When asked, unsatisfied women overwhelmingly mentioned a factor “not captured” by surveys.

It’s common for women to notice changes in their drive and sex lives in their 40s and 50s, sexologist and author at Passionerad, Sofie Roos, previously told HuffPost UK. 

Sometimes, these can be caused by hormonal shifts like perimenopause and menopause. Vaginal dryness, reduced blood flow, and pain during penetrative sex can become more likely during this life stage.

But Roos added that these shifts are not inevitable, nor are they always negative.

Indeed, a 2012 paper suggested that women over 80 are among the most sexually satisfied, despite lower sexual desire or sexual activity. Another study found that women’s levels of age-related sexual “dysfunction” didn’t seem to affect their likelihood of staying “active” in the bedroom. 

Instead, the greatest factor by far was the importance they placed on sex.

So perhaps it shouldn’t be all that surprising to learn that in a 2023 study, male-partnered middle-aged women didn’t say age or menopause were the biggest reasons behind declining sexual activity. 

Sex frequency may go down without a decline in satisfaction

In this study, researchers looked at data from 2,133 female participants involved in the third British National Survey of Sexual Attitudes and Lifestyles, conducted between 2010 and 2012. They sought to find links between male-partnered women’s sexual satisfaction, activity and function in midlife with health and lifestyle factors.

The team also conducted interviews with 23 women, aged 45-59, who’d said they weren’t happy with their sex lives in the survey. This, the authors said, was done because “women’s perspectives rarely inform interpretation” of data like these.

The study found that having sex less often was a lot more common than lower sexual satisfaction among this cohort. In other words, it’s possible that women in midlife were perfectly happy with their sex lives, even if they weren’t “getting it on” as regularly.

Interestingly, after analysing their data, the researchers also found that “neither menopausal stage nor age was independently associated with any of the dimensions of sexual experience”. 

But relationship dissatisfaction was independently linked to lower sexual satisfaction, activity, and function. Difficulties in communicating with their partner were also tied to two of these factors (dissatisfaction and lower function), too. 

Tiredness might be an ignored factor here 

After in-depth interviews with unsatisfied women in midlife, the study authors “identified influences on sexual activity not captured in the survey”. 

A recurring theme was exhaustion due to the “contemporary challenges of midlife”. This “dominant” tiredness may be more likely to decrease sexual activity and satisfaction if a woman’s relationship also felt lacking.

Speaking to HuffPost UK about women’s sleep in midlife, Dr Ghazala Aziz-Scott, a specialist in women’s health at the Marion Gluck Clinic, formerly told us that “Women tend to have children in their 30s and later so perimenopause comes with juggling many competing responsibilities, and we have an ageing population, [the responsibility for whom] also falls on the shoulders of women in society”. 

She added, “All this plus managing working outside the home takes its toll on the stress levels of midlife women, and their own self-care in terms of eating well and exercising goes on the back burner”.

This isn’t to say that physiological changes have no role in women’s sexual experiences during midlife. Another study that looked at factors affecting women’s sex lives in middle age found that those who got fewer hot flashes had more intercourse than others, and higher oestradiol levels were associated with fewer sexual difficulties.

However, the same paper also found that fatigued middle-aged women tended to be more likely to have a partner, but also had more sexual difficulties.

The 2023 study, which included interviews with women, concluded, “sexual experience in midlife must be interpreted in light of both life-stage and era, notably, the increasing demands on women in contemporary society and their impact on vitality.

“Efforts to address sexual wellbeing should take account of the wider social context.”