The qualitative experience of sexuality in ageing women: a narrative review

Sexuality remains an important yet frequently marginalised aspect of ageing women's health. Existing research has largely prioritised biomedical decline and menopausal dysfunction, often overlooking women's lived, relational, and sociocultural experiences of sexuality in later life. This narrative review synthesises qualitative evidence exploring how women aged 45 years and over experience, negotiate, and make sense of sexuality as they age. A targeted literature search identified nine qualitative studies, whose findings were thematically synthesised using a combined deductive-inductive approach. Analysis was organised around organic and physical factors, psychogenic and sociocultural influences, and support or intervention-related domains. Across studies, sexuality emerged as an enduring and adaptable aspect of identity rather than something that disappears with age. Women described navigating bodily change, chronic illness, and medication effects alongside powerful social forces, including ageism, stigma, gendered caregiving responsibilities, and healthcare invisibility. Sexual expression was frequently reframed through intimacy, relational connection, and solo practices rather than penetrative sex alone, and women highlighted evolving concerns such as risk of sexually transmitted infections in midlife and later life. The review identifies substantial barriers to accessing appropriate sexual health support and points to promising psychosocial and embodied approaches that may support confidence, sensuality, and wellbeing. Collectively, these findings challenge reductive biomedical models of sexual ageing and underscore the need for integrative, gender-sensitive approaches that recognise sexuality as a vital component of healthy ageing.