Sex drive in older women: What a study finds may surprise you

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CNN
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It is a myth that women lose interest in sex as they enter midlife and beyond, according to research that followed more than 3,200 women for about 15 years.

“About a quarter of women qualify sex as very importantregardless of age,” said Dr. Holly Thomas, lead author of an abstract presented during the September 2020 virtual annual meeting of the North American Menopause Society.

“The study showed that a substantial number of women still highly value sex, even as they get olderand it’s not abnormal,” said Thomas, an assistant professor of medicine at the University of Pittsburgh.

“If women can talk to their partner and make sure they’re having sex that’s satisfying and pleasurable to them, then they’re more likely to rate it as very important as they get older,” she said.

“That’s quite refreshing, that there was a quarter of women for whom sex not only remains on the radar but is very important,” said Dr. Stephanie Faubion, medical director of the North American Menopause Society, who did not participated in the study.

“Studies like these provide valuable information for healthcare providers who might otherwise dismiss a woman’s waning sex drive as a natural part of aging.”

It’s true that previous studies have found that women tend to lose interest in sex as they get older. But women’s health professionals say that attitude is at odds with the reality they see.

“Some of the earlier studies had suggested that sex goes downhill and all women lose interest in sex as they age,” Thomas said. “That’s really not the kind of story I hear from all of my patients.”

One problem, he said, is that previous studies took a single snapshot of a woman’s desire at one point in her life and compared it to similar snapshots decades later in life.

“That kind of longitudinal study would only show averages over time,” Thomas said. “And if you look at things on average, it can seem like everyone is following one path.”

The study presented in 2020 used a different type of analysis that allowed researchers to follow the trajectory of a woman’s desire over time, Thomas said at the time.

“We wanted to use this different type of technique to see if these different patterns actually existed,” he said. “And when you look at these trajectories, you see that there are significant groups of women who follow another path.”

The research, which analyzed data from a national multi-site study called SWAN, or the Study of Women’s Health Across the Countryfound three distinct pathways in a woman’s feelings about the importance of sex.

About a quarter of women (28%) followed traditional thinking on the subject: They valued sex less during their midlife years.

Yet another quarter of the women in the study said the exact opposite. Some 27% of them said that sex remains very important throughout their 40s, 50s and 60s, a striking contradiction to the belief that all women lose interest in sex as they age.

“Sex will look different,” said Faubion, who is director of the Mayo Clinic Center for Women’s Health.

“It will not look the same at 40 as at 20; it won’t look the same at 60 as it does at 40, and it won’t look the same at 80 as it does at 60,” he said. “There may be some modifications we have to make, but people in general who are healthy and in good relationships are still sexual.”

The women in the study who valued sex highly shared the following characteristics: they were more educated, less depressed, and had experienced better sexual satisfaction before entering middle age.

“Women who had more satisfying sex in their 40s were more likely to continue to value sex highly as they got older,” Thomas said.

There could also be socioeconomic factors at play, he added. For example, more educated women may earn more and feel more stable in their lives with less stress.

“So they have more headspace to make sex a priority because they don’t worry about other things,” Thomas said.

The study found another important factor for both low-interest and high-interest pathways: race and ethnicity.

African-American women were more likely to say that sex was important to them during middle age, while Chinese and Japanese women were more likely to rate sex as unimportant during middle age.

“I want to emphasize that it is much more likely due to sociocultural factors than any biological factor,” Thomas said. “Women from different cultural groups have different attitudes… different comfort levels regarding aging… and whether it is ‘normal’ for a woman to continue to value sex as she ages.”

Most of the women (48%) fell into a third way: they valued a healthy sex life when they entered menopause, but gradually lost interest throughout their 50s or 60s.

There are a number of emotional, physical and psychological factors that can affect the way a woman views sex, experts say. Most can be divided into four categories:

Medical conditions: As women enter perimenopause in their 40s and 50s, they begin to experience hormonal changes that can make sex less satisfying or even painful.

The drop in estrogen causes the vulva and vaginal tissues to become thinner, drier, and easier to break, bruise, or irritate. Arousal can become more difficult. Hot flashes and other signs of menopause can affect mood and sleep quality, leading to fatigue, anxiety, irritability, brain fog, and depression.

Many medical conditions can arise or worsen during middle age that can also affect libido.

“Do they have medical conditions like hip arthritis that cause pain with sex? Or arthritis in the hand that can make it difficult? Or things like diabetes where they don’t feel the same, or they have heart disease?” Faubion asked.

“But there is modifications that we talk about all the time to help people remain sexual, even for quadriplegics,” he said. “There are ways to maintain sexuality despite the disability.”

Mental and emotional considerations: The psychological component of sex can have a huge influence on a woman’s levels of sexual desire. A history of sexual or physical abuse, struggles with substance abuse, and depression, anxiety, and stress are important factors in this category.

“I can’t say enough about the impact of anxiety and stress on sex,” Faubion said. “Think about that fight or flight mechanism: your adrenaline is pumping, so you go back to the cave days and a lion is chasing you.

“Are you going to lie down on the grassy knoll and have sex while the lion chases you? The answer is no. And that’s how women are with anxiety all the time, so anxiety is a very, very important factor in determining whether women will be sexual.”

While the study didn’t look specifically at anxiety, the results showed that women with more symptoms of depression were much less likely to rate sex as a priority in life. In addition to the emotional impact, reduced libido is a side effect of many antidepressants prescribed to treat depression.

Partner Component: Midlife women can also face dramatic and unsettling changes in their romantic lives that can affect their interest in sex.

“Are you losing a romantic partner through divorce or death? Is a romantic partner developing health problems that make sex more difficult or inconvenient? Are they busy with other aspects of their lives: their career, taking care of grandchildren, or even adult children who are moving again? That makes it hard to prioritize sex,” Thomas said.

Even if they do have a partner, relationships may have had ups and downs that can affect how a woman feels about being intimate with her partner.

“Do you like your partner?” Faubion asked. “Is your communication good? Even logistics can get in the way: are you in the same place at the same time?

Social customs: Society also affects how a woman feels about sex. Religious, cultural, and family values ​​on the subject can play an important role in sexual comfort and satisfaction.

“Then there is what society teaches us about aging women,” Faubion said. “So for some women, being sexual is a bad thing. Women aren’t supposed to like sex.”

“I’ve seen a lot of women in my clinic in the 60-65 age group who never got sex education, their partners never got sex education, and they really don’t want to know about all of that.”

Of course, if a woman isn’t bothered by a lack of sex, then there’s no reason to see a doctor, Faubion and Thomas said. But both said previous studies have shown that about 10% to 15% of women who have less interest in sex are bothered by it and would like to find a solution.

There are ways doctors can help, including medications and therapies, but first a woman needs to reach out and talk to her doctor.

“Previous research has shown that women are often really hesitant to contact their doctors, perhaps because they feel embarrassed or because they see it as part of normal aging and don’t think it’s worth mentioning,” Thomas said.

Faubion added: “Bottom line: Women should talk to their providers if they have concerns about their sexual health. It’s an important part of life and there are solutions for women who struggle with it.”