Prevalence and Predictors of Sexual Difficulties and Associated Distress Among Partnered, Sexually Active Older Women in Norway, Denmark, Belgium, and Portugal

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.

Sexual Health and the Pandemic Crisis: Testing the Role of Psychological Vulnerability/Protective Factors on Sexual Functioning and Sexual Distress During a Critical Life Period in Portugal

“…However, the negative impact of age was not observed for sexual distress, suggesting that despite the trend for lowered levels of sexual functioning in older individuals, the perceived sexual distress associated is not significantly higher. Although research on the impact of age on sexual distress is less common compared to sexual functioning, previous findings are in line with this result, suggesting that, particularly in women, lower levels of sexual functioning and increased sexual difficulties associated with age are not always perceived as distressful (Graham et al, 2020;Hayes & Dennerstein, 2005).…”

Predicting partnered sexual activity among older adults in four European countries: the role of attitudes, health, and relationship factors

“…The measure includes sexual satisfaction, sexual intimacy, physical affection, perceived sexual compatibility, and perceived distress over sexual problems Štulhofer et al, 2020). This recent approach addresses the implications of the fact that being entirely free from sexual restraints at an advanced age is illusory but that concerns over sexual difficulties seem to be low in the older population Graham et al, 2020;Hald et al, 2019;Santos-Iglesias et al, 2016). As with previous measures (e.g.…”

“…Another possible pathway is that emotional closeness fosters healthy sexual aging by buffering negative health declines, such as minimizing distress associated with sexual difficulties (Erens et al, 2019;Graham et al, 2020). For instance, a four-country study among partnered older women shows that women who tended to feel emotionally close during sex were less likely to be distressed about orgasmic difficulties; women with greater emotional intimacy reported less distress about vaginal dryness (Graham et al, 2020). Further, in a dyadic assessment of the relationships between emotional intimacy, sexual distress and helpseeking behavior among older couples, higher emotional intimacy within couples decreased the likelihood of the female partner feeling distress about sexual functioning .…”

Prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada

“… 56 – 58 Distress about sexuality among women in the general population also varies, from 24% to 51%. 56 , 59 In the context of HIV, women often struggle with issues of sexuality and intimacy, with previous qualitative research revealing experiences of on-going guilt, shame, and rejection, all of which lead to reduced sexual desires and inhibited intimacy. 5 Our finding that concerns related to relationships, sexual self-esteem, and emotional aspects of sex were most prevalent, and that relationships caused the most severe distress, has important implications for the design of programs to promote positive adaptation or resilience in sexuality following an HIV diagnosis.…”