Table 5.

Reasons for positive changes in sexual function

Stronger emotional connection	“Because I was younger – I had boyfriends and it was hormonal… As you get older, your feelings change. And you care more about the person… Because you actually love this person… so when you make love, [there’s] just more substance to it… (51-year-old woman)
Better ability to understand and communicate sexual needs	[O]ver the time, you learn with that partner, so the longer you’re with that partner, you learn what they like, they learn what you like, so it’s not like having to teach the kid how to ride the bike every time they get on. (46-year-old woman, focus group 3)
	I couldn’t communicate what I wanted when I first started having sex… I just couldn’t guide him on what would feel right or what would feel good. It just seemed like he should know… Eventually I think I felt more confident as a person and just being able to communicate better in general. I think part of it was maturity… (58-year-old woman)
	[Until recently] I’ve never had a mate… help me get to know my body. A lot of times, we just go in and expect them to know what to do… so I’ve found myself talking during intercourse and say, “OK, touch me here”… Or saying “No, that ain’t working, let’s try something else.”… so it’s important to me now as a 48 year-old woman… I just feel more free and able to communicate and I know my body now ‘cause I really didn’t know my body, even at 27, I really didn’t know myself… It was different then because it was just about the getting the guy off… As opposed to now, I’m getting gratified and my partner’s gratified. (48-year-old woman)
Decreased family concerns	I find that as I get older… I get an orgasm a lot faster – I went through menopause and I think a lot of times when I was younger that fear of getting pregnant… And now that I don’t have to worry about it anymore, I just… find that it’s sort of easier to have a climax than it was… (58-year-old woman, focus group 1)
	Because my kids are both now going to college… now that they’re gone… there’s a whole new freedom I have. This is the first time in 20 years that I’ve not had children in my house… Yeah, I have a whole new sense of freedom about myself. That I can have fun in any way. (48-year-old woman)
More self confidence	57-year-old woman: For me [sex] really, really is intense. I had to have a hysterectomy in my 30’s… after that, I think I became extremely uninhibited and I dated an older gentleman… and our sex is intense. Every time it gets better. I think as you get older, for me, it was I’d say more of a comfort level… Just being more comfortable with yourself.
	46-year-old woman: Yeah, I think I would have to agree with her… now as I’m getting older in age, sex for me is more intense. I feel like when I was younger, I just wasn’t comfortable with myself… And so as I’m getting older, even though I’ve just worked through a few different men, I feel like I have a little bit more confidence about it… and it allows me to be a little more free with the whole experience.
	57-year-old woman: I think for me, the physical feeling is probably less intense than when I was young, but the emotional piece of it is much better. I can feel more playful, I can be less inhibited, I’m more comfortable with my body. I’m able to express myself better and accept his expression better. So even physically, although it’s not like fantastic as it was, there’s other pieces that compensate to make it better. I’d rather be here than there… (Focus group 2)