Testosterone is the hormone of sexual desire. Perimenopausal and menopausal women often experience a decreased desire for sex caused by an imbalance in the hormones: estrogen, progesterone, and testosterone. Surgical menopause (i.e., removal of uterus and ovaries) causes immediate decline in testosterone by 50% as well as an 80% fall in estradiol. The decline in women’s sex drive and libido continues steadily from approximately 30% of 30-year-old women to 50% of 50-year-old women. Women who are having normal periods in their 40's and 50's may still be 50% low in testosterone levels compared to 30-year-old women. Testosterone levels are reduced by more than 40% with estrogen replacement. This is because, normally after menopause, the pituitary gland in our brain continues to secrete a hormone (LH) that stimulates the ovary to continue producing androgens. (Libido actually improves for some women after 50.) Adding replacement estrogen, however, keeps the pituitary from producing the androgen-stimulating hormones. Symptoms in addition to low sex drive and decreased intensity of orgasm may include loss of energy and sense of well being, and affect as many as 50% of menopausal women.
Besides hormone replacement therapy (HRT), a natural way to increase female libido is bio-identical hormone replacement therapy (BHRT).