Many people believe that a decline in libido in midlife is the result of hormonal changes during menopause. However, a recent report by Science alert shows that a national survey in the UK suggests that infrequent sex in midlife is less related to hormonal fluctuations and more related to stress and fatigue.Menopause has limited negative impact on sex lifeMany women often complain of a low sex drive after the menopause, but this does not mean that the menopause itself is solely responsible for a low sex drive.
Menopause is a period of profound physiological change, characterised primarily by the end of the cyclical menstrual cycle, accompanied by significant declines in oestrogen and progesterone, and a sustained decline in testosterone, a hormone that plays an important role in libido and sexual function.
In a national survey of 2,133 female participants in the UK, researchers asked participants to rate their sex lives using three measures: satisfaction, frequency and function.
In the end, a third of the respondents said they had not had sex in the past month. However, less than half were dissatisfied with their sex lives. In other words, middle-aged women generally enjoyed their sex life more, even if the act was infrequent.
In a follow-up interview with 23 female participants aged between 45 and 59, it was revealed that a person’s age and stage of menopause were not associated with their sexual experience.
The researchers explained, “Only two women attributed their lack of interest in sex directly to menopause, and in one case the effect was also influenced by other factors that coincided with bereavement, recent injury and depression after starting to work night shifts”.
Unhappiness in romantic relationships may affect sex life more.
Unhappiness in romantic relationships was the only lifestyle factor that was independently associated with all three indicators of sexual experience.
In fact, those who were unhappy in their romantic relationships were twice as likely to report sexual inactivity, more than twice as likely to report decreased sexual functioning and nearly three times as likely to report an unsatisfactory sex life compared to others.
Many of the women interviewed said that they had neither the time nor the opportunity to talk about sex with their partners in their lifetime.
“We’re just tired,” one woman said of her and her partner, “I’d rather sit in front of the TV with a glass of wine and fall asleep in an armchair, that’s our life”.
Even those without children can be exhausted by life, stating that they “are busy all day, spend evenings with colleagues, and the only time I can get some peace and quiet is when I can get five or six hours of sleep.”
Other lifestyle factors, such as poor mental health, are strongly associated with low sexual function. Meanwhile, the researchers said that higher levels of education were associated with greater sexual dissatisfaction, which may be a reflection of higher expectations.
Overall, the findings suggest that middle-aged women in the UK do not consider menopause to be the main reason for changes in their sex lives, findings that are yet to be supported by larger population studies in other countries.
Menopausal women experience multiple stressors in their lives.
Kaye Wellings, a sexual and reproductive health scientist at the London School of Hygiene and Tropical Medicine, said: “In trying to understand the various factors that influence the sexual experience of midlife, few studies have taken into account the female perspective. Declines in the frequency of sex need to be determined in the context of social change and individual circumstances”.
Today, more and more women are choosing to have children later in life. At the same time, parents are living longer, leading to a ‘sandwich generation’ where middle-aged mothers find themselves financially and emotionally responsible for both their children and their ageing parents.
Many middle-aged women are also juggling a full-time job and may even be coping with their declining health. All these pressures combined also leave women with little energy to devote to a regular and enjoyable sex life.
Many factors need to be considered for a woman’s sexual well-being.
To date, research on whether menopause affects the sexual behaviour of middle-aged people has had mixed results. Some studies have indicated no significant effect, while others have found a 44% increase in sexual activity in menopausal women treated with hormone replacement therapy.
Separating the various factors that contribute to health, well-being, mood and sexual desire in a study can be a challenge. What is unique about this UK survey mentioned above is that it asks women directly what they are experiencing, even though the study was limited to women who were heterosexual.
Wellings, the study’s author, suggests that it is important not to focus “narrowly on the direct determinants of sexual expression”, such as hormones, but to emphasise the “broader social context” that influences sexual well-being.
At the same time, he adds, “we hope this finding will reassure women that they are not out of step with other women in their menopausal lives. The frequency of sex has little to do with sexual satisfaction, suggesting that intimacy may be a more important determinant of sexual well-being – a useful message for health care workers to send to women”.
