Dear Betsy,

This is going to sound weird, but after 25 years of marriage, my wife is suddenly crazy about sex.  I know it's strange, but seriously, she's like an 18-year old boy.  She wants to have sex all the time, once a day instead of once a week.  I'm not complaining but I'd like to understand what's happening. Her doctor says she's nowhere near perimenopause, so why would this be happening now? Signed, Whoa Nellie ______________________________________

Dear Whoa, First I need to check in.  Unless your wife has already gone a full year without having a period--in which case she is already postmenopausal--it's quite likely she is, in fact perimenopausal.  Given that you've been married for 25 years, those are the only two possibilities I can think of.   

Since these terms can be confusing, let me start by explaining the differences.  A woman is said to perimenopausal during that period of her life when her estrogen and progesterone levels begin to decline, signaling the gradual end of her fertile years.  This transitional period usually begins in a woman's forties, but can begin over a decade earlier. The symptoms of perimenopause vary widely from woman to woman.  Some women experience only mild symptoms, while others suffer from every symptom in the book: hot flashes, night sweats, mood swings, anxiety, depression, insomnia, vaginal dryness, thinning of vaginal tissues, and a decrease in sex drive.  Some of these symptoms are caused by wildly fluctuating hormones, while the others--like vaginal dryness--are simply caused by the decline of estrogen.  

Technically speaking, a woman is in menopause for just one day.  That day is exactly twelve months after her final menstrual cycle.  After that, she is said to be postmenopausal.   But enough with these definitions and onto your question.  Why is your wife suddenly craving sex like a teenager?  This is curious.  From an evolutionary standpoint, it makes perfect sense that healthy young women want to have sex.  After all, they've got eggs ripening each month; they've got plenty of hormones; they're as healthy and fit as they'll probably ever be; and their window of opportunity is wide open.  Their bodies are screaming: "BABIES!"    

But as perimenopause approaches and sex hormones decline, it's only natural that a woman--especially one who is experiencing severe symptoms--might be less interested in sex.    You didn't mention in how old your wife was, but since you did say you'd been married 25 years, I can only assume that she's at least in her early 40s.  Most women in their 40s and 50s do tend to be less interested in sex, although they often enjoy it more once they've hit menopause, because they can stop worrying about getting pregnant or having their kids wake up in the next room. 

So what might be going on with your wife?  One possibility is that her estrogen levels are fluctuating, which can cause a surge of sexual desire.  Occasionally, I've seen this happen to women in their late 40s.  One minute they're having hot flashes, the next minute, they're hot to trot.  This can be a wild ride for these women and for those who love them.  I've also seen this happen to women in their 30s, whose reproductive window is starting to close.  It's as if their bodies are saying "Now or never!"  This can translate into a very strong interest in sex.  

The other times I have witnessed this phenomenon in older women have been: 1) At the start of a new love relationship, where an intoxicating blend of novelty, uncertainty, insecurity and excitement produces a new-found surge of desire, 2) After a woman has lost a lot of weight or has started some new  form of exercise that's causing her to feel sexier, 3) When a woman is feeling insecure about her relationship (because her partner has become distant, disinterested, or has had an affair) and the desire is a symptom of that insecurity, or 4) When the woman is consciously working on increasing desire by reading erotic literature, renting erotic movies, or experimenting with other ways to stimulate desire. Whatever the reason, my advice on this matter is: Have fun, if you can.   

Interestingly enough, when married couples stop having sex, more often than not it's the man who calls it quits, not the woman.  Barry McCarthy, a renown sex therapist believes this is because men in their 40s are also going through hormonal and physical changes related to the natural aging process.  As testosterone levels drop, a man's libido may suffer, as may his ability to achieve or maintain the kind of erections he used to with the frequency he's used to.  These physical challenges, along with the tendency in our society for men to be performance-focused during sex, can cause men to become less confident sexually, and more tentative or insecure about sex as they age.   

I recommend that you and your wife talk about the changes that are happening for each of you so can navigate these choppy waters with humor and grace and can express any feelings of insecurity, pressure, or uncertainty you might have before they cause distance or misunderstanding in your relationship.   

Good luck to you both.  Hope you both enjoy the ride...
Betsy