By Linda Carroll

(Reuters Health) – The number of women who have sex regularly falls off with age as does the number who report enjoyable sex after menopause, a new study shows.

In a survey of nearly 4,500 women over age 50, researchers found that less than a quarter were sexually active, according to the report published in Menopause. While the primary reason for lack of sexual activity was want of a partner, most often due to widowhood, other reasons included a partner’s sexual dysfunction and the woman’s own physical and/or mental health problems.

“The central message from our study is that health is an important factor for continued sexual activity and satisfaction in older age, but lack of communication – between healthcare professionals and women and their partners – hinders appropriate support for those who need it,” said the study’s lead author, Helena Harder, a research fellow at Brighton and Sussex Medical School at the University of Sussex in the UK.

To take a closer look at sex and older women, Harder and her colleagues analyzed surveys filled out by 24,305 women, half of whom were 64 or older. The researchers chose to focus on 4,418 women who also filled out a comment section that allowed them to write down their experiences in more detail.

Just 22.5% of the women, whose ages ranged from 50 to 75, said they had had intercourse in the preceding month. Lack of an intimate partner was the most common reason women cited, at 34.7%, for giving up sex. Among the 65.3% of women who did have a partner, just 34.5 reported being sexually active in the preceding month.

In the comments section, women talked about issues such as menopause symptoms, including vaginal dryness and painful sex, embarrassment about their bodies, lack of libido and medical conditions or sexual dysfunction in partners as obstacles to sexual activity.

While speaking with a doctor might help with some of those issues, those conversations often don’t occur, Harder said. “There is still a stigma around aging and sexuality, and we know that healthcare conversations about sex can be difficult for both doctors and patients,” she said in an email. “We know that aging in and of itself is not a barrier to healthy sexual activity and there are things that can be done to ensure this is maintained.”

Harder would like to see healthcare providers be more proactive in bringing up the subject with women. “This could ‘open the door’ for women – and their partners – and might invite them to talk more openly about possible changes or concerns associated with aging and/or menopause.”

Although the surveys were conducted among British women, the study’s findings most likely also apply to women in the U.S., said Dr. Judith Volkar, a midlife physician and quality director for the department of obstetrics and gynecology at Magee-Womens Hospital of UPMC in Pittsburgh, Pennsylvania. “The women’s complaints are certainly reflective of my practice and I can’t imagine things in British society that are culturally different from ours.”

Volkar suggests that women talk to their providers if they’d like to have intercourse but are experiencing discomfort or pain. “If you have any questions ask your provider,” she said. “And if they make you feel uncomfortable, then find a new provider.”

SOURCE: Menopause, online July 8, 2019.