I'm late to this discussion but it's so important to talk about these things. I'm female, happily married 54. We always had a good sex life, but then I experienced "vaginal atrophy" a few years ago, which basically just means shrinking of the vagina, usually due to menopause. I couldn't understand why sex was suddenly painful, at least at first. I got prescribed a hormone cream which helped, but honestly then I read in a menopausal website to try masturbation. So in the name of science (lol) I did - problem solved. BTW no dildos or anything were needed.
Then my husband (who is 64) got ED. He just has no interest in sex anymore, and also says he's not attracted to me at my current weight (I'm obese but not morbidly so). We have been going through intense stresses for other reasons so I haven't pushed the issue. I self-pleasure at least once a week to keep everything working (honestly I don't have much drive either). So... I am losing weight then I will raise the issue again. ED drugs work for him but give him a headache afterwards. I am just not willing to spend the rest of my life sexless - what if I live to be 100???? Half my life with no sex?