Articles by Dr. Dubey on mental health.

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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