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Oh misery! Your sex life will get worse as you get older

September 26th, 2008

Dr Petra

Do you remember just a few weeks ago there was some research in the news that said that sex was very important as we age, and that seventy year olds still reported a good sex life? Or a couple of years back when a survey claimed that sex was extremely important to seniors?

You do? Well, I’m afraid that’s all been called into question with a new survey out this week that suggests (according to the press release) ‘baby boomers want sex but face physical challenges’.

Apparently the majority of adults aged 50-70 expect the amount they have sex, the amount the want it and the ability to do it will decline with age, although women are supposedly less prepared than men for the effect the menopause will have on their sex lives. When questioned 65% of women who experienced menopause-induced symptoms said they hadn’t expected they’d have such symptoms, whereas 51% of men did.

It isn’t clear whether the men were reporting on having menopause-induced symptoms (they’d be very unusual men in that case) or if they were talking about a spouse. And if they were talking about a spouse it isn’t clear whether said spouse was also included and compared in the research and whether they had such symptoms. The press release states the survey was based on 354 women, of whom 174 had experienced menopause induced sexual symptoms. Of these 174, 121 were postmenopausal and 53 were not. The remaining 351 respondents were males, of whom 131 had experienced symptoms of erectile dysfunction. [It wasn’t clear if participants had experienced a one off difficulty or a chronic problem]. All participants were heterosexual.

The survey was completed online (no details where though) and it isn’t clear how participants were selected, whether they were paid, or how representative they were of the wider population. Although the fact they had access to the internet and wanted to answer personal questions about their sexual functioning suggests they were probably more affluent than an average baby boomer and had a personal interest in this topic. In other words they’re probably not a representative sample.

While self reporting on a survey can reveal symptoms it isn’t the best way to capture what’s going on in someone’s life. A better way would be to ask someone to keep a diary and include independent measures – preferably without telling the person what you wanted to measure. That way they wouldn’t be led to see menopause-induced symptoms as necessarily negative, and they might be able to explain some of the problems as related to factors other than menopause.

The press release stresses that people do expect men to have age-related problems that get in the way of sex (particularly ED) but are not so prepared for women to have problems – such as vaginal dryness, lack of libido or pain.

And of course this has been how the press have interpreted the research – with several newspaper articles claiming that women have more sexual problems than men as they age.

Which this survey didn’t actually measure. The survey asked people what they thought might go wrong as they aged (which in itself could lead people into giving negative responses), what problems they’d encountered that they’d not experienced, and what specific sexual dysfunctions they had. The majority of participants did not have a dysfunction (see stats above) although that’s not how the press has covered it.

You can’t just measure sexual problems by a self report survey, particularly if participants may be led in a particular way to answer. Even by asking people to list the sexual problems they had you’re already encouraging them to answer in a negative way.

If the researchers had taken a sexual history, asked about people’s lifestyles, relationship quality, what their sex life was like (and had been like), how they felt about aging and what their quality of life was – not to mention checking their general psychological and physiological health, then we might be more convinced by this data.

We could also be more convinced of this research if any formal analysis had been completed or if the survey questions were made available (the press release is vague about the questions asked and no statistical analysis outside of frequency data is presented). If the research is so groundbreaking one might expect it to be published in a journal related to reproductive health – but instead the study was run by a market research company and sent direct to media by a PR company.

Why? Because it’s a drug company funded study for Duramed Pharmaceuticals, Inc., a subsidiary of Barr Pharmaceuticals, Inc. They are currently developing hormonal products for post-menopausal women.

So you could interpret these results in two ways. You could see it as an opportunity to raise an issue about women’s health, or you could be more cynical and interpret it as a company creating a market for a forthcoming product.

After all if you tell women that they’ll be surprised how many sexual problems they encounter, while suggesting women have as many sexual dysfunctions as men do post-menopause, you can make women worried while suggesting they’ve somehow been neglected within healthcare. The next step, inevitably, will be to suggest a hormonal cure – most likely in the form of estrogen therapy but possibly testosterone therapy. Watch this space on that one.

If you want an example of this approach in action see this media treatment. It’s worth noting as you read this the consultants to the survey probably didn’t design or analyse it – it’s most likely they’re paid to front the study (if they want to tell me otherwise I’m happy to put that information in a future blog).

Journalists covering this story should have asked more questions about the accuracy and reliability of the survey, the purpose of the research, what the company behind the survey are aiming for, and what was the involvement of those acting as advisors – do they have shares in the drug company or are they paid by them? Is there any conflict of interest there? What qualifications do the spokespeople for the survey have? One is an MD, one has a relationship therapy qualification, the other is a nutritionist (and is married to the relationship therapist). Last time I looked being a nutritionist wasn’t the same thing as a sex researcher or survey analyst, and being married to a therapist didn’t exactly make you one by proxy. Yes that sounds mean, but perhaps that’s another question a journalist should have asked before reporting.

This survey doesn’t fit with other more reputable research published in scientific journals that acknowledges sex problems do increase with age, but that not all of them are solely related to hormonal deficiencies and not all of them can be ‘cured’ by hormonal treatments.

A story here for a canny journalist would be why is this company sending out this release at this time, what are they planning on launching, how reliable is their survey and why doesn’t it match with more reliable findings?

But that might take some time to investigate, and it’s so much easier to just write from a press release.

Meaning we’ve been misled again about the menopause, we’re all now primed to see it as a problem – and have been coached that there are treatments we should be asking for. Not because this research painstakingly measured this phenomena, but because it’s something that worked within a PR message.

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