Are Older Women Interested in Sex?

Research in the field of sexual dysfunction has taught us several things about patients and healthcare visits. Most medical providers don’t ask about sexual function, most patients don’t bring it up, and women’s sexual health has a history of being undervalued and under-evaluated. Authors Maciel and Lagana describe the common myth that as women age, sexual interest decreases, and review literature to propose improved strategies. The study highlights the fact that there are positive physical health effects for older adults, and that by approaching sexual desire through a biopsychosocial method, further understanding of the issues can be gained.

Several factors have been found to be linked to healthy sex in older females. Having a positive attitude towards sex, an interesting an interested partner, good health, and a willingness to experiment sexually can all contribute to an active sex life. Women who are dealing with high stress, anxiety, and depression are known to be less sexually active. In this paper, the authors describe the work of Sobecki and colleagues, who found that older women have just as much interest in talking about sexual health as younger women, but that doctors aren’t usually asking about it. Sobecki et al. found that a patient reported feeling less embarrassed about bringing up sexual dysfunction if the medical provider demonstrated a professional demeanor, comfort with the topic, and a disposition that is kind and empathetic.

This last point seems worthy of pause and reflection in relation to the role of the pelvic rehabilitation provider. I would submit that most pelvic rehab therapists are highly capable of presenting a professional, kind, and empathetic demeanor. I wonder how many of us, however, had enough education regarding sexual health to demonstrate to patients a level of “comfort with the topic” that inspires a patient to bring up sexual concerns. The more comfortable we are with our own sexuality and the more knowledgeable we are about sexual health practices that are outside of our own experiences, the more we have to offer to our patients.

This excellent review article describes issues that older women often face: menopausal shifts in hormones and vaginal and perineal health, concerns about body image and self-worth. The authors also point out that the healthcare system has medicalized menopause, so that most women are offered little more than pharmaceuticals. One simple suggestion offered in the article is use of the Decreased Sexual Desire Screener that can help identify areas of concern in sexual health. If you are interested in learning more about sexual health and dysfunction, check out Institute founder Holly Herman’s Sexual Medicine for Men and Women continuing education course taking place next in April in New Jersey. If that date does not work for you, you could sign up early for the next course in San Diego in November!