In-depth interviews with women and experts reveal how stigma, silence, and outdated beliefs undermine sexual health after menopause, and what strategies can help women thrive in this transformative life stage.
Study: Improving the quality of sexual life in postmenopausal women: a qualitative study. Image Credit: FAArt PhotoDesign / Shutterstock
Did you know that between 68% and 86.5% of postmenopausal women experience sexual problems, yet most never seek help? A recent study in the journal BMC Public Health explored how cultural beliefs, personal experiences, and lack of communication affect sexual well-being after menopause. Researchers also examined strategies to enhance intimacy and improve the sexual quality of life.
Menopause
Menopause is a natural phase for all women, but it brings complex changes beyond physical health. As hormone levels decline, symptoms such as vaginal dryness, reduced libido, and discomfort during intimacy often occur. However, these changes are not solely biological in nature. Psychological well-being, relationship dynamics, cultural beliefs, and access to education significantly shape a woman’s sexual life after menopause.
Despite known physiological effects, most research has focused on hormonal treatments and physical health, often neglecting emotional and social aspects of sexual satisfaction. Studies show that many postmenopausal women value intimacy as essential to well-being. Yet, social stigma and lack of dialogue can lead to silence and dissatisfaction, especially in conservative societies where discussing sexuality remains taboo.
The Current Study
This qualitative study, conducted in Qazvin, Iran, from 2022 to 2023, employed content analysis to explore the experiences of postmenopausal women and gather expert insights on enhancing the quality of life in this context.
The study involved 21 participants: 15 postmenopausal women and six professionals in sexology, psychology, or reproductive health. Researchers ensured diversity by including participants of varying ages, education levels, socioeconomic statuses, and durations of menopause. Data were collected via semi-structured, in-depth interviews conducted in private, participant-selected settings. Questions focused on experiences, barriers, facilitators of intimacy, and possible solutions.
Interviews were recorded, transcribed, and analyzed through repeated readings and systematic coding of 495 meaningful statements. These were grouped into subcategories, categories, and themes: understanding influencing factors, gaining new perspectives, and adapting to changes. Confidentiality was maintained, informed consent was obtained, and recordings were securely stored. Interviews continued until no new insights emerged (data saturation).
Key Findings
Improving sexual lives requires a multifaceted approach including personal reflection, partner support, and cultural change. Three themes emerged: managing influencing factors, reframing sexual perspectives, and adapting to postmenopausal changes.
Participants identified internal and external factors affecting sexual experiences, including emotional stress, health conditions, financial issues, marital dynamics, and cultural expectations. Barriers such as hormonal changes, lack of privacy, and household dynamics (e.g., proximity of children's rooms) were highlighted. Personal appearance and mutual hygiene also influenced satisfaction.
Increasing awareness and challenging misconceptions were crucial. Many lacked knowledge about sexual health post-menopause. Some women, after understanding physical effects like vaginal dryness, explored new forms of intimacy. Experts emphasized replacing outdated views with respectful, open approaches to aging sexuality. Both women and professionals agreed on the importance of mutual adaptation and partner involvement.
Adaptation was key. Women who accepted physical and emotional changes were better able to maintain fulfilling relationships. Strategies included planning intimacy, sharing positive memories, and exploring counseling or educational resources to support their relationship. Effective communication and emotional support from partners were essential to achieving better outcomes.
Limitations included the influence of cultural stigma on participant openness and the limited generalizability of the findings beyond the Iranian context. The authors recommended future studies with more diverse populations across various backgrounds and regions.
Conclusions
Enhancing sexual well-being after menopause requires more than medical treatment. It involves addressing personal, social, and cultural influences, promoting open dialogue, and supporting emotional well-being and adaptation. Empowering women with knowledge, empathy, and opportunities for self-expression can significantly improve the quality of life during this transition. The study also emphasized the importance of integrating sexual health into routine care for postmenopausal women.