The clitoris is likely to be less sensitive than in earlier years, possibly due to reduced estrogen levels and changes in the vascular and nervous systems.
Many of the age- and menopause-related hormone changes and vaginal changes that can dampen arousal around midlife can also affect women’s enjoyment of sex and ability to achieve orgasm. Here again, the vaginal atrophy and dryness related to low estrogen play a role, as does reduced blood supply to the clitoris and lower vagina. Also, the clitoris—a key center of sexual pleasure for most women—is likely to be less sensitive than in earlier years, possibly due to reduced estrogen levels and changes in the vascular and nervous systems.
All of this may mean some reduction in the sensations and pleasure you experience during lovemaking. It also can affect orgasm, which may be less intense, take longer to achieve, or rarely happen at all. If you are troubled by a consistent difficulty or delay in reaching orgasm, or a consistent inability to reach orgasm after adequate stimulation, you may have what has been called "female orgasmic disorder."
Orgasm problems are more common in women over 45.
In a large nationwide survey about sexual behavior among older US adults, 23% of women ages 57 to 85 said they did not find sex pleasurable.5 Of these women, 64%—or 15% of women in the overall survey—said they were troubled by this lack of pleasure. Another large nationwide survey found that about 5% of US women have a problem achieving orgasm that causes them concern.1 In that survey, the rate of these problems with orgasm was higher among women ages 45 to 64 and those 65 or older (6% in both groups) than among women younger than 45 (3%).
The experience of sex as anticlimactic and less pleasurable is likely to dampen desire over time. This makes it easy to see just how interrelated sexual problems can be.