Changes in sex life during the pandemic 4:59
It's a myth that women lose interest in sex as they enter middle age and beyond, according to new research that followed more than 3,200 women for about 15 years.
"About a quarter of women consider sex to be very important, regardless of their age."
So said Dr. Holly Thomas, lead author of a summary that was presented at the 2020 North American Menopause Society annual virtual meeting, which opens Monday, September 28.
"The study showed that a significant number of women still value sex highly, even as they age, and it is 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 have satisfying and enjoyable sex for them, they are more likely to rate it as very important as they get older," she said.
"It's actually quite reassuring that there are a quarter of women for whom sex is not just on the radar but is very important," said Dr. Stephanie Faubion, NAMS Medical Director, who was not involved in the study.
"Studies like these provide valuable information to healthcare providers who might otherwise dismiss a woman's diminishing sexual desire as a natural part of aging," he said.
Destruction of myths
It is true that previous studies have found that women tend to lose interest in sex as they age.
But women's health professionals say that attitude does not match the reality they see.
"Some of the previous studies had suggested that sex is going downhill and that all women lose interest in sex as they get older," said Thomas.
"That's really not the kind of story I hear from all 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 in later decades of 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 that everyone follows a path."
Thomas said the new study used a different type of analysis that allowed the researchers to track a woman's desire over time.
"We wanted to use this different kind of technique to see if these different patterns really existed," Thomas said.
"And when you look for these paths, you see that there are important groups of women who follow another path."
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High and low sexual interest paths
The research, which analyzed data from a multi-site national study called SWAN, or the Study of Women's Health Across the Country, found three different pathways in terms of a woman's feelings about the importance of sex.
About a quarter of the women (28%) followed traditional thinking on the subject.
They valued sex less during the middle-aged years.
Yet another quarter of the women in the study said the exact opposite.
About 27% of them said that sex continues to be very important throughout their 40s, 50s and 60s.
That is a striking contradiction to the old age belief that all women lose interest in sex as they age.
"Sex will look different," said Faubion, director of the Mayo Clinic Center for Women's Health.
«It will not look the same at 40 as at 20;
It will not look the same at 60 as at 40 and it will not look the same at 80, as at 60, "he said.
"We may have to make some modifications, but people who are generally healthy and have good relationships are still sexual."
The women in the study who highly valued sex shared the following characteristics.
They were more highly educated, less depressed, and 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," said Thomas.
There could also be socioeconomic factors at play, he added.
For example, more educated women may have higher incomes and feel more stable in their lives with less stress.
"So they have more mental space to make sex a priority because they don't care about other things," Thomas said.
The study found another factor that was important for both low-interest and high-interest paths: 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 their middle-aged years.
"I want to emphasize that it is much more likely to be due to sociocultural factors than to any biological factor," Thomas said.
"Women of different cultural groups have different attitudes… different levels of comfort about aging… and whether it is 'normal' for a woman to continue to value sex as she ages."
The middle group
Most of the women (48%) fell in a third way.
They valued a healthy sex life as they entered the menopausal years, 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:
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 makes the vulva and vaginal tissues thinner, drier, and easier to break, bruise, or irritate.
Arousal can get more difficult.
Hot flashes and other signs of menopause can affect your mood and quality of sleep.
This can lead to fatigue, anxiety, irritability, mental confusion, 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 when having sex?
Or arthritis in the hands that can make things difficult?
Or things like diabetes, where they don't feel the same or they have heart disease? ”Faubion asked.
"But there are modifications that we talk about all the time to help people maintain sexuality, even quadriplegics," he said.
"There are ways to maintain sexuality despite disability."
Mental and emotional considerations:
Mental and emotional considerations:
The psychological component of sex can have a great 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 the main players in this category.
"I can't tell you 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're back in caveman times and a lion is chasing you.
Will you lie down on the grassy knoll and have sex when the lion is chasing you?
The answer is no.
And so are women with anxiety all the time.
So anxiety is a huge, huge factor in determining whether women will be sexual.
While the study didn't specifically look 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.
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Middle-aged women can also face dramatic and disturbing changes in their romantic lives that can greatly affect their interest in sex.
Are you losing your romantic partner to divorce or death?
Is a romantic partner developing health problems that make sex more difficult or inconvenient?
Are they busy with other aspects of your life: your career, taking care of your grandchildren, or even adult children who are moving back?
That makes it difficult to prioritize sex, ”Thomas said.
Even if they 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?" Asked Faubion.
«Is your communication good?
Even logistics can get in the way: are you in the same place at the same time? "
Society also affects how a woman feels about sex.
Religious, cultural and family values on the subject can play an important role in sexual ease and satisfaction.
"Then there is what society teaches us about aging women," Faubion said.
And for some women, being sexual is a bad thing.
Women are not supposed to like sex.
"I've seen a lot of women in my clinic in the 60-65 age group who never received sex education, their partners never received sex education, and they really don't want to know about all that."
What is to be done?
Of course, if a woman is not bothered by the lack of sex, then there is no reason to see a doctor, Faubion and Thomas emphasized.
But they both said that previous studies have shown that between 10% and 15% of women who have less interest in sex feel upset and would like to find a solution.
There are many ways that doctors can help, including medications and therapies, but first a woman must reach out and speak with her doctor.
'Previous research has shown that women are often hesitant to approach their doctors.
Maybe because they are embarrassed or see it as part of normal aging.
Or they don't think it's worth mentioning, ”Thomas said.
"Bottom line: women should talk to their providers if they have concerns about their sexual health," Faubion said.
"It's an important part of life and there are solutions for women who struggle with it."