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Low libido in older women - if not menopause then what

A qualitative study by researchers at the University of Pittsburgh School of Medicine found that women in their 60s report various reasons behind why they lack libido.

The study, published in Menopause, distilled interviews with dozens of women about their lack of desire for sex into several major themes -- including sexual dysfunction in their partners.

"If a woman is having sexual problems, what's going on with her partner may be contributing. Sex doesn't occur in a vacuum," said lead author Dr Holly Thomas, Assistant Professor of Medicine at Pitt.

Up to 40% of women over age 60 have low libido, and about 10% of them report feeling bothered by it.

To understand what's causing these women to have lower libido than they'd like, Thomas and her team conducted three 12-woman focus groups and interviewed 15 other women privately, depending on which setting the participant preferred.

Through these conversations, five major themes emerged:

  • Postmenopausal vaginal symptoms.
  • Erectile dysfunction in partner.
  • Fatigue or bodily pain.
  • Life stressors.
  • Body image.

The most surprising thread here, Thomas said, was that so many women identified sexual dysfunction in their male partners as a major contributor to their own lack of desire for sex.

"Some women find workarounds, but others get stonewalled by their partner because he feels defensive," Thomas said. "As women we're encouraged to be accommodating, so we learn to tamp down our own needs and desires, and prioritize those of others."

Another revelation was that for some women, despite having retired from their jobs and successfully ejected their adult children from their houses, they were still too stressed to view sex as a priority.

For instance, one woman bemoaned the emotional burden of caring for her ailing mother while simultaneously supporting her daughter through recovery from a substance use disorder.

There were several limitations of this study, most notably the small, racially homogeneous sample and the lack of quantitative data.

Still, since most of the research on low libido in older women has focused on hormones, Thomas said, hearing detailed accounts from the women themselves produces novel ideas that may not come out of a large survey.

Abstract

Objective:

Low libido is common among women over 60 and negatively impacts well-being and relationship satisfaction. Causes of low libido in this age group are not well understood. We used qualitative methods to explore older women's perceptions of causes of low libido.

Methods:

We conducted 15 individual interviews and 3 focus groups (total N = 36) among sexually active women 60 and older who screened positive for low libido using a validated instrument. Interviews were audio-recorded, transcribed, and coded using a codebook developed by two investigators. Codes were examined, and themes related to causes of low libido emerged.

Results:

Women noted a number of different factors that contributed to low libido. The common factors that women discussed included postmenopausal vaginal symptoms, erectile dysfunction in male partners, fatigue and bodily pain, life stressors, and body image concerns. Women often found ways to adapt to these factors. These adaptations required open communication between partners regarding sex, and some women noted these conversations were difficult or not successful.

Conclusions:

A wide variety of factors contribute to low libido in women over 60, but many of these factors are addressable. Low libido in older women should not be automatically attributed to "normal" aging or to menopause; providers should take an approach to assessment and treatment that addresses biological, interpersonal and social, and psychological factors. 

Reference

Thomas HN, Hamm M, Hess R, Borrero S, Thurston RC. "I want to feel like I used to feel": a qualitative study of causes of low libido in postmenopausal women. Menopause. 2019 Nov 18. doi: 10.1097/GME.0000000000001455. [Epub ahead of print]

Content created 19 December 2019

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