Why women tend to avoid sex as they age

By Ana Sandoiu 

Fact checked by Jasmin Collier

New research investigates the reasons behind why aging women tend to lose interest in sex after going through menopause.

The findings will be presented at the North American Menopause Society (NAMS) Annual Meeting, which will be held in Philadelphia, PA. Dr. Amanda Clark, from the Kaiser Permanente Center for Health Research in Portland, OR, is the lead author of the study.

The research examines the prevalence of so-called genitourinary syndrome of menopause (GSM) among postmenopausal women, and how it impacts women's ability to enjoy sex.

GSM is the collective name for the range of vaginal and urinary tract issues affecting women who are either going through menopause or who are postmenopausal.

Common GSM symptoms include bladder control problems and pain during sex, or dyspareunia, which tends to occurs because the vaginal walls become thinner with age.

Studying GSM symptoms in aging women

From March to October 2015, Dr. Clark and her colleagues surveyed more than 1,500 women aged 55 and above using email.

The women were predominantly white, and nearly half (48 percent) of them reported not having had any sexual activity in the 6 months leading up to the study.

The women were approached within 2 weeks after they had visited their primary care physician or gynecologist, and the researchers selected the participants using electronic health records. In the survey, the women were asked about their history of "vulvovaginal, urinary, and sexual symptoms."

The researchers compiled questions from the International Urogynecology Association-Revised Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, and they combined them with similar questions that they designed specifically for vulvovaginal atrophy symptoms.

Fear of painful sex makes women avoid it

The main self-reported reasons for why women were not sexually active were lack of a partner, with 47 percent of respondents saying that this was the case, or the partner's "lack of interest or physical inability," with 55 percent of participants responding thusly.

However, in addition to these, the respondents reported several medical reasons. "Bladder leaks, urgency, or too frequent urination" was noted by 7 percent of the women, while 26 percent of them said that their sexual inactivity was "due to vulvovaginal dryness, irritation, or pain," and 24 percent said that dyspareunia was the main reason.

Sexually active women also reported feeling "pain or discomfort" while having sex, with 45 percent of them saying that they "usually" or "always" feel such pain. Also, 7 percent of these women said that they experienced urine leakage during intercourse.

Vaginal dryness was another common problem, and 64 of the women who did not use lubricant reported experiencing this issue.

Overall, "[For] both sexually active and inactive women, fear of experiencing [painful sex] was reported as [the] reason for avoiding or restricting sex more often [...] than fear of bladder symptoms," write the authors.

More specifically, 20 percent of the women reported a fear of vulvovaginal atrophy symptoms, while just 9 percent reported a fear of bladder control symptoms.

Dr. Clark and her colleagues conclude, "Postmenopausal women report that [GSM] symptoms occur during sexual activity. Further, these symptoms limit the ability to be sexually active and negatively affect the emotional experience of their sexual life."

"Our findings underscore the need to further expand the sexual history after a woman reports that she is not currently sexually active."

Strengths and limitations of the study

Speaking to Medical News Today about her research, Dr. Clark said, "[The strengths of the study were that] we evaluated the full age spectrum for postmenopausal women, up to age 89, [and that] we [were] able to link survey and electronic health record data."

Dr. JoAnn Pinkerton, the executive director of the NAMS, also weighs in on the findings, saying, "This study provides just one more reason why healthcare providers need to have an open and honest discussion with peri- and postmenopausal women so that appropriate treatments options can be evaluated."

But Dr. Clark noted some limitations of the study, as well. She told MNT, "Our study population differs from the general population in that these women had sought preventive care. We evaluated women immediately after a well-woman visit."

"Also," she continued, "women in our study may have increased awareness of GSM since they volunteered to participate in a study named 'Yes to Vulvovaginal Health.'"

She said that future research should test the findings in larger cohorts. "[The] next steps," Dr. Clark concluded, "are to continue to find ways to include sexually inactive women in studies of sexual function related to GSM."

SOURCE: MEDICAL NEWS TODAY