THE ESSENTIAL
- Women’s sexuality declines with age.
- Physiological explanations can be advanced, without however neglecting the psychosocial aspects.
Menopause, a period of hormonal upheaval, is an important stage in a woman’s life. Accompanied by more or less unpleasant side effects such as hot flushes, sleep disturbances or vaginal dryness, menopause also often corresponds to a time of decline in sexual relations.
In 2015, a study published in the journal Endocrinology & Metabolism Clinics of North America I concluded that “sexual dysfunction increases with age and is highly prevalent in postmenopausal women“. Other research has shown that 42% of premenopausal women report symptoms of sexual dysfunction. After 8 years, the number rises to 88%.
What are the explanations for this decline in sexual satisfaction? Studies have highlighted physiological factors associated with menopause: vaginal dryness and the drop in estrogen levels that can lead to more difficult or unpleasant sexual intercourse. But these physiological factors are not the only ones that have a significant impact on a woman’s libido or sex life, psychosocial changes should also be taken into account.
Loss of self-confidence, stress… lead to a drop in libido
A 2019 study, published in Menopause, addressed these psychosocial factors. Conducted by researchers from the University of Sussex in Brighton and University College London, UK, as well as the University of New South Wales in Sydney, Australia, the research revealed that the sex life of many women decline with age and that this decline is linked to issues that have been neglected by the research community: problems related to body image, self-confidence and the perception of desirability, stress, mood swings and relationship issues.
To reach these conclusions, the researchers relied on data from 4,418 women with an average age of 64 who participated in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). At the start of the study, regarding half of the women reported being sexually active, but over time all aspects of sexual activity declined. They reported that their sexual relations were less frequent, less pleasant and more uncomfortable. The major reason for not being sexually active is the absence of a partner, mainly due to widowhood.
Other reasons are frequently cited to justify less frequency of sexual intercourse, in order of importance: the health of the partner, his sexual dysfunction, the health problems of the woman, the symptoms of menopause and the prescribed medications. When it comes to low libido, many women have exposed relationship issues, the logistics of arranging a physical relationship, and the effects of aging on their image and self-confidence.
Only 3% of participants reported positive sexual experiences. Yet only 6% sought medical help for sexual problems.
Better training for doctors on the sexuality of postmenopausal women
For these researchers, the new findings “will have implications in clinical practice”, particularly the care of women who report sexual dissatisfaction related to menopause. According to them, “them sexual difficulties are often under-reported, under-recognized and under-treated” in a medical setting.
They also advise practitioners to discuss these aspects with their menopausal patients in order to better support them in regaining their sexual life. “Open communication regarding sexuality, including wants, needs, and dysfunctions, is important and will lower the threshold required for women to discuss sexual function. Extra sex education [pour les praticiens de la santé] is necessary to facilitate this process“, say the researchers.
