The commonly held belief that women lose interest in sex during midlife got some support, but also some contrary evidence, from a longitudinal cohort study involving more than 3,000 women.
About 45% of women in their pre- and perimenopausal years said sex was extremely important at the start of midlife, but it became less so over time, reported Holly Thomas, MD, of the University of Pittsburgh, and colleagues. Another 27% said sex wasn’t important at all.
Still, that left 28% who consistently maintained that sex was highly important and remained so at menopause, Thomas said in a presentation at the North American Menopause Society (NAMS) 2020 virtual meeting.
Thomas and colleagues found that race and ethnicity predicted how important sex was for women in their menopausal years. Black women, for example, were more likely to maintain that sex was highly important across the midlife trajectory, while Japanese and Chinese women more often rated it as less relevant.
“Not all women will follow the same path when it comes to the importance of sex during midlife, and we should recognize these nuances,” Thomas said in her presentation.
“There are indeed racial and ethnic differences in how importance of sex changes as women age, but I would highlight that these differences are likely to result from sociocultural, not biological variations.” Examples of sociocultural differences, Thomas added, are the variances across racial and ethnic groups about body image and attitudes towards aging.
While understanding of sexual function among women in the menopausal period has deepened in recent years, Thomas said, there is still much to learn about interest in sex as women age, as its perceived importance correlates strongly with sexual function.
Thomas and colleagues used data from the The Study of Women’s Health Across the Nation (SWAN), which recruited pre- and perimenopausal women from five different racial and ethnic backgrounds, and followed them annually for 20 years to date. Study participants completed 14 visits, which involved interviews, blood tests, and biometric measures. About 3,250 were included in the analysis.
The researchers categorized importance of sex into three different groups: those who regarded it as not at all important, moderately important, and extremely important. The group used a trajectory analysis to identify distinct patterns over time, and used a multinomial logistic regression to control for race/ethnicity, education, partner status, BMI, blood pressure, menopause status, hormones, depression symptoms, perceived stress, sexual orientation, sexual satisfaction, and menopausal symptoms.
Women who had symptoms of depression were more likely to regard sex as less important (P=0.003), while women who had higher sexual satisfaction and higher educational attainment found it more significant (P=0.009 and P=0.004, respectively).
NAMS Medical Director Stephanie Faubion, MD, said in a press release that “studies like these provide valuable insights to healthcare providers who may otherwise dismiss a woman’s waning sexual desire as a natural part of aging.”
“Often there are other treatable reasons, such as vaginal dryness or depression, as to why a woman’s interest in sex may have decreased,” Faubion added.
Last Updated October 01, 2020
This research was supported by the National Institutes of Health (NIH), the Department of Health and Human Services (HHS), the National Institute on Aging (NIA), and the NIH Office of Research on Women’s Health.
Thomas reported receiving grants from the NIH and NIA.