While women experience changes with the menopausal transition that can negatively affect their sex lives, they often adapt behaviorally and psychologically to these changes, according to a qualitative study by University of Pittsburgh researchers.

The results of the study, which included individual and focus group interviews, was published online in the journal Menopause on November 1.

Midlife, which is defined as 40 to 60 years old, can bring physical, psychological, social and partner-related changes. Menopause-related vaginal dryness or pain, aging joints and reduced flexibility may lead to negative changes in sexual function for some women. Additional contributing factors such as career, financial and family stress, and concerns about changing body image, may add to decreased frequency of sex, a low libido and orgasm difficulties. However, not all changes are negative. The positive psychological changes aging brings—such as decreased family concerns, increased self-knowledge and self-confidence, and enhanced communication skills in the bedroom—may lead to improvements in sexual satisfaction with aging.

During the course of the study, the researchers interviewed a total of 39 women who were 45 to 60 years old and had been sexually active with a partner at least once in the prior 12 months. Participants chose to take part in either an individual interview or focus group.

“While prior longitudinal studies have documented negative changes in sexual function as women move through midlife, few have highlighted the positive changes,” said Holly Thomas, MD, MS, assistant professor of medicine, Pitt School of Medicine. “We found most study participants were prompted to try new adaptive behaviors to overcome negative challenges to maintain their overall sexual satisfaction.”

Such adaptations included using lubricants, different sexual activities/positions and changing priorities, with greater focus on emotional satisfaction. Women also discussed changing their priorities around sex; as they aged, they de-emphasized physical sexual satisfaction and placed more importance on emotional satisfaction.

“It is important for health care providers to recognize that each woman’s experience of sexual function during menopause is unique and nuanced, and they should tailor their care accordingly. Midlife women can learn strategies, such as adapting sexual behavior and enhancing communication of sexual needs, to help ensure and maintain satisfying sex lives as they age,” explained Thomas.