Menopause doesn’t have to affect a woman’s sex life for the worse.
A national survey in the UK suggests less frequent sex in middle age has less to do with hormonal fluctuations and more to do with stress and fatigue than many of us have been led to believe.
Of course, menopause remains a time of profound physiological changes, defined in large part by the end of periodic menstrual cycles and accompanied by a significant drop in estrogen and progesterone. With a continued decline in testosterone, these are hormones that play an important role in libido and sexual function.
But just because a low libido is a common complaint after menopause does not mean that menopause itself is solely responsible.
“Few studies have taken women’s perspectives into account to try to understand the range of factors influencing sexual experience in middle age,” said Kaye Wellings, sexual and reproductive health specialist, London School of Hygiene and Tropical Medicine.
“The decline in frequency must be defined in the context of social change as well as individual circumstances.”
These days, more and more women are choosing to have children later in life. At the same time, their own parents are living longer, leading to a “sandwich generation” in which middle-aged mothers find themselves financially and emotionally responsible for both their children and their aging parents.
Many middle-aged women also juggle a full-time job and may even be coping with their own declining health.
The combination of all these stresses seems to have left women without much energy to devote to a regular and enjoyable sex life.
In a national survey of 2,133 participants in Britain, researchers asked participants to rate their sex life using three measures: satisfaction, frequency and function.
In the end, a third of those questioned said they had had no sexual intercourse during the past month. Yet less than half of this group felt dissatisfied with their sex life.
In other words, middle-aged women generally liked the sex they had when they had it, even if it wasn’t frequent.
Unhappiness in a romantic relationship was the only lifestyle factor tested that was independently associated with all three measures of sexual experience.
In fact, those who were unhappy in their romantic relationships were twice as likely to report being sexually inactive, more than twice as likely to report reduced sexual function, and nearly three times as likely to report being dissatisfied with their sex life.
Other lifestyle factors, such as poor mental health, were strongly associated with lower sexual function. While higher educational attainment was linked to greater sexual dissatisfaction – perhaps, the researchers sayas a reflection of higher expectations.
In contrast, a person’s age and stage of menopause were not associated with any measure of their sexual experience.
Follow-up interviews with 23 participants aged 45 to 59 confirmed these findings.
“Only two women directly attributed their lack of interest in sex to menopause, and for one the impact was compounded by other factors, with the onset coinciding with depression following bereavement, a recent injury and the start of night work”, researchers explain.
Many women interviewed said that they had neither the time nor the opportunity in their life to talk about sex with their partner.
“We’re just tired” said a woman of her and her partner, “I’d rather sit in front of the TV with a glass of wine and fall asleep in the chair, that’s us.”
Even those who have no children felt drained by the demands of life: “…you’re busy, busy, busy all day, you go out with coworkers in the evenings…and the only time you find yourself is literally the five or six o’clock when you sleep … “
Larger, population-based studies in other countries are needed to back up these findings, but the findings suggest that middle-aged women in Britain do not see menopause as the main reason for their life change sexual.
Studies to date have produced mixed results on the impact of menopause on a person’s sexuality in midlife. Some show no effectwhile others have found that postmenopausal women treated with hormone replacement therapy see a 44% increase in their sexual activity.
However, distinguishing between the different factors that contribute to a person’s health, well-being, mood, and sexual desires is challenging. This survey is unique in that it asks women directly about their experiences, although the study was limited to cis women referring to their heterosexual relationships.
However, the study authors warn against “focusing narrowly on the immediate determinants of sexual expression,” such as hormones, and instead emphasizing “the broader social context” that influences sexual well-being.
“We hope the results will reassure women that they are not out of step with other women at this point in their lives,” said Wellings.
“This frequency of intercourse bears little relation to satisfaction with sex life suggests that intimacy may be a more important factor in determining sexual well-being – a message that health workers could convey beneficial to women.”
The study was published in the Journal of Sex Research.