While women are usually blamed when sex fades in a relationship, it is the health of the partner that sometimes determines whether she enjoys sex after menopause or not, reveals a new study.

Many past studies have looked into the physiological reasons why women stop wanting, having and enjoying sex later in life. But is menopause largely to blame?

The new study involving 4,418 participants, more than two-thirds of them with intimate partners, finds that the reasons why, for many women, sex in later years is not as satisfying as it used to be are more complex than just hormonal changes.

One in four, or about 27 percent, of the post-menopausal women who had an intimate partner but were not having sex blamed the situation on their partner’s poor health, shows the study recently published in the Journal of the North American Menopause Society Menopause. The rate was double that of women who ascribed their waning sex life to problems associated with menopause. Two-thirds, or 2,883 participants, had intimate partners.

Some women reported that they or their partner were embarrassed and reluctant to discuss sexual issues with a healthcare provider. “My husband is taking tablets which may or may not make him impotent. At 75 he thinks it's not necessary to discuss that with his doctor. I disagree,” said a sexually inactive 68-year-old.

Overall, two-thirds (65 percent) of study participants with intimate partners were not having sex. Sometimes multiple medical conditions and complex care needs were reported. “My husband has Parkinson’s disease and TB of the vertebrae. At the age of 77, he also has dementia and is in hospital at this present time due to a fall,” said a 73-year-old woman who is not having sex.

Sexual dysfunction of the intimate partner was mentioned by about 14 percent of participants with spouses. This predominantly involved erectile dysfunction (ED) which had limiting effects on women’s sexual satisfaction. ED is often related to chronic medical conditions such as heart disease, obesity or diabetes.

In some cases, psychological factors interfered with sexual feelings and resulted in ED. “My husband has a very stressful job and when we make love he has a problem with keeping his erection long enough to satisfy us both,” said a 57-year-old participant.

Sexual problems were sometimes linked to medication use for women and their partners (seven percent). Most responses referred to drug-related loss of libido, ED or the inability to have penetrative sex. Few women mentioned that these problems had been restricting their sex life for many years while others had accepted the situation. “My husband is on medication which prevents him from getting an erection. However, we are both quite happy with a kiss and cuddle after 42 years of marriage,” said a 64-year-old respondent.

Embarrassed and reluctant

Many of these physical health-related problems had significant effects on sexual function. Some women reported that they or their partner were embarrassed and reluctant to discuss sexual issues with a healthcare provider. “My husband is taking tablets which may or may not make him impotent. At 75 he thinks it's not necessary to discuss that with his doctor. I disagree,” said a sexually inactive 68-year-old.
One in six women with partners, or 510, also reported that their own health-related problems impacted sexual activity and satisfaction.

Still, about 13 percent of the problems faced by the women were associated with menopause, including vaginal dryness, painful intercourse, reduced libido and arousal, and difficulty achieving orgasm. “Since the menopause, an extremely important part of my life, intercourse, is ruined. This is because of vaginal dryness and spasm, reduction in physical desire (but not mental), and change and huge reduction in gaining orgasm and in intensity of orgasm,” said a woman age 55 who is not having sex.

Many women also mentioned multiple issues as disruptive to their sex life. The study that involved respondents with a median age of 64 years found that seeking help and treatment for sexual problems was low. Just six percent of the women with intimate partners, predominantly sexually active ones, sought help and treatment. A primary care physician was the main source of support for participants who disclosed this information.

Few women described how treatment for menopausal symptoms had a positive influence on their general well-being: “The menopause and tiredness has been affecting me badly. I began hormone therapy this month and feel more positive that am doing something about it with great support from my doctor, friends and family,” said a sexually active 50-year-old.

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