Sex is good for older adults. In both men and women, good sex appears to: prompt the release of substances that bolster the immune system; release endorphins that act as painkillers and reduce anxiety; benefit the heart and lungs by increasing breathing and circulation; help us relax and feel good about ourselves.
Sexuality and sensuality are an important part of the aging process. Most people want and need to be close to other people. We want to touch and be touched, both physically and emotionally. As we grow older, some of us become more attuned to our sensuality—our ability to be fully present in each moment and to notice the smells, textures, and sounds that enhance our lives. How sensual you are plays a key role in your overall ability to derive pleasure from life.
Physical closeness and companionship are important to most seniors. Just being physically near is important, but many of us also want to continue an active, satisfying sex life as we grow older.
Is sex only for the young?
As people age they often worry about their sexual performance. Some may feel that at a certain age sex is no longer appropriate—that sex is for the young. Others are embarrassed about their lack of sexual "performance" and begin to back away from regular sexual encounters. Sometimes illness or loss of a partner interferes with sexuality. Without appropriate information, and sometimes professional help, a temporary situation can often turn into a permanent one.
However, given good health and a willing partner, studies show that both men and women can enjoy sex for as long as they wish. All it takes is a willingness to learn and compensate for some of the normal changes of aging, and to ask for professional help when needed. With proper information and support, your midlife and later years can be an exciting time to explore the emotional and sensual aspects of your sexuality.
How does our sexuality change as we age?
oung men and women often find that although the physical aspects of their sexuality are strong, they have difficulty with timing and frequency of desire. Research has shown that the typical young male sexual cycle builds quickly and climaxes quickly, while a women's sexual arousal tends to build more slowly. Additionally, young male sexuality tends to be more physically based, while women want more of an emotional connection during their lovemaking. As we age, however, the relationship aspects of our sexuality often become a more important aspect of our sexual expression. As physical sexuality changes, couples can explore new ways to stimulate each other by being more intentional about creating a romantic atmosphere for lovemaking with candles, romantic music, sensual massages etc. They may wish to explore new aspects of their sexuality through erotic reading, sex toys, or videos. For couples with families, the later years provide the time and freedom to cultivate "love nests", something that might not have been possible in a house ruled by young children, carpools, sports schedules and the many other demands of raising a family.Being informed about the normal changes of aging and the many options for supporting our sexuality is much easier than it was a generation ago. More information is available on the Internet, in books, and from the medical community. Also, more middle-aged and older adults feel freer to discuss sexuality with their friends and learn from and support each other. Openly discussing your sexual needs and desires, particularly with your spouse or partner, becomes even more important as you age. Several physiological changes of aging can affect your sexuality, as outlined below.
Women
The major changes that women experience during midlife are related to diminishing hormonal production. This accounts for the symptoms of perimenopause (the time when monthly periods begin to change) and menopause (after monthly periods cease) experienced by many women. Common symptoms include:
- Lower libido and/or slowing of sexual arousal
- Hot flashes and/or night sweats
- Sleep disturbances
- Emotional changes such as irritability, mood swings or depression
- Vaginal dryness and itching
- Increased sensitivity to sounds
- Dry skin
- Weight gain and/or food cravings
Several excellent websites can provide you with more information about this important time of life and tips for adjusting to your body's changes (see References and resources).
Men
Men often find that it takes them longer to have an erection as they get older. They also find that their erection doesn't last as long, and that it takes longer for them to have another erection once they climax. Men who do not know that this is normal become overly concerned, leading to even more "dysfunction" from the increased anxiety.
What can be done to compensate for these changes?
Women
If you are experiencing any of the symptoms related to menopause, it is important to educate yourself. Sometimes women feel like they are the only ones "going crazy", or that they should be able to get through these things by themselves. Fortunately there is more information available to us today than there was a generation ago, and you can learn a lot from internet research, books, magazines, and open discussions with female friends.
Using a water-based lubricant during sex can usually help one of the most common sexual problems related to menopause, vaginal dryness. Additionally, hormone replacement therapy (HRT, available in pills, patches, creams or vaginal rings) can help many women decrease vaginal dryness and other menopause related symptoms. However, with the latest research showing HRT to be associated with higher risks of heart attack, stroke, breast cancer, and gall bladder problems; many women are reluctant to take estrogen. You may want to explore one or more of the many alternative or complementary health care supplements now available. Talk to your doctor about the best approach for your particular symptoms and feelings.
If you feel that your low libido may be related to stress, anxiety, depression, past traumas or other emotional issues, this may be a good time to see a mental health professional. Be sure to let the person know that you are dealing with sexual issues and ascertain whether they have expertise in this area of psychotherapy. You may also find that exploring other interests and activities, like taking a dance class, learning how to meditate, or doing yoga can have a positive effect on mood and help enhance your sexuality and sensuality. Some women have found that a medical provider who specializes in female sexual dysfunctions can be helpful.
Men
As men age, they need more direct physical stimulation to get an erection. Often taking more time during lovemaking, exploring new ways of expressing love, and not focusing on "performance" are enough to break the cycle of tension and allow men to enjoy lovemaking again. Considering lifestyle changes, such as increasing physical exercise, eating a more nutritious, well-balanced diet, stopping smoking, decreasing alcohol intake, and reducing stress can enhance sexuality.
When more frequent problems arise, or when a man is unable to get or maintain an erection, medical intervention may be helpful. Men sometimes think the problem is their fault, or have been told that the problem is psychological. We now know that over 80% of the time impotence or erectile dysfunction (ED) is caused by a physical problem.
If you are having trouble maintaining your erection, you are not alone. It is estimated that 5% of 40-year-old men and 15-25% of 65-year-old-men are experiencing erectile dysfunction. To explore solutions, it is important to not only talk openly with your partner, but also to seek help from your health care provider. A physical exam and lab tests can help pinpoint the cause of your ED, and help determine the best way to help. The now very well known drug Viagra and other similar medications are helpful to 60-75% of the men who try them. Mechanical devices and surgeries are other options to discuss with your physician.
Sometimes illnesses and the drugs used to treat them can also interfere with sexual functioning. Open discussions with your physician can lead to changes in your medical regime that can mitigate these effects.
Medical conditions that affect sexuality
In addition to the normal changes of aging, illnesses and other conditions can contribute to sexual problems. These include:
| Medical Conditions that Affect Sexuality | |
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In addition, women sometimes experience a loss of bladder control. It is important to discuss any physical condition with your medical provider if it is interfering with your sexuality. Many times these problems can be overcome by changing medications, or by effectively treating the medical problem.
How will cancer affect my sexuality?
Understandably, many cancer patients have a difficult time thinking about their sexuality while undergoing treatment. During a time of so many changes, it can be very disappointing to realize that the cancer and treatments also negatively affect your sex life. The Cancer Care sites listed in References and resources can help answer some of your questions and concerns about how cancer and cancer treatments for cancer might affect your sexuality, as well as suggestions for coping with the changes.
Am I too old to worry about safe sex?
As women get closer to menopause they may not have their period for many months and think they can no longer get pregnant. However, until you have missed 12 months in a row, you may still be ovulating and you may still get pregnant. Therefore birth control is still needed. A more important problem, however, can be sexually transmitted diseases.
Although young people are most at risk for these diseases (including syphilis, gonorrhea, chlamydial infection, genital herpes, hepatitis B, genital warts, and trichomoniasis), older sexually-active people can still get them as well. Anyone who is sexually active is also at risk for being infected with HIV, the virus that causes AIDS. Many people do not realize that the number of older people with HIV/AIDS is growing. One out of every 10 people diagnosed with AIDS in the United States is over age 50. You are at risk if you have more than one sexual partner or you have started dating and having unprotected sex again. Always use a latex condom during sex, and talk to your doctor about ways to protect yourself from all sexually transmitted diseases.
Does living in an institution mean my sex life is over?
For many seniors, institutional living marks the end of sexual freedom: no locks on doors, shared rooms, single beds, segregation of male and female residents, no provision for couples to room together. Combined with insufficient knowledge about aging and sexuality, and negative attitudes on the part of staff and family, seniors may find themselves in a sexual desert. Expressions of sexuality and intimacy are often treated as behavior problems, if not actively discouraged. For some seniors, negative attitudes toward sexuality in general are compounded by homophobia: whether living in the community or in a retirement residence or institution, gay men and lesbians can face significant barriers to healthy expression of their sexuality. If you find yourself or a friend or relative in this situation, it is important not to ignore the importance of sensual, and if possible sexual expression. Love, caring, and touching should be acceptable in any setting. Some institutions even allow for privacy among consenting adults for "intimate relations". However, the opportunity for sexual expression in these settings is often very limited, and much more education of staff and family members is often needed for institutionalized older adults to have appropriate expressions of their sexuality.
How do emotions affect your sexuality?
Sexuality is often a delicate balance of emotional and physical issues. How you feel may affect what you are able to do. For example, men may fear that once they have had a sexual "failure" they are less manly, and become overly concerned about their sexual prowess. This worry can actually cause enough stress to trigger further erectile dysfunction. A woman who is worried about how her looks are changing as she ages may think her partner will no longer find her attractive. This focus on youthful physical beauty may get in the way of her enjoyment of sex. Older couples also face the same daily stresses that affect people of any age. But they may also have the added concerns of illness, retirement and other lifestyle changes. These worries can be cause depression and anxiety and affect sexual functioning as well.
Emotional health is important to having a healthy and fulfilling sex life. It is important to address emotional issues as they surface. For more information on passionate feelings and emotions in marriage and other intimate relationships, see Helpguide's relationship series, Building and Preserving Joy and Excitement in Adult Relationships. Open communication with your partner is vital, but if you are sensitive about the subject matter, a therapist specializing in sexual issues might also be helpful. Talking about your concerns and actively addressing them is the only way to overcome them. You may find that expressing your worries and anxieties can help you see them in perspective or reveal ways that you can work to correct them.
Improving our sex life
Recognizing that most couples have difficulty with their sexuality sometime during their relationship and not taking it personally can be a very helpful first step. Next, it is essential that you and your partner develop ways to talk about the problem. First, choose a time when you are both able to give full attention to the conversation, and aren't feeling particularly stressed. Focus on the positive, (your love for your partner and your desire to work things out together). Objectively describe your feelings and perceptions of the problem without being judgmental. Ask open-ended questions, such as "What can I do to make things better for you?" or "What are your concerns about talking with your doctor?". Take time to create a romantic atmosphere and add more playfulness, laughter, and foreplay to your lovemaking. Explore other options, such as sex toys, oral sex, mutual masturbation etc. that do not require an erect penis to obtain sexual satisfaction. This is also a great time to explore doing more sensual things together, such as giving each other a gentle, loving massage, taking dance classes, or exploring Tantra yoga together. And finally, don't be afraid or embarrassed to get professional help when it is needed. Life is too short to deprive yourself of one of life's greatest pleasures.
Kegel exercises, also known as pelvic floor exercises, are overwhelming recommended by doctors for women (and men!) to improve and enhance sexuality. The exercises are simple to do and can be inconspicuously done anytime and anywhere. Strengthening the pelvic floor area should result in heightened feeling and sensitivity, and hopefully, better sex. See References and resources for information about how to do Kegel exercises.
References and resources on sexuality and aging
Sex Over Sixty – Offers a readable and comprehensive overview of sexuality over 60. (Canadian Bulletin of the National Advisory Council on Aging)
Sexuality in Later Life – Provides suggestions for overcoming some common physical problems that affect sexuality. (National Institute on Aging)
Women's Health
Project Aware – Offers an excellent overview of perimenopause and menopause, including a list of common symptoms. (Association of Women for the Advancement of Research and Education)
Perimenopause – Provides recommendations for seven common perimenopausal symptoms from three leading women's health experts. (Discovery Health Online)
Women's Sexual Health Foundation – A nonprofit corporation, offers pamphlets on a variety of women's sexual issues. (The Women's Sexual Health Foundation (TWSHF))
Menopause – Offers an excellent overview of menopause, with good links to other relevant websites. (National Institute on Aging)
Instructions for Kegel Exercises – Provides information on how to do Kegel exercises and why they are beneficial for both men and women. (Midwest Institute of Sexology)
Men's Health
Erectile Dysfunction or Impotence – Features a short video explaining the physiology of an erection and information about causes, diagnosis, and treatment of erectile dysfunction. (Urology Channel)
Erectile Dysfunction – Provides a list of commonly asked questions concerning the causes, diagnosis, and treatments of erectile dysfunction. Includes a list of additional organizations to seek information and help. (National Kidney and Urologic Diseases Information Clearinghouse)
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