Sexually satisfied but feeling frumpy: It's body image, not 'the change'

University Park, Pa. – Penn State researchers, who analyzed the responses of midlife women, ages 35 to 55, to a survey on body image, have concluded that the emphasis in U.S. culture on being young and thin has a more important influence than menopause on sexual functioning and satisfaction.

Patricia Barthalow Koch, associate professor of biobehavioral health and women's studies who led the study, says, "The success of Viagra for men has created a heightened interest in marketing hormones and other medications to midlife women to insure sexual functioning and satisfaction. Our results suggest that 'treatment,' via medication, of menopausal effects for this purpose seems unwarranted in light of the findings that menopausal status did not have a significant impact on the sexual responding of the women in this study."

Analysis of the survey results showed that, regardless of the woman's specific age, she was more likely to consider herself more attractive when she was 10 years younger whether or not she had been through menopause. In addition, there was no significant statistical relationship between a woman’s perception of her own attractiveness as she aged and her current sexual satisfaction.

Koch, who was installed as president of the Society for the Scientific Study of Sexuality earlier this month, added, “There has been a dearth of research examining the relationship between body image and women’s sexual response. These new results support a link between body image and sexual responding that needs further study.”

The study is detailed in a paper, "Feeling Frumpy": The Relationships Between Body Image and Sexual Response Changes in Midlife Women, published in the current issue of The Journal of Sex Research. The authors are Koch; Phyllis Kernoff Mansfield, director of the Tremin Research Program on Women's Health; Debra Thurau, Penn State graduate with an M.S. in health education; and Molly Carey, former project manager, of Tremin.

The researchers used survey data collected by the Tremin Research Program in 1993. Tremin is one of the world's oldest ongoing research programs dedicated to studying women's health and menstruation.

The responses came from 307 women who were heterosexual, 99.2 percent Caucasian; 99 percent college-educated; 83 percent employed outside the home and 80.1 percent married or living with a partner. Nearly 21 percent of the respondents self-reported that they were pre-menopausal, 63.5 percent said they were undergoing some menopausal changes (i.e. perimenopausal) and 15.5 percent were post menopausal.

Nearly 21 percent of the respondents could not think of even one attractive feature and reported an overall sense of dissatisfaction with their bodies. The features that the women considered least attractive were stomach/abdomen, hips, thighs and legs.

The researchers note that it is the norm for U.S. women to be dissatisfied with these parts of their bodies which are affected by weight gain as they age. The percentage of body fat generally doubles by the time women reach age 50. Weight also tends to be redistributed so that breasts become larger, waists thicken and fat increases on their upper back. While it is natural for midlife women to change shape in these ways, the U.S. standard of attractiveness remains a youthful and slender body which creates anxiety about aging and pressure for older women to disguise normal changes.

The researchers found that the more a woman perceived herself as less attractive, the more likely she was to report a decline in sexual desire or activity over the past 10 years. Two- thirds of the women reported one or more changes in their sexual response, most frequently desiring sex less and engaging in sex less often; although some women reported improved sexual response.

Yet, despite these changes in desire and activity, the women reported that when they did have sex, there was a high level of enjoyment. Among the women in the study, 72 percent reported being physically and emotionally satisfied in their sexual relationship and 71 percent reported general sexual satisfaction.

The study was supported by the Tremin Research Program on Women's Health, a unit of Penn State’s Population Research Institute.