Sexual older women-Older women's sexuality | The Medical Journal of Australia

Testosterone caused spikes in desire, arousal, orgasm, and responsiveness as well as a decrease in distress related to sexual function. LONDON - Women who experience sexual dysfunction after menopause may feel more desire and pleasure when they use testosterone treatments, a recent study suggests. Researchers reviewed data from 36 trials with 8, participants, most of whom had already gone through menopause. The trials randomly assigned some women to use testosterone treatment and others to take a placebo or an alternative hormone treatment like estrogen alone or in combination with progesterone. Prior research has suggested that testosterone therapy can improve sexual function in women, but the available formulations have been designed for men and evidence for their safety or for adverse side-effects in women is scant.

Sexual older women

Sexual older women

Are changes in sexual functioning during midlife due to aging or menopause? There is an urgent need to better use the existing data held by the the Department of Health to understand the full extent of sexual assault Sexual older women nursing homes. Many challenges Sexjal opportunities arise from this demographic transition. Marsiglio W, Donnelly D. MacNeil SByers S. Aged care Sex abuse Sexual assault Elder abuse nursing homes residential aged care.

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Prior studies show a decline in sexual activity with age, but these studies often fail to consider the role of sexual satisfaction.

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Prior studies show a decline in sexual activity with age, but these studies often fail to consider the role of sexual satisfaction. The aim of this study is to give updated prevalence estimates of sexual activity among women and to elucidate factors associated with sexual activity and sexual satisfaction.

The survey used self-administered questionnaires to assess demographic data, self-rated physical and mental health, medical problems and medication use, relationship factors, and sexual activity and satisfaction. The proportion of women who were sexually active decreased with advancing age.

Among women aged 60 years and older who were married or cohabitating, most Psychosocial factors relationship satisfaction, communication with romantic partner, and importance of sex matter more to sexual satisfaction than aging among midlife and older women.

The US population is aging. By , there will be about As this unique population moves through midlife and into older age, there is an increased interest in how sexuality changes with aging. There is a strong link between a healthy sex life and higher quality of life as individuals age. In this study, we used the second wave of a nationally representative sample the Study of Midlife Development in the United States, MIDUS II of women aged 28 to 84 years to examine the prevalence of sexual activity by age.

We identified the correlates of both sexual activity and sexual satisfaction, as well as the relationship between sexual activity and sexual satisfaction. For each household contacted, 1 respondent between the ages of 25 and 74 years was randomly selected.

Older people and men were oversampled. Non—English-speaking and institutionalized individuals were excluded. All participants provided informed consent, and the Institutional Review Board at the University of Wisconsin-Madison approved the study. Participants completed a telephone interview and self-administered questionnaires regarding demographics, physical and mental health, and sexuality. Women were asked how many sexual partners they had in the previous 12 months. Individuals who answered never or not at all were considered sexually inactive; all others were considered sexually active, unless they did not answer the question.

Women who were married or living with someone in a marriage-like relationship were considered romantically partnered. Menopausal status was assigned based on self-reported bleeding status using a modification of the Stages of Reproductive Aging Workshop classification. Medication use and pain with intercourse in the prior 30 days was evaluated by self-report. Depression status was assessed using a validated self-report scale based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Revision diagnosis of depression.

Means, medians, standard deviations, and percentages, as appropriate, were used to describe sexually inactive and sexually active women. Poststratification weights based on race, age, and education status provided by the MIDUS II study group 20 were used to present means and percentages for the general population.

Because no sampling was conducted for the second wave follow-up study, only population-based adjustment weights were created for MIDUS II.

The sexual satisfaction variable was divided into 3 levels 0—3, 4—7, 8— Univariate logistic regression was used to examine factors that may be related to sexual activity based on published literature. Romantic partner factors, such as partner age and health status, were highly collinear with whether the respondent was married or cohabitating and were not included in the multivariate model of sexual activity.

Univariate ordinal logistic regression was used to examine factors that may be related to sexual satisfaction. The final model met the proportional odds assumption. Analyses of sexual satisfaction were restricted to women who were sexually active in the prior 6 months. Sampling weights were not significantly related to either sexual activity or sexual satisfaction and were not used in the regression models.

All statistical analyses were conducted with StataSE Of women who were not romantically partnered, were sexually active. Of all women who responded to the questions regarding sex, 1, Characteristics of sexually inactive and active women are summarized in Table 1. The mean ages of sexually inactive women and sexually active women were Most respondents were white, and approximately one-half the sample either naturally or surgically postmenopausal.

Note: Of 31 women who had missing data regarding partner status, 23 were not sexually active, and 8 were sexually active. Satisfaction is based on a scale from 1 to 10, where 1 indicates the lowest level of sexual satisfaction. The proportion of women who were sexually active decreased with older age Table 2. Most Frequency of sexual activity differed by age, with older women reporting less frequent sexual activity than younger women Figure 2.

Overall, Other factors associated with being sexually active were lack of depression, higher prior sexual satisfaction, younger age, and lower body mass index. We conducted a sensitivity analysis for missing data regarding sexual activity. We repeated the analysis assuming all women who had missing data regarding sexual activity were sexually active, and then repeated the analysis assuming all women who had missing data regarding sexual activity were not sexually active.

Mean sexual satisfaction was much higher among sexually active women than among sexually inactive women Figure 1. Weighted mean satisfaction for sexually active and inactive women including women both with and without romantic partners was 6. Factors associated with higher sexual satisfaction among sexually active women in the multivariate model included higher relationship satisfaction, better communication, higher ratings of the importance of sex, more frequent sex, higher prior sexual satisfaction, absence of dyspareunia, and absence of antidepressant use Table 4.

Age and menopausal status were not related to sexual satisfaction in multivariate models. In this large cross-sectional study of adult women, we found that the proportion of women who were sexually active in the previous 6 months decreased with age. If they were romantically partnered, however, Romantic partner status was the factor most strongly related to whether a woman was sexually active or not.

Among the women who were sexually active, psychosocial factors such as relationship satisfaction, communication with her romantic partner, and importance of sex were significantly related to sexual satisfaction, whereas age and menopausal status were not. Prior studies have suggested that lack of a romantic partner is one of the most common reasons sexual inactivity in this population.

As women move through midlife and older age, they may lose romantic partners to death, divorce, or separation, and become sexually inactive. Loss of a partner is only one reason why women may be less likely to engage in sexual activity as they age. Advancing age may bring new health concerns in the woman or her partner, or menopausal changes, such as vaginal dryness, could affect sexual activity.

In this analysis, the relationship between increasing age and decreasing sexual activity persisted, even when controlling for these factors and others.

One reason may be a birth cohort effect—attitudes towards female sexuality have become more progressive during the past 5 decades, 25 and women born in later decades may be more likely to participate in sexual activity at every age or more likely to report being sexually active on a survey. Longitudinal studies using a broad age range of women are necessary to untangle the effects of birth cohort from aging. Our findings suggest that those women who do remain sexually active with age are able to maintain sexual satisfaction through the years despite the changes of menopause and aging.

Women may adapt to these physical changes by changing their sexual behavior. For example, women who develop vaginal dryness may incorporate types of sexual activity other than penile-vaginal intercourse or incorporate therapeutic aids, such as lubricants. Women may also place more emphasis on other aspects of sex, such as emotional closeness, and less emphasis on physical sensations. Prior studies have also shown a close connection between relationship satisfaction and sexual satisfaction, 6 , 23 , 28 — 34 but few studies have examined communication in particular.

Sexual satisfaction was lower among women who were not sexually active in the previous 6 months. It may be that these women would prefer to be active but lack a partner or have other interfering factors. Our study has several limitations. This study is cross-sectional, so causality cannot be determined. Second, a validated measure of sexual satisfaction was not used. Health care professionals should be aware that many women maintain or want to maintain a satisfying sex life into middle age and beyond.

Clinicians should ask women about sexual activity and sexual satisfaction and work with women to develop strategies to maintain a satisfying sex life with aging, including ways to improve relationship satisfaction and communication, such as relationship therapy.

The authors gratefully acknowledge the investigators, staff, and individuals who participated in MIDUS. Search for Keyword: GO. User Name Password Sign In. Previous Section Next Section. Measures Participants completed a telephone interview and self-administered questionnaires regarding demographics, physical and mental health, and sexuality. Statistical Analyses Means, medians, standard deviations, and percentages, as appropriate, were used to describe sexually inactive and sexually active women.

View larger version: In this window In a new window. View this table: In this window In a new window. Factors Associated With Sexual Satisfaction Mean sexual satisfaction was much higher among sexually active women than among sexually inactive women Figure 1.

Previous Section. Aging Statistics Updated May 8, ; cited Aug 8, Rossi A Edwards JB. Sexuality, a marriage, and well-being: the middle years. In: Rossi A , ed. Sexuality Across the Lifespan. Google Scholar. A study of sexuality and health among older adults in the United States. N Engl J Med.

CrossRef Medline Google Scholar. Sexual problems among women and men aged 40—80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res.

Sprecher S. Sexual satisfaction in premarital relationships: associations with satisfaction, love, commitment, and stability. J Sex Res.

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Whether or not we want to admit it, we have ideas about sex when it comes to women of a certain age, and those ideas can actually prove super harmful to their health and well-being. Here are 4 myths about older women and sex that need to hit the road, immediately.

Women are seen as having a sexual expiration date, only being attractive and available up until a certain point. This is called vaginal atrophy , and it can make intercourse painful. Regular intercourse can actually help atrophy, as it brings more blood flow and circulation to the vaginal walls. A woman prescribed the right hormones or vaginal moisturizers along with adequate foreplay can have a fulfilling sex life with mind-blowing orgasms.

MaryJo Rapini , a sex therapist and love and relationships expert for the Houston Chronicle, says that she meets many older folks in her practice who are the opposite of embarrassed when it comes to sex talk. According to a report from the U. Center for Disease Control and Prevention , cases of syphilis and chlamydia in 45 to 64 year olds increased between and In , 15 percent of HIV diagnoses were in people over

Testosterone improves sexual function in older women - Reuters

In consultations with older women, doctors should ask about sexual problems. A holistic approach is needed to examine the many different factors that can affect sexuality. Hormonal changes associated with ageing have an impact on women's sexuality. Doctors need to have a clear idea of the place of hormonal treatment for different sexual problems.

Physical changes associated with ageing, including illness and disability, may interfere with sexual expression. Diseases of the endocrine, vascular and nervous systems will most commonly affect sexual function. In Australia, older people are defined as those aged over 65 years.

Sexual intimacy is an important aspect of human relationships, and sexual problems should be addressed as part of a holistic health assessment.

However, doctors are often uncomfortable talking about sexuality, and the topic is often ignored in consultations with older patients. As these women grew up in a generation in which sex and sexuality were rarely discussed, the onus of initiating discussion of sexual issues often rests with the doctor. Physical problems associated with hormonal changes and acute and chronic illness become more prevalent later in life. These inevitably affect a woman's physical wellbeing and may alter her sexual response or ability to physically engage in intercourse.

When older women present with sexual problems, clinicians should take a detailed sexual and drug history and do a careful vulval and pelvic examination to identify any localised treatable conditions Box 2.

Underlying conditions and risk factors see above should be sought and treated, and any drugs likely to interfere with sexual function should be withdrawn. Drug therapy with substances such as sildenafil citrate or prostaglandins may potentially provide a means of enhancing sexual excitement by increasing clitoral vasocongestion and generalised vasodilation.

The use of drugs for this purpose is currently at an experimental stage. The treatment of sexual problems of hormonal origin is discussed in more detail below. Local urogenital symptoms are a common cause of sexual problems in older women. It may be more appropriate in this age group to use topical oestrogen therapy in the form of vaginal pessaries or creams that are not systemically absorbed.

A Danish study found that the most common sexual dysfunction in older women was vaginal dryness, which was present in a third of women. Topical use of oestrogens may also help to alleviate other urogenital problems, including prolapse of the uterus, cervix, vagina, bladder and rectum, and incontinence. Such problems can have physical and emotional effects on older women's sexual wellbeing. Long-term use of oral, continuous, combined hormonal preparations may be inadvisable in view of the increased risk of breast cancer.

Doses can be titrated according to symptom relief. The use of tibolone, a synthetic corticosteroid, may also be considered. Studies in postmenopausal women have shown that it can enhance libido and mood and reduce vaginal dryness and consequent dyspareunia. Testosterone replacement therapy in selected older women may also be considered after appropriate counselling about risks and side effects.

Clinical experience has shown that testosterone therapy is helpful for some women who have diminished libido and persistent fatigue with no clear cause. The presence or absence of a partner affects the sexual practices of older women.

With life expectancy of women exceeding that of men, many older women will eventually live alone and may have limited opportunities for intimate relationships. In a US study, Should an older woman choose not to conform to societal norms in expressing her sexuality, she may have to battle with family and friends who find her behaviour confronting. However, some women report experiencing greater sexual freedom as they become older. Acknowledging the sexuality of older women is often difficult in a society that promotes positive messages about youth and sexuality as a societal norm, but is silent on the subject of sexuality in older people.

However, there are some signs that attitudes are changing — for example, the Aged Care Act Cwlth has recently been amended to allow the right to privacy for older people in institutionalised care. As they reach an advanced stage of life, many women grapple with losses that affect their self esteem. These include loss of employment, loss of status, loss of mobility, and loss of partners, friends and family.

Any or all of these factors can have a negative influence on sexuality. For an older woman who has a partner, the frequency of sexual activity will also be affected by the partner's health status. However, a loving and caring partner will positively encourage the continuation of a sexual relationship. Factors that have been shown to encourage continuing sexual activity for older women include having a positive attitude towards sexuality, an active sex life in the younger and middle years, good health, an interested and interesting partner, and a willingness to experiment sexually.

Doctors can play an important role in facilitating discussion and management of sexual problems in older women. This requires a positive, proactive, holistic approach that addresses psychological and social issues as well as providing appropriate medical care. Genital area: decreased lubrication, atrophic skin changes, shrinkage and atrophy of the clitoris and vagina, diminished sensation, urogenital prolapse, urinary incontinence;.

She has met "Ben", a year-old widower who would like to marry her. Marge comes to see you, her general practitioner, about resuming an "intimate relationship". She mentions that her children do not like Ben. Take a general medical history, including details of medications, gynaecological history eg, age at menopause , any urogenital problems, and past sexual history. Taking the history in an empathic way will provide opportunities to explore psychosocial issues, such as:. Any unresolved issues about her relationship with her previous husband.

Is she ready for a new relationship? Is she guilty about "moving on"? Marge's difficulties with loss of mobility due to osteoarthritis. Does it affect her self image? Will it affect her ability to participate in intercourse? Marge's difficulties with her children. Does she feel guilty? Is it difficult for her to marry Ben without the support of her family?

Inspect the vulva and vagina to assess vaginal atrophy. Take a Pap smear, if appropriate, and assess any urogenital problems. Offer hormone replacement therapy, either topical or systemic, if necessary. Discuss the impact of any medications on sexual function, and provide treatment for any concurrent urogenital problems. Provide the opportunity for Marge to discuss any psychosocial issues further. Publication of your online response is subject to the Medical Journal of Australia 's editorial discretion.

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Date range from. Date range to. Article type. Author's surname. First page. Short reports. Guidelines and statements. Narrative reviews. Ethics and law. Medical education. Volume Issue Med J Aust ; 12 : Topics Women's health. Abstract In consultations with older women, doctors should ask about sexual problems. A broad range of psychosocial factors associated with ageing may influence sexuality. Physical causes of sexual problems Physical problems associated with hormonal changes and acute and chronic illness become more prevalent later in life.

Management of sexual problems When older women present with sexual problems, clinicians should take a detailed sexual and drug history and do a careful vulval and pelvic examination to identify any localised treatable conditions Box 2. Hormonal treatment Topical therapy Local urogenital symptoms are a common cause of sexual problems in older women.

Hormone replacement therapy Long-term use of oral, continuous, combined hormonal preparations may be inadvisable in view of the increased risk of breast cancer. Testosterone cotherapy Testosterone replacement therapy in selected older women may also be considered after appropriate counselling about risks and side effects. Psychosocial factors affecting sexuality The presence or absence of a partner affects the sexual practices of older women.

Conclusion Doctors can play an important role in facilitating discussion and management of sexual problems in older women. Taking the history in an empathic way will provide opportunities to explore psychosocial issues, such as: Marge's feelings about restarting a sexual relationship.

Is she apprehensive? What Ben can offer Marge. View this article on Wiley Online Library. Competing interests:. Sexual dysfunction in the United States.

Prevalence and predictors. JAMA ;

Sexual older women