It is not uncommon for women over 60 to have a lower sex drive, or libido. Most research on low libido in older women has focused on declining hormones, but a new qualitative study suggests that it is affected by a number of factors. Researchers had women over 60 talk about their experience of sexual desire as a way to uncover underrecognized roots of low libido among this age group.

A better understanding of what older women see as contributing to a loss of sex drive can help researchers develop more effective treatments. “Hearing detailed accounts from women themselves produces novel ideas that may not come out of a large survey,” Holly Thomas, lead author of the study, told TheDoctor.

Some women find workarounds, others may be stonewalled by a defensive partner.

University of Pittsburgh researchers conducted three roundtable discussions with 12 women each, and interviewed 15 more women privately to identify the sources of their low libido.

Five major themes came up in the course of these conversations: postmenopausal vaginal symptoms such as pain and dryness; erectile dysfunction (ED) in their partner; fatigue or bodily pain; life stress; and body image.

Thomas and her team were surprised that a partner's erectile dysfunction might negatively affect a woman's libido. “Because of the ED, sexual encounters were not always satisfying for these women, and that led to low libido,” she said.

Although some women find workarounds, others may be stonewalled by a defensive partner. “As women, we are encouraged to be accommodating, so we learn to tamp down our own needs and desires, and prioritize those of others,” Thomas explained.

Life stress was another issue study participants said affected their interest in sex. Women mentioned stressors like caring for aging parents, helping to raise grandchildren or helping launch grown children as factors interfering with their sex lives.

Because low libido is so common, women should not be embarrassed to bring it up. Drugs like sildenafil — Viagra — have helped men feel comfortable discussing erectile problems and low libido with their doctors. Women should also feel the same way. Addressing the issue is the first step.

“As a doctor, I am flattered when patients feel comfortable enough with me to bring up these kinds of problems,” said Thomas, an assistant professor of medicine at the University of Pittsburgh. She and her team are working to develop non-pharmaceutical interventions to help women over 60 who report low libido. “We know therapies such as cognitive behavioral therapy or mindfulness meditation can help.”

The study is published in Menopause.