Women's Sexuality in Menopause


A few years ago Karen Giblin asked me to write a theme song called Red Hot Mama for her Red Hot Mama’s menopause organization. One of the lines in it goes – “Just because I’m in the ‘Pause doesn’t mean I’m dead.” That line underscores what a number of studies show; that sexual activity is alive and well as women age. Here is the whole truth about women’s sexuality and menopause.

A study in the New England Journal of Medicine from the National Social Life, Health, and Aging Project provided a baseline of information on women’s sexuality everyone should know.

In that 2007 survey of 1,500 women aged 57 to 85, sexual activity was shown to decline as age increases. Below is the sexual activity level in the past year among women who had a partner:

  • 62% among those aged 57 to 64 years
  • 39% among those aged 64 to 74 years
  • 17% among those aged 75 to 85 years

Of course, not everyone has a partner or spouse, but if they did have a partner and they were sexually active, no matter the age group:

  • 50% were active 2-3 times per month
  • 23% of the oldest group was active at least once per week

The study also showed that about half of both men and women have at least one bothersome sexual problem. For women, the most common were:

  • 43% had low desire
  • 39% had poor vaginal lubrication
  • 34% were unable to have an orgasm (come)

So now you know that sex can decline with age and sexual problems can increase with age. But here is what I want you realize that can change your life: only 22% of women over the age of 50 have had a discussion with a physician about this problem. That’s only 1 in 5. The rest of you aren’t getting the help you need.

The following year another study shed more light on women’s sexuality. The authors surveyed 50,000 US households that included some 31,000 women over the age of 18 and found that 43% of women had some type of sexual problem, but it distressed only 12% of them. Interestingly, although the older women had more sexual problems than the younger ones, they distressed older women less. The most common distress occurred in women aged 45 to 64. In other words, it’s the women in and around menopause that have the most distressing sexual lives.

Often women with sexual problems were also struggling with another problem such as poor health, depression, anxiety or urinary problems. But as it was in the first study I told you about, only about one third of women had a conversation with their doctor about this problem and when they did, the woman rather than the doctor started the conversation 80% of the time. This tells you women have to speak up about sexual problems and be more assertive with their health care providers.

Going through menopause effects sexual activity in many women due to painful intercourse, or decreased sexual desire, frequency or arrousal. When some 3,000 women in and around menopause ages 42 to 52 were asked what affected their sex lives the most, the answers can back as:

  • Their relationship with their partner or not having a partner
  • The importance of sex to them
  • Their attitude towards aging
  • Vaginal dryness

In another report of sexual activity in menopausal women ages 41 to 68, 68% were sexually active within the past 6 months. The largest reason for not being active was not having a partner. Those women who were sexually active and who had the most enjoyment with sex were more likely to:

  • Have less medical illnesses
  • Be physically active
  • Have a lower body mass index (thinner)
  • Have better social support
  • Sleep well
  • Not have vaginal pain

Other studies of women aged 40 to 65 have shown that vaginal pain and thinning of the vaginal tissues called vaginal atrophy or atrophic vaginitis are very strong causes of sexual problems. This is a very treatable problem if you discuss it with your doctor.  I’ve made a video about painful sex if you’d like to hear more about it. Just a few months ago in the journal Menopause, 27,000 women aged 50-79 were studied for 6 years and they were evaluated for vaginal atrophy. Older age, health problems and loss of a partner were the main reason many of the women were less sexually active. Women who were on hormone therapy (HT) improved their vaginal atrophy symptoms significantly.

I’ll talk more about sexual function in other articles. But for now, here is what I hope you will take with you. Intimate relationships remain important to women and sexual activity is a natural part of aging, even to age 99. Those women with a partner and who are healthy enough to be sexually active continue to enjoy sexual relationships. But sexual problems are common, especially among women with other health issues. The good news is that most can be treated. But most patients don’t ask their doctors and most doctors don’t ask their patients about sexual problems.

So when you go to your doctor, ask him or her about your sexual problems. They will either help you or refer you to another person who can. Sexual problems are common, treatable and worth the effort.


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