Senior Sexual Health: Why it's Time to Drop the Taboos

As part of our population becomes older, one problem becomes more prevalent: senior sexual health. Due to misconceptions and stereotypes, the topic is sometimes not emphasized enough. Sexuality is a very important element of happiness and quality of life for all age groups [1]. The World Health Organization (WHO) defines an older adult as a person aged 60 years or older, and the population of older people is increasing [1]. By 2050, one in five people will be 60 or older, which is due to medical advances allowing people to live longer [1]. This increases the need for a conversation on senior sexual health. What are the general misconceptions and stereotypes? Misconceptions about senior sexual health cause discourse around the topic to be seen as taboo. There is a misconception that people completely lose the desire for sexual activity as they get older [1]. This is a false idea and is, unfortunately, believed by all different age groups. In reality, older adults do engage in sexual activity, while “almost half of partnered older adults engaged in sexual activity within the past 6 months,” [1]. Sexuality and sexual health are emphasized in young adults, leading to fewer conversations in the older population. The University of Chicago administered a survey in 2007 and found that over half of Americans continue their sex life into their 70s [2]. Misconceptions for Women There are more misconceptions about the sex lives of older women than men. One of these misconceptions is that aging women are not sexually active [3]. Data shows that sexual activity declines with age, for several reasons, but is still performed. In particular, there is a lack of understanding of female sexual function in older women. Sexual function in women is related to somatic (related to the physical body), psychosocial and neurobiological factors [3]. While women age, it is normal to have difficulties in sexual function. The changing of hormones leads to less sexual desire, and changes in the shape of the vagina can cause pain and discomfort during intercourse. There is also a decrease in blood flow to the genitals, which can cause a delayed or less intense orgasm [3]. Health issues are also the main reason for a decrease in sexual activity in older women; those who “rate their health as poor are less likely to be sexually active, and women with poor health who do remain sexually active often report sexual problems,” [3]. Health Issues One study found that age is not the reason for the decline in sexual activity; it is partner availability and health [1]. The body’s hormones change in many different ways that can affect sex life. Women experience a decline in estrogen and progesterone levels. This leads to less ovarian function causing menopause. Side effects of this can be reduced libido, lack of energy, osteoporosis, irritability, and mood swings [4]. For men, there is a decrease in testosterone levels and sperm production, which can cause a decrease in lean body mass, body hair, erectile dysfunction (ED), and an increase in fat [4]. Other than hormones, there are health issues that can also cause a decrease in sexual desire or more difficulty being sexually active [5]:

  • Alcoholism/Alcohol use- causes erection problems in men and delayed orgasm in women

  • Arthritis- can make sexual activity uncomfortable

  • Chronic pain- can make intimacy unenjoyable

  • Dementia- may cause a lack of boundaries and misunderstanding of appropriate behavior

  • Depression- possible lack of emotion and interest in sex

  • Diabetes- illness that can cause ED

  • Heart diseases- may take longer to become aroused, risk of cardiovascular incident

  • Uncontrollable bladder- can be increased during sex because of pressure on the bladder

  • Obesit