Table 2.

Frequently discussed negative changes in sexual function among midlife women

Decreased frequency of sex	Interviewer: And so how often do you feel the desire for sex? Woman: Maybe a couple times a week now… So it’s not like it used to be 20-something years ago, like we had to be at it constantly. [laughs] Interviewer: I was just going to ask if it changed at all as you’d aged. Woman: Yes, yes, most definitely has. (58-year-old woman)
Low libido	[There is] definitely a difference for me pre-menopausal and peri-menopausal… It takes me a lot longer to talk myself into wanting to have sex. And if he initiates it, I have to think harder like, “Do I really want to do this? [laughs] Or do I really want to go to sleep? Or do I really have something else I’d rather do?” So very, very different, and I don’t like it. (53-year-old woman)
Vaginal dryness	Because my problem just came about in the last year or two when I really started noticing the dryness down there, and he thought that I just didn’t want to have sex. I said, “It’s not that I don’t want to have sex. It hurts!”… I had to explain to him that the tissues down there, my hormones were changing… (55-year-old woman)
Orgasm difficulties	I don’t climax nearly as often and when I do, I have to work much, much harder at it… Whereas before menopause, I would say I probably reached orgasm probably 75% of the time… Now, it’s 25%, certainly a big change… My orgasms are not as intense as they used to be… It’s like everything has gotten diluted as I’ve gotten older… it’s just like someone poured water on it and it’s just not as good, it doesn’t taste as good, doesn’t feel as good, doesn’t work as well… Oh, [if] I could go back to the sex I was having when I was 40 or 41. [laughs] Oh, it was awesome. (53-year-old woman)