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Sex and sexuality communicate a great deal: affection, love, esteem, warmth, sharing, and bonding. These gifts are as much the right of older adults as they are of those who are much younger.
Three aspects of sexuality are covered in this topic: the changes that come with aging, suggestions on how to adjust to these changes, and information about sexually transmitted infections.
In most healthy adults, pleasure and interest in sex do not diminish with age. Age alone is no reason to change the sexual practices that you have enjoyed throughout your life. But you may have to make a few minor adjustments to accommodate any physical limitations you may have or the effects of certain illnesses or medicines.
Most physical changes are the result of gradually decreasing testosterone levels. These changes affect energy, strength, muscle and fat mass, bone density, and sexual function.
Most physical changes take place after menopause and are the result of decreased estrogen levels. These changes can be altered if a woman is taking hormone therapy.
Not all women experience these problems. Those who do can experiment to find ways to enjoy sex despite these physical changes.
In addition to physical changes, there are cultural and psychological factors that affect sexuality in later years. For example, in our culture, sexuality is equated with youthful looks and youthful vigor. Too many people seem to think that as a person ages, he or she becomes less desirable and less of a sexual being. Older adults may accept this stereotype and buy into the notion that they are not permitted or expected to be sexual.
Joy in sex and loving knows no age barriers. Almost everyone has the capacity to find lifelong pleasure in sex. To believe in the myth that older people have no interest in sex is to miss out on wonderful possibilities.
Being single through choice, divorce, or widowhood can present a problem also. As you get older, you may not have as many people in your age group to choose from for partners. Women and men who are single may not know how to deal with their sexual feelings. Generally speaking, it is better to express your desires than to suppress them until you are no longer aware that they exist.
Physical and emotional needs change with time and circumstance. Intimacy and sexuality may or may not be important to you. The issue here is one of choice. If you freely decide that sex is no longer right for you, then that is the correct decision. It is possible to live a fulfilling life without sex. But if you choose to continue enjoying your sexuality, you deserve support and encouragement. You may still find uncharted sensual territories to explore.
Just as exercise is the key to maintaining fitness and health, having sex on a regular basis is the best way to maintain sexual capacity.
And just as it's never too late to start an exercise program, it's never too late to start having sex. Many older people who have been celibate for years develop satisfying sexual practices within new loving relationships. For others, self-stimulation (masturbation) is common and poses no health risks or side effects.
You may have sexual changes as you get older. But some changes may be the first sign of a medical problem. So talk with your doctor about any changes that concern you. He or she may be able to recommend treatments that will help you.
Here are some other considerations:
Sexuality goes far beyond the physical act itself. It is part of who we are. It involves our needs for touch, affection, and intimacy.
Touch is a wonderful and needed sensation. Babies who are not touched do not thrive. Children who are not touched develop emotional problems. Touch is important to older adults as well. Touch helps us feel connected with others and enhances our sexuality.
To give and receive affection is a wonderful feeling. If you like someone, be sure to let them know. If someone seems to like you, appreciate it. It is never too late to make new friends and strengthen bonds with longtime companions.
Intimacy is the capacity for a close physical or emotional connection with another person. Intimacy is a great protector against depression.
Talking with a confidant can help ease life's problems. When you lose a loved one, intimacy may be what you miss most. You may not find someone to fully replace a loved one who died, but you can begin to rebuild intimacy in your life in the following ways:
Sexually transmitted infections —also known as STIs or venereal diseases—are infections passed from person to person through sexual intercourse, genital contact, or contact with semen, vaginal fluids, or blood.
Older people may think of STIs as a problem that affects only young people. But because of physical changes related to age, older adults who are exposed to STIs may be more likely than young people to get STIs.
As you age, your immune system is not as strong, so it's harder to fight off disease. And women who are past menopause have thinner vaginal walls and less vaginal moisture than they did before menopause. Using a lubricant, such as K-Y Jelly, may keep you from getting a sore or a tiny cut on your penis or inside your vagina. This can reduce your risk of getting STIs or HIV.
Practice safer sex. For older adults, this means always using condoms and lubricants until you are in a monogamous relationship and know your partner's sexual history and HIV status.
STIs can affect anyone, no matter what his or her age. Talk openly with your partner about STIs, and take whatever precautions are needed to protect yourself before you engage in any form of sexual contact. If you think you may have an STI, see your doctor.
For more information, see:
Other Works ConsultedAgronin ME (2015). Sexuality and aging. In DC Steffens et al., eds., American Psychiatric Publishing Textbook of Geriatric Psychiatry, 5th ed., pp. 389–414. Washington, DC: American Psychiatric Publishing.American Geriatrics Society (2011). Safe sex for seniors. Available online: http://www.healthinaging.org/resources/resource:safe-sex-tips-for-seniors.Centers for Disease Control and Prevention (2008). What Persons Aged 50 and Older Can Do. Available online: http://www.cdc.gov/hiv/topics/over50/protection.htm.Johnson LE, Alline KM (2007). Sexual health. In RJ Ham et al., eds., Primary Care Geriatrics, 5th ed., pp. 401–407. Philadelphia: Mosby Elsevier.
ByHealthwise StaffPrimary Medical ReviewerAnne C. Poinier, MD - Internal MedicineE. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineMartin J. Gabica, MD - Family MedicineCarla J. Herman, MD, MPH - Geriatric Medicine
Current as ofMarch 16, 2018
Current as of: March 16, 2018
Author: Healthwise Staff
Medical Review: Anne C. Poinier, MD - Internal Medicine & E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine & Carla J. Herman, MD, MPH - Geriatric Medicine
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