Low Libido in Older Women Isn’t Just From Menopause

A qualitative study by researchers at the University of Pittsburgh School of Medicine found that women in their 60s report various reasons behind why they lack libido.

The study, published in Menopause, distilled interviews with dozens of women about their lack of desire for sex into several major themes — including sexual dysfunction in their partners.

“If a woman is having sexual problems, what’s going on with her partner may be contributing. Sex doesn’t occur in a vacuum,” said lead author Holly Thomas, M.D., M.S., assistant professor of medicine at Pitt.

Up to 40% of women over age 60 have low libido, and about 10% of them report feeling bothered by it.

To understand what’s causing these women to have lower libido than they’d like, Thomas and her team conducted three 12-woman focus groups and interviewed 15 other women privately, depending on which setting the participant preferred.

Through these conversations, five major themes emerged:

• Postmenopausal vaginal symptoms.
• Erectile dysfunction in partner.
• Fatigue or bodily pain.
• Life stressors.
• Body image.

The most surprising thread here, Thomas said, was that so many women identified sexual dysfunction in their male partners as a major contributor to their own lack of desire for sex.

“Some women find workarounds, but others get stonewalled by their partner because he feels defensive,” Thomas said. “As women we’re encouraged to be accommodating, so we learn to tamp down our own needs and desires, and prioritize those of others.”

Another revelation was that for some women, despite having retired from their jobs and successfully ejected their adult children from their houses, they were still too stressed to view sex as a priority.

For instance, one woman bemoaned the emotional burden of caring for her ailing mother while simultaneously supporting her daughter through recovery from a substance use disorder.

There were several limitations of this study, most notably the small, racially homogeneous sample and the lack of quantitative data.

Still, since most of the research on low libido in older women has focused on hormones, Thomas said, hearing detailed accounts from the women themselves produces novel ideas that may not come out of a large survey.

Reference: “’I want to feel like I used to feel’: a qualitative study of causes of low libido in postmenopausal women” by Holly N. Thomas, MD, MS; Megan Hamm, Ph.D.; Rachel Hess MD, MS; Sonya Borrero, MD, MS and Rebecca C. Thurston, Ph.D., 18 November 2019, Menopause.
DOI: 10.1097/GME.0000000000001455

Additional authors on the study are Megan Hamm, Ph.D., Sonya Borrero, M.D., M.S., and Rebecca Thurston, Ph.D., all of Pitt; and Rachel Hess, M.D., M.S., of the University of Utah.

The study was supported by grants from the National Institute on Aging (K23AG052628) and National Heart, Lung, and Blood Institute (K24HL123565).

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