Understanding the sexual concerns of older women presenting for care to women's health clinics: a cross-sectional study.

To compare the prevalence of female sexual dysfunction (FSD) and distress between sexually active midlife women (50-64 y) and older women (65+ y) presenting for care at women's health clinics at a tertiary care center. This cross-sectional study included women aged 50 and above who received care at Mayo Clinic women's health clinics in Rochester, MN; Scottsdale, AZ; and Jacksonville, FL, between May 1, 2015, and August 31, 2022. Sexual function and distress were compared between midlife and older women using the Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and self-reported sexual health concerns. Among 3,465 sexually active women, older women were less likely to report loss of sexual desire (33.4% vs. 47.6%; P<0.001) and reduced genital sensation (13.0% vs. 16.9%; P=0.024) compared with midlife women. There were no significant differences for vaginal dryness, painful intercourse, or arousal/orgasm difficulties. FSFI scores were higher in older women for desire (3.0 vs. 2.4; P<0.001) and lubrication (3.9 vs. 3.6; P<0.001). While total FSFI scores were similar between older and midlife women (21.2 vs. 22.2; P=0.11), sexually related distress was lower in older women compared with midlife women (13.0 vs. 15.0; P=0.015). The prevalence of FSD (defined as FSFI score ≤26.55 and FSDS-R score ≥11) was similar between groups (51.8% vs. 56.2%; P=0.056). Older women experienced FSD at similar rates as midlife women but reported less sexual distress, potentially reflecting lower expectations regarding sexual function. Addressing sexual health concerns in older women may enhance quality of life.