For women over 50, sexual function and satisfaction may depend most on desire and arousal, a small study of middle-aged British twins suggests.
"Desire has been suggested to be the main motivation for sexual activities, and as such, it was not surprising to find it to be one of the predictors of subsequent sexual health," lead study author Dr. Andrea Burri said by email.
How the study was done
The researchers surveyed roughly 500 women about sex from 2008 to 2009, then followed up with half of them four years later to see if their feelings about sex changed with age.
While small, the study adds to a growing body of research showing that women can have a satisfying sex life even as they age and go through hormonal changes related to menopause, said Burri, a psychologist at the University of Zurich in Switzerland.
Burri and colleagues reviewed sexuality surveys from twins who were 56 years old on average at the start of the study period. They excluded women who said they were single, virgins or lesbians.
For the purposes of the study, the researchers assumed all women 49 and younger were premenopausal, while participants at least 50 years old had gone through menopause.
Menopause typically happens to women in their 40s and 50s as the ovaries gradually produce less of the hormone estrogen and then stop releasing eggs, ending monthly menstrual cycles. After menopause, the lack of estrogen can lead to vaginal dryness and pain during sex and many women also experience diminished libido.
In the study, researchers asked women how satisfied they were with their current relationship and also quizzed them on aspects of sexual function including desire, arousal, lubrication, orgasm and pain.
At the first interview in the study, women in the postmenopausal group were more likely to be experiencing sexual dysfunction. But being older didn't make the women any more likely to develop sexual problems by the time of the second interview four years later, Burri and colleagues report in the Journal of Sexual Medicine.
How reliable is the findings?
The study is flawed because it only follows women for four years, not enough time to see dramatic changes in sexual function, and because it defines menopause only based on age, Dr. James Simon, a professor of obstetrics and gynecology at George Washington University, in Washington, DC, said by email.
The research also lacked details about the women's romantic partners, which is important for understanding sexual function, said Simon, who wasn't involved in the study. Changes in the sexual function of a partner can affect a woman's desire or ability to enjoy sex, he said.
The good news, though, particularly for women with longtime partners, is that sexual communication and preferences can be learned over time, leading to satisfaction that isn't tied directly to vaginal intercourse, said Burri.
"Especially in terms of sexual satisfaction, as you get older you might have expanded - sometimes and ideally together with your partner - your definition of sexuality," Burri said. "Even if physiologically the body changes with age and certain functions decrease, you will still be able to enjoy a fulfilled sex life using other methods or by engaging in other activities."
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