Abstract
There has been little comparative, cross-cultural research on sexual difficulties and associated distress, and factors associated with these, among older women. Therefore, the aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated sociodemographic, relational, and health factors, among sexually active older women (60–75 years) in committed relationships across four European countries (Norway, Denmark, Belgium, and Portugal). These data could inform us about what differentiates women who do and do not experience distressing sexual difficulties and facilitate the identification of older women who might benefit from clinical interventions as well as the development of new interventions. In total, 1057 women (357 Norwegian; 322 Danish; 237 Belgian; 141 Portuguese) completed a cross-sectional questionnaire assessing six sexual difficulties—vaginal dryness, orgasmic difficulties, lacking interest in sex, lacking enjoyment in sex, pain during sex, and no excitement/arousal during sex—and associated distress. We found a high prevalence of sexual difficulties lasting 3 months or longer in the past year (between 23.5 and 50.2%, depending on the specific difficulty). With the exception of vaginal dryness and pain during sex, however, the majority of women reporting sexual difficulties (50.0% to 86.1%, depending on the specific difficulty) reported no or mild distress. There were relatively few cross-country differences, either in the prevalence of sexual difficulties or related distress. Few sociodemographic or health variables were associated with distressing sexual difficulties, but higher sexual intimacy, higher emotional intimacy, and better mental health were associated with less distress about some sexual difficulties. The findings underline the importance of healthcare professionals asking older women about sexual function and especially associated distress, and suggest that careful attention to the psychological and relationship context of these sexual difficulties is needed, as these could be important targets in the treatment process.
Highlights
Research suggests that while sexual difficulties are more prevalent among older women compared to younger women (Hayes & Dennerstein, 2005; Hendrickx, Gijs, & Enzlin, 2015; Mitchell et al, 2013; Peixoto & Nobre, 2015), older populations of women tend to report less distress about sexual difficulties (Bancroft, Loftus, & Long, 2003; Lee, Nazroo, O’Connor, Blake, & Pendleton, 2016; Santos-Iglesias, Byers, & Moglia, 2016)
The aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated sociodemographic, relational, and health factors, among sexually active older women (60–75 years) in committed relationships across four European countries (Norway, Denmark, Belgium, and Portugal)
We focused on sexual problems and associated distress as two possible threats of successful aging and sought to address two gaps in the literature on sexuality among older women: the lack of understanding about what predicts reported distress about specific sexual difficulties, and the lack of cross-cultural comparative data on sexual difficulties and associated distress
Summary
Research suggests that while sexual difficulties are more prevalent among older women compared to younger women (Hayes & Dennerstein, 2005; Hendrickx, Gijs, & Enzlin, 2015; Mitchell et al, 2013; Peixoto & Nobre, 2015), older populations of women tend to report less distress about sexual difficulties (Bancroft, Loftus, & Long, 2003; Lee, Nazroo, O’Connor, Blake, & Pendleton, 2016; Santos-Iglesias, Byers, & Moglia, 2016). In the English Longitudinal Study of Ageing, with increasing age, women reported less concern about sexual problems and lower levels of concern compared to men (Lee et al, 2016). Only 9.5% of women in this age group reported “distress” or “worry” about their sex life (compared with 12.7% of women aged 45–54 years). In a further analysis of Natsal-3 data, estimates of the prevalence of sexual function problems meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013) morbidity criteria (“fairly” or “very” distressed, duration of problem at least 6 months, and symptoms occur “very often” or “always”) were obtained (Mitchell et al, 2016). For women aged 65–74 years, less than two percent met all of the above morbidity criteria, compared to 2.8% to 5.3% in the younger age groups
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