Month: <span>July 2018</span>

Mind related reasons affecting sex in midlife

Mind-body issues affecting sex in midlife marriages – Part 2

The human body and mind are connected and the complexity of this connection is most evident when it comes to the human sexual experience. Body or physical health related issues affect sex in midlife marriages. But, there are many more mind related reasons that determine how satisfied midlife couples feel with their sexual relationship. The following are five main issues that affect sex in midlife marriages.

Relationship satisfaction

The most important thing that affects a couple’s sex life is the quality of their relationship. When resentments, anger, constant criticism or disconnection come to characterise the marriage, intimacy gets killed.

Physical intimacy and relationship satisfaction are closely linked – one affects the other. The hormone oxytocine released after an orgasm is believed to create a sense of bonding between sexual partners. This helps strengthen the relationship. Intimacy flourishes in a relationship where there is mutual love, affection, admiration and support. Therefore, a positive loop gets created.

Creating that positive loop is as important for midlife couples as it is for younger ones. An international study examined sexual satisfaction amongst couples who had been married on average 25 years. They found that the midlife couples who were more often physically intimate, and where both partners experienced orgasm, tended to be the most satisfied with their sex lives. And, with their relationship.

Interestingly, the same research found that women were more satisfied with their sex lives later in life than when they were younger. So, the good news is that sex in midlife can actually be better than it was when couples were younger. By the same token, a couple’s relationship can become stronger and more satisfying later in life, too.

There is also a stereotype that men are only interested in sex and women are happier without sex. This has been contradicted by research. Men have reported being more satisfied with their sex life when their relationship is going well. So, it’s not all about sex for men. The same study also found that women felt good about themselves when they engaged in sexual activity. Hence, women are interested in sex, too, for it can make them feel good.

So, feeling good about yourself, enjoying sex with your spouse and being happy in your midlife marriage form a positive feedback loop. If any part of this loop is not working, it is important to fix it.

Emotional wellbeing

Studies suggest that low sexual desire is not, by itself, a midlife malady. However, low sexual desire is an outcome of emotional issues. In fact, emotional wellbeing affects sexual functioning at all ages. When you don’t feel good about yourself, your life, or are preoccupied by life stresses, sex is the last thing to enter your mind.

Midlife brings with it many stresses that can affect one’s emotional wellbeing. Even for those who are in a happy marriage, midlife can bring about many changes. These can include physical changes, health conditions, financial or career related stresses, and family transitions with kids leaving home and elderly parents needing care. All these changes and challenges affect one’s emotional balance.

Mental health conditions, like depression and anxiety disorders, also impact one’s sex life in midlife.

If life’s stresses or untreated mental health conditions are ruining your sex life, it is important to seek help. Not only for the sake of good sex, but also to enjoy the midlife years. Please remember, mental health conditions are treatable.

Perception of self/body image

Body image is how one views one’s body or how satisfied one feels with one’s body shape and size. One’s body image begins to form in childhood. It is influenced by many factors, including personality, family, and media definitions of attractiveness.

Young girls, whether they are in the big city or small village, are sensitive to comments around body size. “You’re fat,” “you’re too thin,” are statements that hurt and invite drastic attempts to alter one’s shape and size. These attempts that begin at a young age often continue into adulthood and midlife.

Women all over the world struggle with ideals of attractiveness imposed on them. But, in countries like India, women are dealt a double whammy. There is a media prescribed beauty ideal that one needs to measure up to. There is also a strong societal message against openly expressing one’s sexuality. Although there are small shifts in attitudes, it is still “item girls” of mainstream Bollywood that have all the liberty to be sexual beings. But then, they are doomed to being one-dimensional characters – sexual beings and nothing else.

It is not surprising then that women not only end up struggling with their body image, but also with their identity as sexual beings.

Unfortunately, studies are telling us that body image, especially for women, shapes their sexual experience.

Studies have found that women’s body related thoughts while they are engaged in sex influence how satisfied they feel with sex. These thoughts mainly include worries around weight, physical condition, and how sexually attractive they think they are while they are engaged in sex. In fact, studies have shown that women who feel ashamed or very self conscious of their bodies during sex feel more dissatisfied with their sexual experience.

Therefore, if the intruder in your bedroom is your body image – it is time to show the intruder the door. There are many ways to do it. If your partner is struggling with body image concerns, counter the concerns by expressing appreciation for him/her as they are, right now.

If you struggle with body image, start by including some positive self talk and expressing appreciation for your body and all you can do with it. Focus on food and exercise as a way to feel fit and healthy and not as a means to lose weight or look thin. Stay away from conversations and folks obsessed with weight and body shape/size. Re-start or explore ways to enjoy your body – dance, exercise, wear clothes that you like, regardless of what the latest fashion is – whatever makes you feel good. You may also find some more ideas in the links given at the end of this article.

History of abuse

Some experts believe that family environment and abuse of any kind in childhood can affect how comfortable a person is with their sexuality in adulthood.

Women who have experienced child sexual abuse often feel uncomfortable with sex and sexuality. They also tend to have a negative body image and often view themselves as sexually unattractive. However, studies have shown that being in a supportive and positive romantic relationship can change an abuse survivors experience of sex. Also, if an abuse survivor is able to view herself as a passionate or romantic person, this view is associated with a more positive sexual experience in adulthood.

Men who have experienced sexual abuse in childhood may also experience some difficulties with sex. Boys who are sexually abused often have concerns around their sexual orientation. Unless these concerns are sorted out earlier, these could continue to affect intimacy in midlife marriage.

If a history of sexual abuse is getting in the way of your being able to enjoy your sexuality and sex in midlife, get help. You can work with a psychologist/psychotherapist/counsellor on issues that might be getting in the way of your relationship.

Internet porn/sex addiction/extra-marital affairs/masturbation

Most marriages are based on an understanding between partners that they will be sexually faithful to each other. For some couples, being sexually faithful is an issue from the beginning. For others, it may become a problem in midlife.

Sexual faithfulness has varied definitions. The behaviours that one couple views as being faithful may be different from another couple’s view. How one partner defines faithfulness can be different from how the other partner defines it. Women often view their partner’s emotional closeness with another person as being unfaithful. Men only define sexual relationships outside of marriage as being unfaithful. Sometimes, it is these contradictory definitions that cause problems in a relationship.

The use of pornography, internet sex, which includes cyber chats and audio/video exchanges, and masturbation – all evoke varied responses in partners. Most research and relationship experts seem to agree that use of pornography can be harmful, but masturbation is okay. Sometimes, one or both partners may carry out these sexual activities in conjunction with sexual activities with each other. For such couples, masturbation and pornography use may not cause any problems in the relationship.

For some individuals, pornography use, masturbation and/or cyber-sex replace sexual activities with one’s partner. These sexual activities become preoccupations or full-blown sex addiction. As with all addictions, secrecy and lying come to characterise the sex addicted partner’s behaviours. When the non-addicted partner discovers the sex addiction,  he/she can go through a range of emotions. These include hurt, betrayal, rejection, humiliation, isolation and anger. The intensity of these emotions can be the same as when confronting an extra-marital affair with a real person.

Like people who suffer from any other addiction, sex addicts, too, benefit from treatment. Seek treatment for yourself if you think you may have a sex addiction. You may need to get professional help for your relationship, too. You may also need professional help if either of you has had an extra-marital affair. It takes a while to get over the breach of trust, but it is possible to repair the relationship.


The good news for midlife couples is that sex can still be an enjoyable experience for a long time. If it has not been fun in the past, it can become fun now. And, it is worth paying attention to your sex life in midlife because sex is good for you and for your relationship. Remember, the two most important things that determine sexual satisfaction are the quality of one’s marriage and one’s own emotional wellbeing. So, even when midlife pulls you in different directions, taking care of yourself and taking care of your relationship have to be priorities number one.



Heiman, J.R., Long, J.S., Smith, S.N. et al. Arch Sex Behav (2011) 40: 741.

Physical Women, Emotional Men: Gender and Sexual Satisfaction in Midlife
Archives of Sexual Behavior, 2009, Volume 38, Number 1, Page 87

Laura M. Carpenter, Constance A. Nathanson, Young J. Kim

Stephen B. Levine (2010) What is Sexual Addiction?, Journal of Sex & Marital Therapy, 36:3, 261-275, DOI: 10.1080/00926231003719681

Jennifer P. Schneider (2000) Effects of cybersex addiction on the family: Results of a survey, Sexual Addiction & Compulsivity, 7:1-2, 31-58, DOI: 10.1080/10720160008400206

Patricia Barthalow Koch, Phyllis Kernoff Mansfield, Debra Thurau & Molly Carey (2005) “Feeling frumpy”: The relationships between body image and sexual response changes in midlife women, The Journal of Sex Research, 42:3, 215-223, DOI: 10.1080/00224490509552276




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physical problems affecting sex in midlife marriage

Mind-body issues affecting sex in midlife marriages – Part 1

Sex is an integral part of life. Even in midlife. However, for many married couples sex is riddled with difficulties. For some, the difficulties are long – standing: Sex was never fun enough. For others, sex becomes unsexy in midlife. Either ways, this is a problem that needs to be addressed.

Midlife, for many adults, is a time of reflection, reprioritization, reorganisation and discovery. And, amongst the many dimensions of their lives that many men and women re-examine is sexuality.

Some couples realize that the sex life they had in their younger years is a thing of the past. Some middle aged men realize that their sexual drive is lower now. Some middle aged women, on the other hand, feel that they are more comfortable exploring and expressing their sexuality.

Some middle aged women or men may also realize that they have not had great sex so far in their relationship and feel a need to fix this problem.

Now, there is no “normal” when it comes to sex. In fact, researchers at the Kinsey Institute have found that there is no common definition of sex. It means different things to different people. For example, some couples consider manually stimulating each other’s sex organs as sex, others only consider intercourse as sex.

For a couple who is on the same page as far as expectations from sex is concerned, there are usually no problems. But, if there is a mis-match of expectations between the partners, that often spells trouble for the relationship.

The mis-match around sex involves two main aspects – desire or the frequency of sex, and satisfaction or the quality of sex. When there is a discrepancy of desire, one partner wants sex less often and the other wants it more often. When there is a discrepancy of satisfaction with sex, two more aspects are involved. One aspect is orgasm – one partner experiences orgasm and the other does not. The other aspect is experiencing the feelings of love and connectedness during sex. These feelings get created through a range of intimate physical behaviours, such as kissing, caressing, etc.

So, how can couples bridge the sex gap? Well, the first step is figuring out what is getting in the way. Based on my work with Indian couples, which is corroborated by western research, there seem to be three body and six mind related reasons that affect couple’s sex life in midlife. The fact that six out of the nine factors are mind related shows that sexual satisfaction is not purely about the physical act.

Let’s first talk about the physical or body related factors that affect sex in midlife marriages:

– Figuring out the mechanics of satisfying sex

Male orgasm is quite well understood but female orgasm is even now shrouded in mystery. Many women believe that they are incapable of achieving orgasm. However, experts believe that every woman, including women in midlife, can experience orgasm.

The problem is that even in today’s day and age, the female sexual anatomy is not widely understood. Most women do not know that the clitoris is the sex organ that is involved in women’s orgasm. But, for many women, the clitoris does not automatically get stimulated during vaginal penetration. Hence, they do not experience orgasm during sexual intercourse. Therefore, other ways of stimulating the clitoris have to be explored.

The good news is that researchers have found that women’s ability to achieve orgasm through clitoral stimulation is not affected by age. In fact, women are equipped to experience multiple orgasms with continued stimulation. Therefore, there is a simple solution to this problem – explore and experiment with sexual touch and sexual positions to find what works.

– Physical wellbeing

Chronic illness often affects how people view themselves, their bodies, and their relationships. Research has shown that women in midlife who are suffering from a chronic illness have many concerns. They are bothered by the changes their body is undergoing, worried about meeting the needs of others, and concerned about expressing their sexual needs and desires. Hence, it is difficult to engage in sex or enjoy sex when one is preoccupied, worried, or feeling negatively about oneself.

Physical illnesses, such as multiple sclerosis (MS) or cancer, are sometimes accompanied by sexual problems. However, researchers have found that couples who have had problems in their relationship or experienced sexual difficulties before the illness, are more likely to face sexual issues after the illness is diagnosed.

Sometimes, the illness itself can create sexual dysfunction when none existed earlier. For example, MS can cause sexual issues that the male partner experiences, such as, erection or ejaculation related problems. Or, the female partner may begin to experience discomfort or pain during sexual intercourse.

Common midlife health conditions, such as diabetes and high blood pressure, can also cause sexual dysfunctions. These dysfunctions are primarily experienced by men and include conditions, such as, erectile disorder.

If your sex life is being affected by a chronic illness or health condition, get help. Talk to your doctor about the impact your condition is having on your sex life. And, check out the additional resources given below that give suggestions about dealing with problems, such as, painful intercourse or erectile dysfunction. Also, seek help from a psychotherapist/psychologist to work through your relationship issues or individual issues related to the illness.

– Hormonal issues

Sex hormones play a role in men and women having satisfactory sex. A change in the level of these hormones, therefore, can take one from good sex to bad sex.

Menopause is a reality for women in midlife. Menopause, as a normal part of growing older, leads to reduced levels of the sex hormone, oestradiol (oestrogen). This sometimes affects women’s ability in midlife to experience arousal, sexual pleasure and orgasm.

Women who enter into menopause at a younger age because their ovaries have been surgically removed may also experience sexual issues. For women undergoing treatment for breast cancer, chemotherapy can also induce menopause and sexual problems.

The normal process of ageing for most men in midlife involves a reduction in the levels of testosterone. But this decline in testosterone levels that begins around age 40 occurs at a very, very slow rate. Its impact on men is, therefore, not as dramatic or significant as the impact of menopause on women.

However, for men, too, endocrine problems can lead to significantly lower levels of testosterone, which may cause sexual problems.

Please look at the additional resources section at the end of this aricle for suggestions on how to deal with sexual issues. Please also speak to your gynaecologist, if you are a woman, or urologist, if you are a man. Or, speak to an endocrinologist to figure out ways to deal with hormonal issues that may be messing up your sex life.


Physical health problems that affect one’s sex life in midlife have many solutions offered by the medical profession. Some solutions are well tested while others may be somewhat experimental. There may be pluses and minuses to the different treatment options.But, getting your sex life sorted is worth the effort.

Coming up: Part 2 of this article where the mind related issues that affect sex in midlife marriages are discussed.


Additional Resources:

Article on how women experience orgasm:

Article on the men’s genitals and possible genital problems:

Article on women’s genitals and possible problems:

Articles on how to deal with painful intercourse:

Articles on how to deal with premature ejaculation:

Articles on how to deal with erectile dysfunction:

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