“We’re Just Tired”: Influences on Sexual Activity Among Male-Partnered Women in Midlife; A Mixed Method Study

ABSTRACT

Studies into decline in sexual activity among women in midlife produce equivocal findings, some implicating hormonal and physiological changes, others psycho-social and environmental factors. Women’s perspectives rarely inform interpretation of the data. Associations between sexual satisfaction, activity and function, and health and lifestyle factors were explored using data from 2133 female participants in the third British National Survey of Sexual Attitudes and Lifestyles (2010–2012). Semi-structured interviews (2012–2015) with 23 women aged 45–59 reporting sexual dissatisfaction in Natsal-3 explored their perceptions of the influences on their sexual activity. Analysis of the survey data showed sexual dissatisfaction to be less common than low frequency and function. Neither menopausal stage nor age was independently associated with any of the dimensions of sexual experience. Only relationship unhappiness was independently associated with all three and communicational difficulty with two (dissatisfaction and lower function). In-depth interviews identified influences on sexual activity not captured in the survey. Tiredness attributed to contemporary challenges of midlife was a dominant theme. Relationship quality mediated its adverse impact. Sexual experience in midlife must be interpreted in light of both life-stage and era, notably, the increasing demands on women in contemporary society and their impact on vitality. Efforts to address sexual wellbeing should take account of the wider social context.

Acknowledgments

We are grateful to all Natsal respondents, but especially those women who gave their time to be interviewed in depth.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Ethical Approval

Natsal-3 was approved by the Oxfordshire Research Ethics Committee A (Ref: 10/H0604/27).

Notes

¹ aOR = age-adjusted Odds Ratio; AOR = fully adjusted Odds Ratio

² Numbers following quotes in the text refer to respondents identified in Table 4

Additional information

Funding

The study was supported by grant G0701757 from the Medical Research Council (MRC) and grant 084840 from the Wellcome Trust, with contributions from the Economic and Social Research Council and the UK Department of Health and Social Care. KRM and RL are supported by the MRC (grant Mc_UU_12017/11; MC_UU_00022/3) and the chief scientist Office (grant sPhsU11).