Women’s Issues in Sexuality and Aging

Abstract

Middle-aged and older women in the U.S.A are faced with conflicting messages about their sexuality. Many segments of the media practically dictate that women do whatever it takes to remain beautiful, healthy, wrinkle free, physically fit, and sexually active and exciting (e.g., the aggressive older “cougar” who seeks out sex with younger men). In contrast, other social stereotypes relegate older women to a passive, androgynous, and sexless existence. Due to a general lack of knowledge, most middle-aged and older women remain unaware of the normal, expected physiological changes that take place with aging. Most of these changes stem from a decline in estrogen during menopause, which takes place at age 51 for the average American woman. Nearly one-half of post-menopausal women report vaginal dryness and pain or discomfort during sexual intercourse. This is not, and should not be considered, normal. The use of various lubricants, cognitive-behavioral therapy, and masturbation can often address vaginal dryness and dyspareunia. Clinicians also need to address middle-aged and older female clients’ participation in breast and cervical cancer screenings, concerns about body image and related social stereotypes, the emergence or reemergence of eating disorders, and the sexual and sensual needs of those with and without partners. With appropriate clinical assessment, psychoeducation, and treatment, many women can be helped to enjoy and relish their female status throughout the life span.