Sexual Wellness Resource Center
For Adults over 50.

Why Do Women Stop Having Sex?

woman and man
By Michael Bates, M.D.

There are many reasons why a woman may stop having sex in her senior years, particularly during and after the menopause. The reasons may be physical, emotional, relational, or a nuanced and complex combination. The good news is that sex does not have to falter with age. It is possible for women to enjoy sexual intimacy into their 50s, 60s, 70s, 80s and beyond.

Whether you are a woman experiencing sexual challenges with aging or a partner looking for advice, this article is meant to bring you solutions and assurance.

A note: This article will focus on why women stop having partnered sex. However, as we emphasize often at X's and O's, solo sex (masturbation) is also a fulfilling, healthy and valid form of sex!

Loss of Partner

One main reason women stop having sex is the loss of her partner through divorce or death. Forty percent of women 65 and older are widowed. Divorce over age 50 is on the rise. Both are devastating and lead to a period of grief.

Grief following such a loss is normal, healing and time-limited. For most people, functional healing and more or less normal participation in life, working, interacting with others, and daily errands of personal care, occurs by 6 months. Eighteen months and then three years are more distant landmarks of greater healing and recovery.

Grieving can initially suppress sexual feelings as part of the whirlwind of strong emotional feelings and reactions. These sexual feelings eventually return and when they do, masturbation is a healthy outlet for sexual tension as recovery progresses.

If you have lost a partner, know that you will eventually stop grieving and will be emotionally prepared to meet new people and begin dating again, if that is what you wish. While it isn't easy to begin navigating the world of modern online dating later in life, it is absolutely doable. Finding a new partner is possible.

Joan Price has an excellent book on this topic entitled "Sex After Grief: Navigating Your Sexuality After Losing Your Beloved." You may find it very helpful on your journey.

Partner With Untreated Erectile Dysfunction (ED)

Fifty two percent of men between ages 40 and 70 report erection problems; the percentage increases after age 70. These problems include arousal difficulties, inability to maintain an erection, erections too soft to permit penetration, and the complete loss of ability to have an erection.

This can deal a devastating blow to a man's psyche, resulting in avoidance of sexual intimacy due to fear of failure or loss of confidence.

Our article, How to Help Your Partner With ED, goes over this topic in detail. It covers potential causes of ED, medical and non-medical treatment options, and how to talk with and support your partner throughout the process.

Pain or Discomfort During Sex

Hormonal changes during the menopause can result in pain and discomfort during sex, even for women who have been sexually active for years with no history of problems. As women approach, experience and pass through the menopause, estrogen levels fall. This results in vaginal atrophy—the drying and thinning of vaginal tissues.

Over my 35 years of OB/GYN practice, when menopausal patients talked to me about painful sex, it was mostly a problem of lack of lubrication and vaginal dryness. Other symptoms included:

  • pain when touching the vaginal opening
  • pain, either at the vaginal opening with initial penetration, or deep pain with full penetration
  • post coital itching, burning, or soreness
  • post coital burning with urination
  • post coital spotting or bleeding

For the majority of the patients it was a new problem brought on solely by the menopause. For others it came after hysterectomy, or pelvic reconstruction for a dropped bladder or uterus, or after pelvic radiation.

Pain or fear of pain can understandably lead to sexual avoidance.

The good news is that there are solutions. Treatment begins with a trip to the gynecologist. If you are menopausal, your doctor will likely recommend some kind of hormone therapy, either topical vaginal estrogen or hormone replacement therapy. My article on Painful Sex outlines different treatment options as well as other potential causes.

Decreased Libido

Let's look at decreased libido first from a physical standpoint. There may be relational or psychological reasons for losing interest in sex, which I'll discuss soon.

It is common for the physical drive for sex to drop due to changes in estrogen levels during the menopause. However, there are different ways to look at desire that may help if you are experiencing problems surrounding low libido.

Much has been written in recent years about spontaneous vs. responsive desire. Spontaneous desire is exactly what it sounds like—the sudden desire for sex, originating in the brain and felt in the sexual organs. Responsive desire, on the other hand, means that desire comes as a response to stimulation and arousal. In other words, you aren't necessarily "in the mood" for sex when you start, but once you get going, you get in the mood.

It is common for spontaneous desire to drop due to the changes of menopause. The sudden physical urge for sex may not be there anymore, or be there as often. However, it is very possible to still experience responsive desire. Feeling "in the mood" beforehand is not required for fulfilling and enjoyable sex. If you're interested in learning more about this topic, there is an excellent book by Emily Nagoski, Ph.D, entitled "Come As You Are: The Surprising New Science That Will Transform Your Sex Life." It is readily available through major booksellers.

Slower Arousal and Difficulty Achieving Orgasm

The clitoris and labia contain erectile tissue. With sexual excitement the erectile tissue fills with blood, which distends the overlying skin and magnifies the sensitivity of the sensory nerve endings. That is why the clitoris and labia become swollen or "puffy" and much more sensitive during arousal.

As estrogen levels decrease during the menopause, so too does blood flow to the pelvic area. (There are other causes of reduced blood flow, like heart disease and diabetes, that I'll discuss in a minute.) Less blood flow equals less sensitivity, which can result in longer arousal times and difficulty reaching orgasm. Longer, stronger stimulation is needed—just at the time that fatigue and arthritic fingers and hands may make providing it more difficult.

Again, the good news is that there are solutions! Having regular sex, including masturbation, can increase blood flow—the more the body gets in the habit of sending blood to the area, the better it gets at it. This is good for your genital and sexual health, whether or not you are having partnered sex.

Sexual aids (sex toys) can also be a tremendous help—not only with arousal and orgasm, but in spicing things up with some new interest.

  • Vibrators provide the strong, consistent stimulation needed for arousal and orgasm, and come in many different intensity levels. Our article on Sex Toys for Women outlines the different types of vibrators and their benefits.
  • Clitoral pumps are designed to increase blood flow to the clitoris or clitoris and labia, making them more sensitive. Simple pumps can be purchased from sex toy retailers, and there are also vacuum pump medical devices, like the Eros, that require a prescription.

Health Conditions and Medication Side Effects

There are numerous common chronic conditions that can affect a woman's sexual desire and response.

Heart disease, diabetes and high blood pressure all affect blood flow, including to the genitals. Arthritis can cause pain and fatigue that makes sex undesireable. Depression can result in deep fatigue and a loss of interest in activities a person once enjoyed, including sex.

Not only that, the medications used to treat these conditions can lower the sex drive. This is particularly true of SSRI antidepressants.

That doesn't mean there's no hope! None of these conditions have to mean the end of your sex life. Begin by seeing your primary care doctor. Treat whatever health condition exists. Review with your doctor the medications you are taking and why. If there are any sexual side effects with your meds, discuss lowering the dose or changing to another medication.

If your doctor doesn't take your concerns about sex seriously, it's time to find a new doctor. Your sexual health and wellbeing are important.

Lifestyle Habits

Smoking, recreational drugs, too much drinking, poor diet and lack of exercise can singularly crush sexual desire and response. Imagine if there is a combination of these habits.

These habits can be hard to break, especially if they have grown to the point of addiction or have been built up over a lifetime. However, the results of a healthier lifestyle not only for your sex life, but for your overall wellbeing, are worth the effort. Stop smoking and using recreational drugs, limit drinking, get into a regular exercise program, and eat healthily (fresh, whole foods and lots of veggies and fruits).

Psychological and Relationship Issues

Women in good relationships place a greater importance on sex and are more likely to stay sexually active with aging. If sex is important to you and your partner, you will try to keep doing it.

There are any number of relationship problems that can factor into a loss of desire to have sex. These can include poor communication, unresolved anger, resentment, feeling ignored or unappreciated, unequal division of labor, and not feeling like equal partners.

Relationship issues are best managed with the help of counseling. If your partner will not cooperate, go alone. It will help you decide between putting up with the problem and trying to live with it or to move on and out of a stressful, unsatisfying situation. Long-term happy relationships thrive on concern for one another, of wanting the best for one another, and of bringing out the best in one another.

Your doctor or counselor may recommend a sex therapist. Sex therapists can help couples discuss levels of sexual interest, communicate about sex in a productive way, and better express their needs and desires.

So is sex worth it?

Yes, sex is important to women's health. It boosts the immune system, reduces the rate of heart attack, and it helps the vagina stay lubricated, elastic and healthy. Not only that, it's fun!

You should be able to enjoy sex well into your golden years, and that's worth it.