches within one foot of me, I start panting. Sometimes a moment of mental arousal hits me randomly during the day and the blood rushes downward so quickly that I get light-headed. It’s very fun and I just want to share with you that it’s possible to get some unexpected goodies from this hormonal chaos.
"Maybe you could give a bit of a shout-out to the diversity of experiences that are normal and valid and healthy."
Yes, I can! Perimenopause and menopause play out differently for each of us individually, and there is a diversity of experiences. Embrace your own experience, feel confident in observing your own body and its responses, and be prepared for happy surprises along the way!
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.