North American Menopause Society

North American Menopause Society

October 14, 2017
2 min read

Self-confidence gained with age can increase sexual satisfaction

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Holly Thomas
Holly N. Thomas

PHILADELPHIA — Many women report that feeling attractive greatly contributes to sexual satisfaction but also that they feel self-conscious about body changes that often occur at midlife. However, a smaller group of midlife women reports increased sexual satisfaction, according to findings from a qualitative study presented at the Annual Meeting of the North American Menopause Society.

“Many midlife women cite feeling attractive as an important reason for engaging in sexual activity,” presenter Holly N. Thomas, MD, MS, assistant professor of medicine at the University of Pittsburgh, told Endocrine Today. “Changes in appearance are common during midlife, such as gaining weight or changes in the breasts. Women who feel self-conscious about these changes discussed feeling distracted during sex, wanting to cover up or dim the lights.”

Thomas and colleagues interviewed 39 sexually active women aged 46 to 59 years (mean age, 58 years) about how they perceived and responded to changes in their sexual function over time. Among participants, 53% were white; 44% were perimenopausal, 28% were postmenopausal, and the rest were premenopausal or unsure of their menopausal status; 37 identified as heterosexual. A trained facilitator using an interview guide talked with 19 of the women in individual interviews and 20 in focus groups. Following a template organizing approach for data analysis, researchers developed a codebook for the data and then identified key themes related to body image.

The researchers found that many women — and more white women than black woman — reported feeling insecure and self-conscious and greatly wishing to lose weight. Many also said having excess weight bothered them much more than it bothered their partners, and several black women reported feeling affirmed in their size and sexuality by their partners.

“A substantial portion of women in our [study] felt confident and attractive, explaining that their self-acceptance had increased with aging,” Thomas said. “These women discussed [that] their self-confidence translated to better overall sexual satisfaction.”

Feeling attractive was among the reasons for participating in sexual activity for many of the women and contributed to sexual satisfaction. Other reasons, such as having fun and maintaining emotional intimacy, had become more important than feeling attractive to some of the women over time.

Encouraging women to have a positive body image and self-confidence can maintain sexual satisfaction with aging, Thomas said. — by Jill Rollet


Thomas HN, et al. Abstract S-20. Presented at: Annual Meeting of the North American Menopause Society; Oct. 11-14, 2017; Philadelphia.

Disclosures: This study was funded by grant HS022989 from the Agency for Healthcare Research and Quality and grants R01HL105647 and K24HL123565 from the NIH and the National Heart, Blood, and Lung Institute. Thomas reports no relevant financial disclosures.