Women over 50 are concerned that they're not thinking as much about sex -- they may be less likely to fantasize about their partners or anticipate what they're going to do in bed. Many wonder: "Does that mean I'm losing it?"
Not necessarily. Younger women feel desire and then progress to arousal, then orgasm. Mid-life women may feel that rush of desire a little later -- after they have started to engage in sex.
This pattern was described by Rosemary Basson, MD, a Clinical Professor in the Departments of Psychiatry and Obstetrics & Gynecology at the University of British Columbia and the British Columbia Centre for Sexual Medicine in Vancouver, Canada.1
Basson says that many women in mid-life may feel less urgency and anticipation. But they still respond once their partners initiate sex. If all else is fine and a woman's hormone levels are high enough to keep vaginal tissues plump and comfortable it's often a question of just plunging in. Some may benefit from the Nike approach -- "Just Do It" -- and discover that desire isn't gone. It just comes into play once the foreplay starts.
Many women no longer look forward to sex with the same eagerness they had when they were young, says Basson. "But after the kissing or intimate talk begins, that old familiar feeling kicks in. Most of my patients are relieved to hear how common this is."
"I don't look forward to it anymore," Sharon S. confesses. "And I never seem to think about sex that much." Sharon is 55, and she still enjoys her partner; she just doesn't initiate the contact. Basson says many women are like Sharon. Their amorous feelings haven't waned; they've been redirected. Instead of occurring up front, they show up in the middle of the process.
Nonetheless, some women complain bitterly that they can't get aroused, no matter what. Swedish investigators gave erotic literature to the women and then measured their level of excitation with a plethysmograph, a machine that indicates the amount of blood flow to the genitals. Surprisingly, these women showed the kind of swelling and congestion that normally occurs with sexual arousal. But these findings were at odds with how the woman actually felt.2
This opens up a number of questions: How much of arousal is purely psychological? How much of it depends upon the relationship and a woman's feelings toward her partner? The number of demands she has on her time? How she feels about herself and the direction of her life?
Arousal is a mysterious and complex issue, and researchers are still trying to understand its many variables.
If a woman complains about her ability to be aroused, says Dr. Basson, clinicians need to look at her hormone levels and be sure that she is getting enough support for her vaginal tissues. They also need to ask if the woman is depressed or taking a medication that may hamper her ability to become aroused, if she's worried about a sexually transmitted disease, and if her partner has a problem with sexual desire or performance.
In addition, they have to consider how desire is affected by stress or life changes. A woman may be so overscheduled that she has little time or interest. She may be dealing with a demanding job, frustrating teenagers, ailing parents, nagging problems in her marriage, or simply be concerned about the lack of privacy with older children in the house. Or, she may be depressed because the children have gone, leaving her with an empty nest.
Often, declining desire simply reflects a shift in a woman's priorities. Women who are in long-term relationships may be satisfied with good companionship and comfortable friendships. "I just don't have these needs any more," Margaret L. confides. In the long run, each woman has to decide what role desire plays at this stage of her life.
If a woman doesn't admit her feelings and keeps on having joyless sex, however, she may end up angry or resentful. This, in turn, can undermine the relationship. The other danger is that she may begin to blame herself. "My husband is a wonderful man," says Polly M. "I don't know why I can't be more enthusiastic." In cases like these, a therapist can help.
When there is a gap in the couple's level of interest, it's wise to consult a medical sexologist or psychotherapist trained in sexual issues. The American Association of Sex Educators, Counselors, and Therapists (www.aasect.org) is a good source of referrals. However, both parties have to commit to a renewal of their intimacy and be willing to work toward a middle ground.
Some women remain sexually active but are less concerned with having an orgasm, Basson notes. They still enjoy sex but don't focus on the climax. These women should talk to their partners about their feelings and their changing needs.
"Finally," says Basson, "we have to ask whether the woman is getting the right kind of stimulation." There may be no erotic spark because the woman is not getting the kind of pleasure she needs, or she does not have the right environment to get aroused. Either her mind is not on sex, or the stimuli are just not exciting enough. In that case, a woman may need to fantasize more, read erotic stories, create a more romantic setting or actually show her partner what arouses her the most.
Notes
1. Basson RJ (2002)
2. Laan E, et al (2003)
This article is for educational purposes only and is not intended as a substitute for medical advice. Please consult with a clinician to review any current symptoms and address your medical concerns.
