Couple with low sex drive lying in bed and facing away from each other

Does Estrogen Increase Sex Drive?

Written on November 25, 2023 by Amy Harris, MS, RN, CNM. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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If it seems like you are never in the mood for sex, you might be wondering what you can do about it. Sex drive (also called libido) is a person’s desire or enthusiasm for sexual activity and satisfaction. Everlywell believes a healthy sex life is part of your well-being. Keep reading to learn more about what hormones affect sex drive and what you can do to try to increase your sex drive.

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What Are The Symptoms Of Low Sex Drive?

Sex drive is complex because biological, psychological, and social factors all influence it. Low libido is more common in women. Scientific studies consistently report that about one-third of US women report low sexual desire or interest and that this low desire is troubling to about one in three of those women.[1,2]

Low sex drive is a problem for some men as well. A 2019 study of more than 12,000 45-year-old men found that about one in 20 reported low sexual desire.[3]

Symptoms of low sex drive in both genders include [4-5]:

  1. Having no interest in any type of sexual activity, including masturbation
  2. Never or only seldom having sexual fantasies or thoughts
  3. Being distressed by your lack of sexual activity or fantasies

Libido naturally varies from person to person. Your sex drive can also change throughout your life. It’s common to experience a drop in sex drive more than once during your life.[5] There’s no right or wrong level of sex drive.

Does Estrogen Increase Sex Drive In Women?

Not directly, but falling estrogen levels can negatively impact libido in those assigned female at birth (AFAB), especially during perimenopause and menopause. The hormones estrogen, progesterone, and testosterone regulate female libido.[6]

Fluctuating and eventually decreasing levels of estrogen and testosterone result in sexual intercourse sometimes becoming less satisfying, more painful, or more challenging for those people with vaginas. Healthcare providers can treat vaginal dryness, difficulty reaching arousal, loss of libido, and an inability to climax (orgasm) with either topical or oral estrogen therapy, also called hormone replacement therapy.[7-8]

Additionally, disrupted sleep, hot flashes, changes in physical appearance, and mood changes caused by perimenopausal hormone shifts in estrogen and testosterone can cause a loss of sexual desire and the ability to enjoy sexual activity.[8] Treatment with supplemental estrogen through hormone replacement therapy (HRT) can sometimes improve these symptoms and indirectly increase your sex drive.[6,8]

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Does Estrogen Increase Sex Drive In Those Assigned Male at Birth (AMAB)?

No. In fact, taking estrogen if you are AMAB will actually decrease your sex drive. Testosterone is the primary hormone controlling male sexual development, desire, and arousal.[9] Small amounts of estrogen, in the form of estradiol, do play a small part in male sexual function.

Medical conditions or medications that increase the amount of estradiol in those AMAB have been shown to cause [9]:

  • Reduced sex drive
  • Male factor infertility (slowed sperm production, reduced sperm number in semen, and unhealthy sperm)
  • Erectile dysfunction
  • Enlargement of male breast tissue (gynecomastia)
  • Delayed puberty or short stature
  • Losing hair all over your body
  • Decreased muscle mass

Testosterone levels in men decrease gradually with age. If you are worried about your sex drive, your testosterone levels, or your overall health. Everlywell offers an at-home Men’s hormone test kit and an at-home Testosterone Test so that you can start learning more about your hormones and sexual health.

What Can Increase Sex Drive In Those Assigned Female at Birth (AFAB)?

Sex drive in those AFAB can be more complex. Some say the brain drives female libido more than the body.[8] Thus, there may be many different ways to approach changes in your sex drive and efforts to improve it. Some of the possible avenues to explore include [5]:

  • Counseling or therapy, with or without your sexual partner
  • Boosting healthy lifestyle habits such as increasing physical activity, reducing alcohol intake, quitting smoking, and trying to reduce stress
  • Managing existing health conditions that may be impacting libido, such as arthritis, heart disease, or diabetes
  • Talking with your healthcare provider about changing any medications you take that may be negatively impacting your libido

If your lack of interest in sex continues, returns, or causes personal distress, you may have a condition called female hypoactive desire disorder.[8]

Part of any treatment plan for female hypoactive desire disorder will include looking for hormone imbalances and assessing whether or not you have been through menopause. Everlywell offers you convenient at-home Female Health Tests, an at-home Women’s Fertility Test, a Perimenopause Test, and a Postmenopause Test to help you put the pieces to the puzzle of your missing libido back together.

In addition to estrogen (in pill, patch, or cream form), healthcare providers sometimes prescribe supplemental testosterone “off-label” to treat decreased female sex drive — meaning that the FDA does not approve the use of testosterone to treat this medical condition, but licensed medical professionals can choose to prescribe it.[6,10]

There are several non-hormonal, FDA-approved medications for the treatment of female hypoactive sexual disorder. These include Addyi® and Vyleesi®.

What Can Increase Sex Drive In Men?

Many of the same strategies that help women regain their sex drive also help men, including:

  • Psychotherapy
  • Couples therapy
  • Sex therapy
  • Increasing physical activity
  • Cutting back on alcohol use and quitting smoking
  • Managing other health conditions such as obesity, diabetes, heart disease, or thyroid disease

Healthcare providers can treat low testosterone (male hypogonadism) with testosterone replacement therapy.[5]

Everlywell Believes a Healthy Sex Life Is Part Of Your Overall Well-Being

According to the World Health Organization (WHO), sexual health is “a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction, or infirmity.”[11]

Everlywell wholeheartedly supports this holistic and positive view of sexuality. That is why we want to make it easy and stress-free for you to take care of your sexual health, just as you would any other part of your body.

Everlywell can offer you support and information about your hormones and overall physical health. Our convenient at-home tests, including a Women's Hormone Test that lets you check estrogen levels, makes it easy for you to check in on important hormones.

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Symptoms Of Low Estrogen And Progesterone

What Causes High Estrogen Levels in Women?

Estrogen vs. Progesterone: Key Points to Know

References

  1. Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women. Obstet Gynecol 2008;112:970-978.
  2. West SL, D’Aloisio AA, Agans RP, et al. Prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women. Arch Intern Med 2008;168:1441-1449.
  3. Meissner VH, Schroeter L, Köhn FM, et al. Factors Associated with Low Sexual Desire in 45-Year-Old Men: Findings from the German Male Sex-Study. J Sex Med. 2019;16(7):981-991. doi:10.1016/j.jsxm.2019.04.018.
  4. Low sex drive in women. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/symptoms-causes/syc-20374554. Published February 4, 2022. Accessed November 26, 2023.
  5. Low libido (sex drive). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15216-low-libido-low-sex-drive. Published January 26, 2023. Accessed November 26, 2023.
  6. Cappelletti M, Wallen K. Increasing women's sexual desire: The comparative effectiveness of estrogens and androgens. Horm Behav. 2016;78:178-193. doi:10.1016/j.yhbeh.2015.11.003.
  7. Rahn DD, Carberry C, Sanses TV, et al. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014;124(6):1147-1156. doi:10.1097/AOG.0000000000000526.
  8. Decreased desire, sexual side effects of menopause. North American Menopause Society (NAMS). https://www.menopause.org/for-women/sexual-health-menopause-online/sexual-problems-at-midlife/decreased-desire. Published 2023. Accessed November 27, 2023.
  9. Schulster, M, Bernie, A, Ramasamy, R. The role of estradiol in male reproductive function. Asian Journal of Andrology 2016;18(3): 435-440. doi:10.4103/1008-682X.173932. https://journals.lww.com/ajandrology/fulltext/2016/18030/the_role_of_estradiol_in_male_reproductive.28.aspx.
  10. Parish SJ, Simon JA, Davis SR, et al. International Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women. J Womens Health(Larchmt). 2021;30(4):474-491. doi:10.1089/jwh.2021.29037
  11. Redefining sexual health for benefits throughout life. WHO. https://www.who.int/news/item/11-02-2022-redefining-sexual-health-for-benefits-throughout-life. Published February 11, 2022. Accessed November 27, 2023.
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