A recent study published in Menopause and reported by Healio challenges long-standing assumptions about sexual health across a woman’s lifespan. The research found that female sexual dysfunction (FSD) is just as common among midlife women—those aged 50 to 64—as it is among older women aged 65 and above.
This finding highlights the complexity of women’s sexual health, especially during and after the menopausal transition. It also underscores the importance of physicians, patients, and partners having open, informed conversations about sexual well-being—something too often overlooked in routine care.
Understanding Female Sexual Dysfunction
Female sexual dysfunction (FSD) is an umbrella term that covers persistent problems with sexual desire, arousal, orgasm, or pain that cause distress or difficulties in relationships. It is far more common than many realize, affecting up to 40% of women at some point in their lives.
The condition is not simply about biology. Hormonal shifts, age-related changes, relationship dynamics, stress, chronic illness, and cultural attitudes toward sexuality all play a role. Because of this, FSD can look very different from one woman to the next.
The Female Sexual Function Index (FSFI) is one tool researchers use to measure aspects of sexual function, including desire, arousal, lubrication, orgasm, satisfaction, and pain. In this study, a score of 26.55 or lower was considered indicative of dysfunction.
Key Findings from the Study
The study compared sexual health concerns between two age groups: women ages 50–64 (midlife) and those 65 and older.
1. High Prevalence in Both Groups
- 70.9% of midlife women and 71.8% of older women scored within the range for FSD.
This shows that sexual dysfunction is not simply an issue of advanced age. Women in their 50s and early 60s—many of whom may still feel young, active, and engaged in relationships—are experiencing these challenges at rates comparable to women over 65.
2. Differences in Distress Levels
Although dysfunction rates were nearly equal, older women reported less sexual distress than their midlife counterparts. In other words, while the physical or functional issues were similar, the emotional or psychological impact seemed less pronounced in older women.
This raises interesting questions: Do older women adjust expectations around sexual activity with age? Do they experience less distress because of shifting life priorities, or because they and their partners adapt more effectively?
3. Differences in Specific Concerns
The study also found meaningful differences in the types of sexual concerns women reported:
- Loss of sexual desire:
- Midlife: 47.6%
- Older: 33.4%
Desire loss is a significant concern for many women in their 50s and early 60s, likely related to hormonal changes during menopause, life stressors, and shifting relationships.
- Reduced genital sensation:
- Midlife: 16.9%
- Older: 13%
- Genital pain:
- Older: 8.1%
- Midlife: 5.8%
Vaginal dryness, thinning of tissues, or pelvic floor changes may contribute to higher reports of pain in older women.
- Pelvic pain:
- Midlife: 6.7%
- Older: 4.5%
Pelvic pain may relate to gynecologic conditions, musculoskeletal issues, or other midlife health concerns.
Why Midlife Women May Struggle More with Desire and Distress
The higher rates of distress and loss of desire among midlife women deserve attention. Several factors may explain these findings:
- Hormonal transitions: During perimenopause and menopause, estrogen and testosterone levels decline. This can cause vaginal dryness, hot flashes, mood shifts, and decreased libido.
- Psychological and relational stressors: Midlife often coincides with caregiving responsibilities for children and aging parents, demanding careers, and marital strain—all of which can affect intimacy.
- Body image changes: Weight gain, aging skin, or surgical scars may affect self-esteem.
- Unmet expectations: Many midlife women expect their sex lives to remain the same as in earlier adulthood, so changes may cause greater frustration or distress.
By contrast, older women may have adjusted to these changes, redefined intimacy, or placed less emphasis on sexual frequency. This may explain why they report dysfunction but with less emotional impact.
Clinical and Social Implications
The takeaway from this research is clear: female sexual dysfunction is common, complex, and not limited to advanced age.
For Women and Their Partners
- Experiencing changes in desire, sensation, or comfort is not uncommon.
- Distress about these changes is valid—and treatable.
- Open communication with partners and healthcare providers is essential.
For Society
This study helps reduce stigma. Too often, sexuality in midlife and older age is overlooked or dismissed. Recognizing that women remain sexual beings throughout life helps normalize conversations and ensures better support.
Moving Forward
The study’s findings should prompt clinicians, researchers, and the public to rethink assumptions about women’s sexual health. It is not simply a matter of aging gracefully out of intimacy. Rather, many women continue to value sexual relationships throughout midlife and beyond, and they deserve care and solutions that address their needs.
Future research will hopefully explore:
- Why does distress decrease with age despite ongoing dysfunction?
- The role of cultural expectations in shaping women’s responses.
- Which interventions—hormonal, psychological, relational—are most effective at different life stages?
Sexual health is an integral part of overall well-being, yet it is often overlooked in women past their reproductive years. This new research underscores that female sexual dysfunction affects more than 70% of women in both midlife and older age groups. While older women report less distress, midlife women often face significant challenges, particularly with loss of desire and changing sensation.
The message is clear: sexual dysfunction is not a taboo issue and not simply a matter of “getting older.” It is a real, common, and important health concern that deserves recognition and care. By breaking the silence and encouraging open dialogue, clinicians and women alike can ensure that sexual health remains a priority at every stage of life.
El Camino Women’s Medical Group offers the latest Minimally Invasive Solutions for gynecologic problems. Drs. Amy Teng, Erika Balassiano, Pooja Gupta, and Vivian Wan, all members of AAGL (American Association of Gynecologic Laparoscopy), are highly trained and experienced in the field of Minimally Invasive Gynecologic Surgery. Dr. Erika Balassiano has also completed a Minimally Invasive Gynecologic Surgery Fellowship under the supervision of world-renowned Dr. Camran Nezhat. Angel Wong, PA-C, is a physician assistant who sees patients for routine and lower-acuity care.
All of our physicians are El Camino Hospital doctors and operate and deliver at the Mountain View campus.
As part of El Camino Women’s Medical Group’s commitment to comprehensive care for women, we offer in-network mental health services with world-renowned psychiatrist Dr. Rania Awaad and experienced therapist Daniya Ahmed, LMFT. For women seeking to improve their health through a healthier diet, Mariam AlAgha, MS, is an excellent nutritionist with over a decade of success helping women achieve their health goals. Her services are also in network.
Serving Mountain View, Los Altos, Los Altos Hills, Atherton, Palo Alto, Redwood City, Burlingame, Saratoga, Cupertino, Sunnyvale, Los Gatos, Campbell, San Jose, Santa Clara, Silicon Valley, Milpitas, Fremont, South Bay, East Bay, and North Bay.