Sexuality in the Later Years

How does age affect sexuality?

Sexuality is the desire and capability for sexual activity. Sexual activity is likely to change over time for older adults. This does not mean that sex at age 78 is not as good as it was at age 18, but it is different. There are positive and negative changes.

Many people are greatly relieved that they no longer have to worry about pregnancy when they have sex. Also, older adults know more about what brings them pleasure sexually. They may be more willing to let a partner know about their desires.

Premature ejaculation is almost never a problem in older men. They often take longer to reach orgasm. A female partner might welcome this because it allows her more time to reach orgasm as well.

Women tend to reach a sexual peak at a much later age than men do. This means, for example, a 50-year-old woman may have a stronger sex drive than when she was younger.

Many sexual problems in older people are caused by worry. Worrying about changing circumstances or about health (their own or their partner's) may cause sexual problems. In men, fear of erectile dysfunction (when a man can't get an erection or can't keep an erection long enough to finish having sex) may create sexual problems. Counseling as well as medical treatments can be very helpful in these circumstances.

Do physical problems affect sexuality?

There are many physical conditions that may affect the sex lives of older adults. It is important to talk with your partner to prevent confusion. For example, you may stop having sexual relations with your partner because of a physical problem. If you don't talk about it, your partner may just feel rejected.

Alcohol and medicines: Heavy use of alcohol can cause sexual problems in men and women. Medicines, such as those used to treat arthritis, high blood pressure, or depression, can cause impotence and reduced sexual desire. Talk to your health care provider if you have a problem with alcohol or if you think your medicine is affecting your sex life.
Arthritis: Joint pain due to arthritis may make sex uncomfortable. Exercise, rest, warm baths, or a change of medicine may help. Trying different positions during intercourse may also help. For example, one position that does not put stress on joints is for partners to lie on their sides with one "spooning" the other.
Diabetes: Diabetes may cause erectile dysfunction. Control of the diabetes often takes care of the problem.
Heart disease: If you or your partner has a heart problem, you may fear that sex will bring on another heart attack. In fact, most people can resume sex 12 to 16 weeks after a heart attack. Talk to your health care provider if you have concerns.
Hormonal changes: Male hormone (testosterone) levels decrease with age. Older men may need direct stimulation of the penis to get an erection. Older women may have thinning of the membranes in the vagina as they age. This may result in tenderness or bleeding during sex. Using a water-based lubricant, available in drugstores and grocery stores, may help. If pain or bleeding persists, even with the use of lubricants, talk with your health care provider.
Stroke: A stroke rarely affects your ability to have sex. Sexual activity is not likely to cause another stroke. You and your partner may need to explore different positions during intercourse to allow for body weakness or paralysis.
Surgical removal of womb, breast, or prostate: In most cases, surgery to remove the uterus, breast, or prostate gland does not affect your ability to have sex.

Other ideas that may improve sexual satisfaction for older adults include:

Try making love in the morning. Being well-rested after a good night's sleep can mean good sex. Older men are more likely to have a firm erection in the morning.
Focus on foreplay. Sharing a romantic dinner, dancing, or giving each other massages can help enhance sexual activity.
Cuddling, kissing, mutual masturbation, and shared fantasy can be healthy and fulfilling even without intercourse.

Medicines to treat erectile dysfunction, such as Viagra, Levitra, or Cialis should only be used after you have been evaluated by your health care provider.

Aging does not protect you from sexually transmitted diseases. Learning about safe sex, such as using condoms, will protect you and your partner from infection. Enjoy your sex life but take care of yourself at the same time.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File AGI3034F.HTM Release 9.0/2006