During the plateau phase, the vaginal orgasmic platform develops, and the uterus elevates. In a postmenopausal woman these changes occur to a somewhat lesser degree than before menopause (Masters & Johnson, 1966).
Orgasm Phase
Contractions of the orgasmic platform and the uterus continue to occur at orgasm, although the number of these contractions is typically reduced in older women. Older women remain capable of multiple orgasms and may continue to experience them (Nusbaum et al., 2005). However, many older women require a longer period of stimulation to reach orgasm, and some experience a reduced capacity to have an orgasm (Nusbaum et al., 2005).
Orgasm appears to be an important aspect of sexual activity to older women. One survey found that 69% of women ages 60 to 91 listed "orgasm" first in response to the question "What do you consider a good sexual experience?" (Starr & Weiner, 1981). Only 17% of the women answered "intercourse" to the same question. In addition, "orgasm" was the most frequent response to the question "What in the sex act is most important to you?" Sixty-five percent of the women reported that their frequency of orgasm was the same as when they were younger.
Resolution Phase
The resolution phase typically occurs more rapidly in postmenopausal women (Nusbaum et al., 2005). Labia color change, vaginal expansion, orgasmic platform formation, and clitoral retraction all disappear soon after orgasm. This is most likely due to the overall reduced amount of pelvic vasocongestion during arousal.
In summary, the effects of aging on female sexuality vary considerably. Most women experience minor changes, and some find their sexual interest, excitement, and orgasmic capacity seriously affected. An active sex life helps maintain vaginal health, and a functional and interested partner, as well as good couple communication, contributes to gratifying sexual relations for the older woman. Hormone therapy can also resolve many of the problems that interfere with enjoyable sexual response.