Women who modify their expectations regarding sexual activity and who change sexual priorities may have improved or maintained overall sexual satisfaction, according to study findings presented at the Annual Meeting of the North American Menopause Society.
“Quantitative studies indicate that many aspects of sexual function decline during midlife,” the researchers wrote. “However, quantitative studies may fail to capture individual women’s lived experience of sexual function during midlife. Qualitative approaches that allow women to speak their own words regarding their experiences can capture nuances and individual variations in women’s lived experiences of sexual function during midlife.”
Holly N. Thomas, MD, assistant professor of medicine at the University of Pittsburgh, and colleagues gathered qualitative data on 39 women (mean age, 58 years) to evaluate their perceptions of changes in their sexual function over time and to determine how they respond to the changes. A trained facilitator conducted 20 interviews and three focus groups using an interview guide.
Holly N. Thomas
“Changes in sexual function are common as women move through midlife, but not all changes are negative, and many women adapt to negative changes by changing sexual behavior or prioritizing emotional aspects of sex over physical aspects,” Thomas told Endocrine Today.
Overall, 13% of participants were premenopausal, 44% were perimenopausal and 28% were not sure.
The most commonly reported negative changes were decreased frequency of sex, lower libido, vaginal dryness and difficulty reaching orgasm; the changes were attributed to psychosocial stressors more often than biological factors. Major sources of negative sexual changes were also attributed to partner issues, including partner health problems, relationship discord and partner sexual dysfunction.
The most commonly reported positive change was increased sexual satisfaction despite a decrease in sexual activity frequency. Participants attributed the positive changes to higher self-confidence, increased self-knowledge and better communication skills.
Responses to negative changes were indifference, distress and adaptation. Vaginal lubricant use, lengthening foreplay, incorporating other types of sexual activity besides penetrative intercourse, trying other sexual positions, masturbating more, encouraging use of erectile dysfunction treatment in their partners and placing higher value on the emotional aspects of sex than the physical aspects were reported as adaptations.
“Providers who care for midlife women should ask about any changes in sexual function during routine visits and recognize that not all changes are attributable to menopause,” Thomas told Endocrine Today. “Psychosocial and interpersonal factors play an important role, including partner sexual dysfunction. Further research on both positive and negative changes in sexual function during the midlife years is needed.” – by Amber Cox
Thomas HN, et al. S-13. Presented at: Annual Meeting of the North American Menopause Society; Oct. 5-8, 2016; Orlando, Fla.
Disclosure: Thomas reports no relevant financial disclosures. The study was funded by the Agency on Healthcare Research and Quality and the National Institute of Health’s National Heart, Lung and Blood Institute.