Low libido after the menopause is not just what stops older women having sex, research suggests.
Scientists from the University of Pittsburgh asked 36 sexually-active women aged 60 and over what puts them off being intimate.
“Body image concerns” was found to be the biggest mood killer, closely followed by erectile dysfunction in their other half.
Plummeting hormone levels leave many women battling low libido and vaginal dryness after the menopause.
While this puts some off intercourse initially, the effect it has on an older woman’s sex life was less clear.
To learn more, the scientists asked a group of women how their sex life has changed with age.
When it came to the biggest turn offs, body image concerns was raised 17 times.
‘‘You know, obviously as you age and gain weight, you don’t feel as attractive as you once did when you were thinner and younger, and everything was tighter and firmer,” one participant said.
Results, published in the journal Menopause, show erectile dysfunction was also flagged by 16 of the women.
Failing to maintain an erection meant many couples could not have sex long enough for the woman to orgasm.
Some also complained their partners became defensive over their impotency, making sex “less satisfying”.
READ MORE: How to enjoy sex during the menopause
“I don’t want him to feel less of a man because I’m like, ‘why can’t you stay hard?’,” one participant said.
“So it’s like he’s just shuts down, he doesn’t want to talk.
“He gets very defensive, he gets hurt, angry, sulky”.
While some encouraged their other half to seek help for their erectile dysfunction, this left them feeling “obligated” to have sex.
“As women we’re encouraged to be accommodating, so we learn to tamp down our own needs and desires, and prioritise those of others,” lead author Dr Holly Thomas said.
Viagra can also take up to an hour to have an effect.
“I think, ‘oh, sex would be nice’ and then it’s like, ‘okay, let’s go take the pill’’, one participant said.
‘‘‘Well, let’s lay down, let’s get in bed, let’s take our clothes off’. It’s not very romantic.”
Dr Thomas added: “If a woman is having sexual problems what’s going on with her partner may be contributing.
“Sex doesn’t occur in a vacuum.”
Postmenopausal symptoms were a concern for 15 of the women.
“I’ve noticed I’ve gotten even more tight and narrow since menopause,” one said.
“I was always small, but it’s even worse now.’’
This can make sex painful, putting women off being intimate again.
Off the back of their study, the scientists stress low libido in older women should not be “automatically attributed to ‘normal’ ageing or menopause”.