“The most common sexual concerns of women of all ages include loss of sexual desire, problems with arousal, inability to achieve orgasm, painful intercourse, negative body image, and diminished sexual desirability and attractiveness.” Sexual Function in Elderly Women: A Review of Current Literature, archives of National Institutes of Health

We all know that getting old is challenging. It is inevitable yet we are never fully prepared for the actual changes we see in the mirror. For many women, this disconnect creates havoc with our self-image and can negatively impact sexual desire.

Will they dislike my droopy boobs?

What does my tummy look like when I’m flat on my back naked?

Are my genitals unattractive?

These are the kinds of thoughts that often run through our heads when we open ourselves up to intimacy. It's stressful, nerve-wracking and it can totally kill the mood.

Negative Body Image Can Affect Your Sex Drive

Many of us have fears and insecurities about a body that no longer looks like it did 10 or 20 years ago. We dwell on these changes, sometimes obsessively, worrying we are no longer desirable. The thing is, that tends to turn into a bit of a self-fulfilling prophecy, because negative body image and fears of aging can keep us from experiencing pleasure during sex.

According to the American Society of Plastic and Reconstruction Surgeons, cosmetic surgery has risen 47 percent for 51- to 64-year-old women over the past five years.

Obviously not all older women struggle with this, but many do. Some women feel more content in their aging skin while others are seeking drastic procedures to "fix" the problem. Some have even given up the idea of being physically intimate because of how they feel about their bodies.

A study conducted by Dr. Patricia Koch that appeared in The Journal of Sex Research in 2005 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 less sex 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% reported being physically and emotionally satisfied in their sexual relationship and 71% reported general sexual satisfaction."

It makes sense. If a woman finds her body unattractive, she’s less likely to be comfortable in an intimate encounter. Those negative feelings can make it difficult to be fully present in her body during sex. But what's really key is that when these women did have sex, their aging bodies were fully capable of experiencing pleasure and satisfaction.

At times, I’ve worried about what my partner was seeing when he looked at my naked body, fearing he would no longer find me desirable. It got in the way of my ability to be present and enjoy sex. The key is to find comfort with our body’s natural aging changes and allow ourselves to engage in sex naturally and without shame. After all, our bodies may look different, but they are still capable of sexual pleasure, even if it happens in different ways. Of course, you and I both know that it’s not that simple. It helps to have a supportive partner, one who isn’t commenting on our bodies, or contributing to our shame. Yet, most of the work is ours.

How do we learn to accept our changing bodies?

We begin by learning to love the body we’re in, as it is, right now. We must find a sense of peace with it. It works differently for each woman; some are happier with their new identities as older women and aren’t upset by the physical changes. Others are struggling - physically, emotionally, and sexually.

I don’t know that there is one simple answer. I think it requires ongoing mental adjustment and acceptance of the changes we’re experiencing. We have to work to confront negative perceptions when and if they arise.

Sharing our bodies with another person requires a willingness to be vulnerable at all stages of our lives. While we work towards that, we’re also working on self-acceptance. We can employ a few tools or strategies to make us feel more comfortable so that we can pursue intimacy in spite of those insecurities.

What do you want your sexual encounters to look like? Think about what would make you feel comfortable. Is it conversation with a partner? Is it modifying your physical environment? Remember, your partner is not seeing you through the same eyes. They’re focused on the intimacy and the physical act of lovemaking. The anxieties we feel, for the most part, arise from our own internal stuff.

Here are a few suggestions of ways to create the kind of sexual experience that makes you feel most comfortable.

Set the Scene

A sexy space can help us feel sexier. Change the lighting if you want. Add candles, use a light in an adjacent room, or drape a scarf over the lamp (but be vigilant about overheating).

Dress Up

Just like the right outfit can make us feel more confident and sexy outside the bedroom, it can work wonders between the sheets too. Do you want some sort of draping or even a sexy top that might camouflage an area that bothers you? You can add some erotic excitement with a sexy camisole that entices while delicately hiding an area that makes you uncomfortable.

Speak Up

It's OK to let your partner know that you are struggling with insecurity. Practice talking about how you want to be seen. “I’m more comfortable with the lights dimmed.” “I like a little bit of covering; I’m a little shy.” Asking for what you want allows you to take some control over the situation. Sharing with your partner is a form of intimacy. It can also empower you by helping you get your needs met.

Most importantly, know this: your body is a treasure and a delight. The person who comes to your bed is privileged to be with you. Most of all, know that your body is capable of pleasure throughout your life.