Determinants of older married women's sexual satisfaction: the mediating role of intimacy.

Abstract

Background: Sexuality is an essential dimension of health in older adults that is often overlooked. Several factors are known to affect sexual satisfaction. Studies have focused on the role of interpersonal processes, such as intimacy, in sexual satisfaction with aging. However, the mediating role of intimacy among determinants of older women's sexual satisfaction was absent in prior studies.

Aim: The present study aimed to determine the factors affecting sexual satisfaction of older married women. Additionally, it investigates the mediating role of intimacy in the relationship between several determinants of sexual satisfaction of older married women.

Methods: In this cross-sectional study, 418 older married women from Tehran were selected using multi-stage random sampling. Questionnaires were completed through individual interviews with the participants. IBM SPSS 25 and AMOS version 24 were employed to assess the determinants of sexual satisfaction.

Outcomes: Sexual satisfaction and its indicators were assessed by using the Global Measure of Sexual Satisfaction, Female Sexual Function Index (FSFI), Short Form-8 Health Survey (SF-8), and questions made by researchers.

Results: Among 418 participants aged 60-80 years old, the sexual satisfaction score was 21.78 ± 7.94. Based on the multiple linear regression model, the strongest determinants of sexual satisfaction were sexual functioning (β = .26, P < .001) and the importance of sexuality (β = .28, P < .001). The result of the structural equational model showed that intimacy mediates the link between several determinants and sexual satisfaction (CMIN = 3.49; CFI = 0.98; RMSEA = 0.07).

Clinical implications: Policies and programs in the field of sexual health should acknowledge the existence of sexual needs in the post-reproductive years and support the promotion of sexual satisfaction in old age, considering the factors affecting it.

Strengths and limitations: The present study attempted to clarify knowledge in the field of sexual health of older women by examining several determinants of sexual satisfaction, using valid questionnaires, and presenting a model that assessed several determinants. The sample was representative of the older married women population from different areas of Tehran. However, sampling from the community level and only from married older women does not provide a perspective concerning older adults without spouses or residents of care institutions.

Conclusion: Several variables at different levels directly or through intimacy are effective on the sexual satisfaction of older married women, so interventions that can promote intimacy between couples can be associated with improvement in the sexual satisfaction of older adults.