Skip to content

Editorial: Midlife Sexuality in Women's Own Words

Key findings

  • As part of the United Kingdom Collaborative Trial of Ovarian Cancer Screening, 4,418 women ages 50 to 74 wrote free-text comments on the Fallowfield Sexual Activity Questionnaire
  • Their comments reflected the influence of physical and sexual health, mental well-being and interpersonal/relationship factors on sexual activity
  • Only 6% of the women with partners reported treatment by a health care professional for sexual problems
  • An editorial accompanying the study praises the researchers for providing a more nuanced understanding of midlife women's sexual experiences and calls for better education of primary care physicians and other clinicians

Over the past decade, observational research from many different countries has assessed the sexual experience of women who are beyond their reproductive years. Cross-sectional investigations have been most common, and several longitudinal studies have provided information about changes in women's sex lives over time.

In an editorial in MenopauseJan Shifren, MD, director of the Midlife Women's Health Center at Massachusetts General Hospital, describes a study published in Menopause by Helena Harder, PhD, Valerie A. Jenkins, DPhil, and co-researchers at the University of Sussex, that took a novel approach: systematic analysis of postmenopausal women's comments about their engagement in sex and their views on sex and sexual problems.


The analysis was undertaken as part of the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), a population-based, multicenter study that measured how different forms of ovarian cancer screening affect disease mortality. A secondary objective was to evaluate the effects of ovarian cancer screening on sexual activity, and at baseline, 24,305 women ages 50 to 74 completed the Fallowfield Sexual Activity Questionnaire (FSAQ).

FSAQ Results:

  • 49% of respondents were sexually active and 78% had an intimate partner. Most sexually active women reported enjoyment of sex (75%), desire to have sex with their partner (66%) and satisfaction with sex (78%)
  • Substantial proportions of sexually active women reported discomfort, including vaginal dryness (34%) and pain with penetration (17%)
  • The principal reason for sexual inactivity was not having a partner (37%)

Free-Text Comments

4,418 of the participants added free-text comments on the FSAQ, of whom 22% were sexually active and 65% had a partner. While often included in questionnaires, such free-text comments are rarely analyzed. In contrast, the researcher coded and analyzed these comments to identify three principal themes:

  • Physical and sexual health
  • Mental well-being
  • Interpersonal/relationship factors

The Importance of Words

Dr. Shifren praises the UKCTOCS team for providing a more nuanced understanding of midlife women's sexual experiences, "beyond percentages and probabilities." Only 6% of the women with partners reported treatment by a health care professional for sexual problems, and she calls for better education of clinicians to improve the sexual health of older women.

Learn more about the Midlife Women's Health Center

Explore OB/GYN research at Mass General

Related topics


These pioneering studies from Massachusetts General Hospital evaluate the efficacy of two common, low-risk treatments for postmenopausal symptoms against a placebo and assess how much postmenopausal women were bothered by vulvovaginal discomfort symptoms, along with their impact on mood and quality of life.


Vulvar and vaginal discomfort is common associated withmenopause, but new research reveals that vulvovaginal symptoms are common both before and after menopause. Overall 40% of women surveyed reported moderate to severe vulvovaginal symptoms within the past month.