Learn · Amie original research · 2026

The State of Desire After 40

What 43,339 women who sought help for low desire told us about arousal, pain, mood and intimacy in midlife.

Written and medically reviewed by Dr. Jessica Russell, MD · Published

35,981 women aged 40+ · July 17, 2026–October 22, 2026 · Methodology · Press release (printable)

Executive summary

Who this describes: women who chose to seek help online, not all U.S. women. See methodology and limitations.

12 headline findings

  1. 83%of the 43,336 women who sought help for low desire through our online assessment were 40 or older. Their median age was 49.See chart
  2. 56%of women 40+ named four or more separate concerns. Just 4% named low desire on its own.See chart
  3. 74%of women 40+ reported difficulty with arousal or lubrication, and 70% difficulty reaching orgasm.See chart
  4. 60% → 72%reported vaginal dryness during or after sex, rising from ages 40–44 to ages 55–59.See chart
  5. 23% → 37%named pain during sex as a reason for seeking care, rising from ages 40–44 to ages 60–64.See chart
  6. 58% → 32%named low mood or irritability, falling from ages 40–44 to 65 and older.See chart
  7. 60%of women 40+ reported both a physical concern (arousal, dryness or pain) and an emotional or relationship concern.See chart
  8. 73%of women 40+ reported vaginal dryness, pain or discomfort during sex, or pain during sex as a concern.See chart
  9. 90%of women 40+ are currently sexually active, including 82% of women 65 and older.See chart
  10. 97%of women 40+ said they want to strengthen emotional connection or intimacy in their relationship.Source: methodology
  11. 1.9×Relationship strain and emotional distress during or after sex were reported together 1.9 times as often as chance alone would predict (women 40+).Source: methodology
  12. 96%of women 40+ had had their vitals checked by a medical practitioner in the past three years.Source: methodology

The charts

Most women seeking help for low desire are in midlifeShare of 43,336 women by age at assessment
Age of women seeking help for low desire18–39: 17%; 40–44: 16%; 45–49: 19%; 50–54: 18.8%; 55–59: 15.4%; 60–64: 8.4%; 65+: 5.4%18–39: 17%17%18–3940–44: 16%16%40–4445–49: 19%19%45–4950–54: 19%19%50–5455–59: 15%15%55–5960–64: 8%8%60–6465+: 5%5%65+

Source: Amie online assessment, 43,339 women, July 17, 2026–October 22, 2026. Methodology.

View data table
AgeShare of womenWomen
18–3917%7,355
40–4416%6,923
45–4919%8,240
50–5418.8%8,145
55–5915.4%6,681
60–648.4%3,633
65+5.4%2,359
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Low desire rarely shows up aloneReasons for seeking treatment, women 40+ (n = 35,981; more than one allowed)

Source: Amie online assessment, 43,339 women, July 17, 2026–October 22, 2026. Methodology.

View data table
ReasonShare of women 40+
Low libido or sexual desire89.2%
Difficulty with arousal or lubrication74.1%
Difficulty achieving orgasm69.6%
Low mood or irritability49.1%
Emotional disconnection or intimacy concerns47.4%
Pain during sex30%
Relationship strain28.2%
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Physical concerns rise with age while mood concerns fallShare of women in each age band reporting each concern
Vaginal dryness during or after sexLow mood or irritabilityPain during sex (reason for seeking care)
Concerns by age bandVaginal dryness during or after sex: 18–39 56.4%, 40–44 59.7%, 45–49 66.5%, 50–54 70.5%, 55–59 72%, 60–64 71.8%, 65+ 70.7%. Low mood or irritability: 18–39 56.7%, 40–44 57.6%, 45–49 53.3%, 50–54 50.6%, 55–59 44.2%, 60–64 39.8%, 65+ 32.2%. Pain during sex (reason for seeking care): 18–39 22.8%, 40–44 22.5%, 45–49 24.5%, 50–54 31.7%, 55–59 36.7%, 60–64 37.4%, 65+ 35.1%0%25%50%75%100%18–3940–4445–4950–5455–5960–6465+Vaginal dryness during or after sex, ages 18–39: 56.4%Vaginal dryness during or after sex, ages 40–44: 59.7%Vaginal dryness during or after sex, ages 45–49: 66.5%Vaginal dryness during or after sex, ages 50–54: 70.5%Vaginal dryness during or after sex, ages 55–59: 72%Vaginal dryness during or after sex, ages 60–64: 71.8%Vaginal dryness during or after sex, ages 65+: 70.7%Dryness 71%Low mood or irritability, ages 18–39: 56.7%Low mood or irritability, ages 40–44: 57.6%Low mood or irritability, ages 45–49: 53.3%Low mood or irritability, ages 50–54: 50.6%Low mood or irritability, ages 55–59: 44.2%Low mood or irritability, ages 60–64: 39.8%Low mood or irritability, ages 65+: 32.2%Low mood 32%Pain during sex (reason for seeking care), ages 18–39: 22.8%Pain during sex (reason for seeking care), ages 40–44: 22.5%Pain during sex (reason for seeking care), ages 45–49: 24.5%Pain during sex (reason for seeking care), ages 50–54: 31.7%Pain during sex (reason for seeking care), ages 55–59: 36.7%Pain during sex (reason for seeking care), ages 60–64: 37.4%Pain during sex (reason for seeking care), ages 65+: 35.1%Pain in sex 35%

Source: Amie online assessment, 43,339 women, July 17, 2026–October 22, 2026. Methodology.

View data table
AgeVaginal drynessLow mood or irritabilityPain during sexWomen
18–3956.4%56.7%22.8%7,355
40–4459.7%57.6%22.5%6,923
45–4966.5%53.3%24.5%8,240
50–5470.5%50.6%31.7%8,145
55–5972%44.2%36.7%6,681
60–6471.8%39.8%37.4%3,633
65+70.7%32.2%35.1%2,359
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Most women 40+ named four or more concernsNumber of separate reasons for seeking treatment, women 40+ (average 3.87)
One concernTwoThreeFour or more
Number of concerns named, women 40+One concern: 7.9%; Two: 13.6%; Three: 22.4%; Four or more: 55.7%One concern: 7.9%Two: 13.6%14%Three: 22.4%22%Four or more: 55.7%56%

Source: Amie online assessment, 43,339 women, July 17, 2026–October 22, 2026. Methodology.

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Concerns namedShare of women 40+
One concern7.9%
Two13.6%
Three22.4%
Four or more55.7%
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What women 40+ experience during or after sexWomen 40+ (n = 35,981; more than one allowed)

Source: Amie online assessment, 43,339 women, July 17, 2026–October 22, 2026. Methodology.

View data table
ExperienceShare of women 40+
Difficulty relaxing or becoming aroused86.8%
Vaginal dryness67.9%
Pain or discomfort39.7%
Emotional distress or sadness32.5%
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Nine in ten are sexually activeShare currently sexually active, by age band
Currently sexually active, by age18–39: 95.6%; 40–44: 95.3%; 45–49: 93.7%; 50–54: 90.6%; 55–59: 86.1%; 60–64: 83.6%; 65+: 81.7%18–39: 96%96%18–3940–44: 95%95%40–4445–49: 94%94%45–4950–54: 91%91%50–5455–59: 86%86%55–5960–64: 84%84%60–6465+: 82%82%65+

Source: Amie online assessment, 43,339 women, July 17, 2026–October 22, 2026. Methodology.

View data table
AgeCurrently sexually activeWomen
18–3995.6%7,355
40–4495.3%6,923
45–4993.7%8,240
50–5490.6%8,145
55–5986.1%6,681
60–6483.6%3,633
65+81.7%2,359
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What this data can’t tell us

Our assessment is a medical intake, so some questions reporters ask most often weren’t in it. We don’t report on when libido changes began relative to perimenopause, whether women had talked to a doctor about desire, why they hadn’t sought help before, menopause status or state-by-state differences. We would rather leave those gaps open than estimate them.

Methodology

Sample
43,339 U.S. women who completed Amie’s online low-desire (Blys) medical assessment; 35,981 were 40 or older. One record per woman (her most recent assessment). Men, internal and test accounts were excluded.
Dates
Assessments completed July 17, 2026 to October 22, 2026.
Questions
Closed-choice intake questions only: reasons for seeking treatment, experiences during or after sex, current sexual activity, interest in emotional connection and whether vitals were checked by a medical practitioner in the past three years. Multi-select questions allow more than one answer, so shares can add to more than 100%. Age is calculated from date of birth at the time of the assessment. No free-text answers were used.
De-identification
Figures were computed inside our secure environment with read-only queries. Only aggregate counts and percentages left that environment. No names, contact details, dates of birth, locations or record IDs were exported, and any group smaller than 50 women is suppressed.
Privacy
Only de-identified, aggregate figures are published: no individual’s answers, and nothing that can identify or be reasonably linked to a person. Amie’s privacy policy explains that personal information does not include information that has been de-identified so that it cannot identify or be reasonably linked to you.
Limitations
This is not a representative survey of U.S. women. Everyone in the sample chose to seek help for low desire online, so concerns are more common here than in the general population. The questions were written for a clinical intake, not as a validated research instrument. We did not ask about menopause status, symptom onset, prior conversations with a doctor or reasons for not seeking help before, so this report makes no claims about them. State-level results are not shown because location is not collected at the assessment step. Associations are not causes. Medical review of answers is done by independent licensed clinicians; this report is not medical advice.

Media contact

Press inquiries: support@tryamie.com

The full aggregate tables are available on request.

Please credit “Amie, The State of Desire After 40 (2026)” and link to this page.

If any of this sounds familiar, you’re not alone, and it’s worth raising with a clinician. Amie’s online assessment takes as little as 3 minutes, and a licensed clinician decides whether treatment is appropriate.

This report is for education and isn’t medical advice. It does not diagnose any condition. © 2026 Amie · Privacy