Women's Subjective Orgasm Experience over Adulthood, with a Focus on Later Life

Abstract

Rather than fading with age, women's sexuality in later life is now being acknowledged as an important and rewarding dimension of health and well-being. Orgasm is central to sexual pleasure, but its subjective experience (SOE) remains poorly understood. Most research has emphasized frequency, dysfunction, or physiology, with limited attention to the psychological, sensory, physical, and relational dimensions of orgasm. Although many older women remain sexually active, the influence of menopause and sexual context (solitary vs. partnered) on SOE has not been examined, and validated measures for older women are lacking. This dissertation addresses these gaps through two complementary studies. Study 1 evaluated the psychometric properties of the Orgasm Rating Scale (ORS) and the Bodily Sensations of Orgasm Scale (BSOS) among pre-, peri-, and post-menopausal women. Factor analyses supported a 10-factor structure for the ORS and a 3-factor structure for the BSOS across solitary and partnered contexts. Measurement invariance testing confirmed that both measures are interpreted consistently across menopausal status groups, supporting their validity for use throughout adulthood. Study 2 applied these measures to compare SOE across adulthood and sexual context, supplemented with qualitative reflections from post-menopausal women. Results showed that post-menopausal women reported fewer physical sensations, yet intensity remained stable across groups. Pre-menopausal women reported greater effort to reach orgasm, and across all groups, partnered orgasms were rated higher than solitary orgasms. Qualitative findings underscored diversity in later-life experiences, challenging assumptions of decline and emphasizing relational and situational influences. Together, these studies validate comprehensive measures of SOE across adulthood and provide new insights into women's orgasm over the lifespan. Clinically, findings highlight the need to distinguish age-related changes from dysfunction and to consider partner-related factors in assessment. Theoretically, they refine the Multidimensional Model of the SOE and demonstrate the utility of validated measures across adulthood. Societally, they challenge deficit-based narratives of sexual decline and call for strengths-focused perspectives that reflect the diversity of women's sexual realities in later life.