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 "There's this popular public perception that as
women age, sex becomes unimportant, and that women just stop having
sex as they get older," lead author Dr. Holly Thomas told Reuters
Health. "From our study, it looks like most women continue to have
sex during midlife," she said.
"It may be detrimental to label a woman as sexually dysfunctional,"
said Thomas, from the University of Pittsburgh Medical Center.
Psychologists and doctors have been debating the value of diagnosing
women with sexual dysfunction since soon after the 1998 release of
the erectile-dysfunction pill Viagra set off a search for a female
version of the blockbuster drug.
Doctors use a test called the Female Sexual Function Index to
diagnose women's sexual problems. The index includes 19 questions
about arousal, orgasm, vaginal lubrication and pain during
intercourse.
In the current study, 354 middle-aged and older Pittsburgh women who
reported being sexually active when they first took the test took it
again four years later.
More than 85 percent of women reported that they remained sexually
active when they took the test the second time between the ages of
48 and 73.
Nevertheless, those women generally scored low on the
sexual-function index, with an average score of 22.3 — below the
cutoff of 26.55 considered sexually dysfunctional.
The authors were surprised to find that sexual function, as measured
by the index, failed to predict whether the women continued to have
sex.
They theorized that the instrument "may be labeling women as
dysfunctional when women don't have a problem," Thomas said.
The index's "focus on intercourse may not accurately reflect what
constitutes satisfying sex in this population, yielding falsely low
scores," she and her colleagues write.
Race, weight, relationship status and how important women deemed sex — rather than their scores on the sexual-function index — were the
most important predictors of sexual activity, according to findings
published in JAMA Internal Medicine.
Women who rated sex as important were three times as likely to
remain sexually active as women who rated it as unimportant, Thomas
said.
White women were most likely to stay sexually engaged, the
researchers found.
So were thinner women. "Whether that has to do with health or body
image, we don't know," Thomas said.
Prior research has shown that obese women's sexual function may
return after bariatric surgery and significant weight loss.
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"We've seen from other research that a healthy sex life is a
predictor of longevity," Thomas said. "So understanding sex might
have broader implications for overall health," she added.
"To narrowly focus on the physical symptoms and to try to look
for a magic pill to me isn't going to work. I'm more interested in a
holistic approach, not just physical factors, but also emotional and
relationship factors," Thomas said.
Leonore Tiefer, a New York University School of Medicine
psychiatry researcher, argued in a 2006 journal article in PLOS
Medicine that the pharmaceutical industry concocted and promoted the
notion of female sexual dysfunction "as a textbook case of disease
mongering . . . to create a sense of widespread sexual inadequacy
and interest in drug treatments."
Tiefer was not involved in the current study but in an email to
Reuters Health praised it for resisting "simple-minded thinking and
marketing pressure."
"There is continuing drug industry pressure to get some sort of
‘female Viagra' approved, despite drug dangers and ineffectiveness,"
she wrote.
Dr. Camelia Davtyan told Reuters Health she would welcome a
better instrument than the sexual-function index. But she does use
it and finds it a valuable tool.
Director of women's health at the UCLA Comprehensive Health Program,
Davtyan was not involved in the current study. The results, however,
resonated with her clinical experience, though the Pittsburgh
patients were not as old as many of hers in Los Angeles, she said.
"A lot of our patients continue to have sex even if they have low
libido or vaginal dryness," she said. "It's just that they need
help."
Last week, a 79-year-old woman complained to Davtyan that she was
bleeding during intercourse. The doctor prescribed daily vaginal
lubricants and vaginal estrogen.
"How am I going to use these results for her?" she asked. "I can't
because she's too old." ___
Source: http://bit.ly/1bjKKa8
JAMA Internal Medicine, online Feb. 10, 2014.
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