It’s no secret that aging means changing. Relationships, responsibilities and bodies change as a woman grows older, and for some, that means what happens in the bedroom also changes. Though it can be tough to start the conversation, medical and mental health professionals say there’s no reason to be resigned to an unsatisfying sex life and every reason to get your groove back.
“There’s this idea that, ‘Well, I’m getting older, I’m going to have less libido, vaginal dryness, urinary incontinence,’” says Eric Grossman, MD, a partner at Advocare Premier OB/GYN of South Jersey. “Women think, ‘My grandmom had it, my mom had it, this is the way it is.’ Without having the conversation, they don’t always realize there are things they can do about it. It’s so common for women to have these symptoms, but these aren’t things they talk about.”
Eric Grossman, MD, partner at Advocare Premier OB/GYN of South Jersey
Some of those symptoms, Grossman says, are very common in menopausal and post-menopausal women, and can drastically affect the enjoyment a woman gets from penetrative sex.
“A woman who goes through meno-pause will have vaginal changes,” he says. “They experience dryness and a loss of elasticity of their vagina. The physical changes can make sex unpleasant or uncomfortable. Thinking, ‘But this is going to hurt,’ kills the mood pretty quickly.”
Grossman says many patients experience positive results using treatments that range from over-the-counter lubricants to estrogen-based medications and the MonaLisa Touch, a laser treatment targeted at thickening the vaginal wall by stimulating cell growth.
Sometimes, the negative affects of bodily changes on her libido have nothing to do with physicial discomfort and everything to do with how a woman thinks, says Charlotte Markey, PhD, a professor of psychology at Rutgers-Camden.
“With some physical changes, women can get help from their gynecologist,” Markey says. “But this is more complicated, because it’s physical and psychological.”
“We value women so much for their appearance, and youth is a huge part of what we consider appealing. It is just so easy to feel less attractive as we age,” she adds. Markey encourages women to be realistic about their own body image and expectations.
“The women we see in the media are women in their 20s,” she says. “If you’re in your 40s, 50s, 60s and compare yourself to that, of course you’re going to fall short. Women need to remind themselves that the beauty ideals they see aren’t appropriate references. Itcould be argued that they never are, but if you’re in your 50s they really aren’t appropriate.”
Markey stresses that eating healthy, staying fit and talking with a romantic partner about physical changes could help women improve their own body image.
“Some of my research focusing on body image among romantic partners shows that communication may improve how women feel about their bodies,” Markey says.
“Women are more self-critical than the men in their lives, and talking with their partners more about some of that may prove helpful. There seems to be a correlation between positive body images and better sex lives. People who feel good about themselves physically seem to have more satisfying physical relationships.”
While much of the problem can be attributed to physical changes and issues, Grossman says there are a huge number of outside factors that can negatively impact sex drive.
“There’s a myth that when you go through menopause, there will be some psychological change that affects libido,” he says. “The truth is no one has ever connected lack of estrogen with psychological deterioration of any kind. The truth is, when you’re in your 40s, 50s and older, there are so many other stressors. There can be marital issues, financial stresses, parents who are sick and dying, kids are moving away. There are so many factors that affect your emotional well-being, and sexual function for women has a strong emotional component.”
Markey says a drop in desire and desirability can be a cycle; an unsatisfying sex life can cause negative emotions, and negative emotions can result in an unsatisfying sex life. She says the best way to get back on track is to start with a potentially uncomfortable conversation with your partner about what each of you wants and needs.
Charlotte Markey, PhD,
professor of psychology at Rutgers-Camden
“The average frequency for people who say they’re happy with their sex lives varies by age, but for a good chunk of adulthood the average is around once a week,” Markey says. “But what’s right for you and your partner might be several times a week or once a month. Understanding one another’s expectations is so important. Approach it as a project for a team. Start by saying, ‘We’ve been in this relationship for 15 years, and I want to be in it for 30 more. It’s natural for relationships to change and evolve, and I just want us to make sure we’re on the same page in terms of what we want and what we’re expecting.”
If you don’t know where to begin, Markey says speaking to a professional sex therapist could be a great choice.
“If people are afraid to have these conversations or they don’t know where to start, getting some help from a sex therapist can be really helpful,” she says. “Having someone else facilitate a difficult conversation can be a great investment in your relationship.”
Carolynn Aristone, a certified sex therapist and owner of the Center for Intimate Relationships in Haddonfield, agrees that outside stress can reduce libido.
“A lot of life stresses can start to shut the system down,” she says. “There’s pleasure in sex. If you’re constantly stressing and thinking about work, money, your family, you’re not really in a mindset where you’re thinking about pleasure. You’re in work mode or task mode, and pleasure is the first to go.”
Simply spending more time thinking about sex can be a big libido-booster, Aristone says, but that alone is not enough.
“Once it’s shut down, you have to make a conscious effort to bring that back up,” she says. “It’s not about putting on sexy clothes and jumping in the bedroom. People may not realize their brain is their biggest sex organ. You read that in magazines all the time, but it really is true. It’s like any other muscle – you can work so hard in the gym, but when you stop going you eventually lose what you’ve gained. And when the pleasure center in your brain shuts down, it takes work to get that to come back. It takes practice to get your groove back.”
Aristone says a number of patients are initially unsure whether they can benefit from seeing a sex therapist, and even the most confident people often struggle at first when asked to discuss their sex lives.
“People are afraid to talk about sex,” Aristone says. “A lot of the time I’m working with couples who’ve never talked about sex with one another, because sex is not something you talk about. Often that’s an idea they had since they were young. With 99 percent of the couples I work with, when I ask how they learned about sex, their parents had nothing to do with it. Most people just had that class in school.”
While most of her patients are couples, Aristone says the most important thing a woman can do to get her groove back is decide to make a change. Addressing the problem head on, she says, can result in improvements not only to a couple’s sex life, but also to their overall happiness and well-being.
“It’s of course preferred that couples come in together,” she says, “but it’s not impossible to create a shift in your life as an individual. A couple is a system, and each has their own role in the relationship. When one partner decides they want to work on something, that partner becomes much clearer about their wants, needs and desires. And when they shift, they affect the whole system. They realize they have a sense of responsibility, both to their partner and themselves. They owe it to themselves to feel good.”
