.jpg)
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
Obesity- increased risk of ED issues
Stroke- can cause weakness or paralysis that makes having sex difficult
Medications can also play a role in sex life. With age, more people tend to be on daily medications for health concerns. Some drugs can have side effects such as ED, difficulty ejaculating, difficulty with arousal and orgasm, reduced sexual desire, and vaginal dryness [5]. This is more common in medications used for regulating blood pressure, antihistamines, antidepressants, sedatives, Parkinson’s disease, cancer, appetite suppressants and anti-ulcer drugs [5]. This can sometimes be resolved by switching to a new medication; talk to your health care provider to see if this is possible.
With the increase of the older population and the development of chronic disease (CD), sex can help those with CDs feel a sense of ‘normality’ [6]. Intimacy can be a great factor in the quality of one’s life that struggles with CD and, for many, be something to look forward to.
How Sex can be Different Later in Life
Sex is closely related to emotional and physical states of being. With age, people are experiencing changes in both, which can change their sexual experiences entirely. When it comes to physical changes, this may determine how you feel about yourself and what is comfortable or uncomfortable for you. As for emotionally, some couples feel even more connected with age, which drives their sexual desire even further. Older couples may have more time to stay connected, no concerns with pregnancy and a deeper connection [5]. Couples with more experiences together may feel more comfortable expressing their wants and needs, which can make their sex life better.
Safer Sex at Any Age
Given the misconception that older people end their sex life, there is less emphasis on safer sex in the age group. Every age group should practice safer sex since anyone can contract a sexually transmitted disease (STD). Those who are sexually active are at risk of contracting HIV, while older people are also at risk for syphilis, gonorrhea, chlamydial infection, genital herpes, hepatitis B, genital warts, and trichomoniasis [5]. In order to protect yourself from any STDs, it is important to incorporate safer sex practices, like the following, in all age groups:
Use a condom for vaginal or anal sex
Use a dental dam during oral sex
Don’t be afraid to get tested and ask about your partner’s sexual history
What can you do?
There are many different ways older people and couples can continue to enjoy their sex lives as they age. Having conversations with your partner about sexual activity and any new emotions or physical changes that are holding you back can help better your sex life. Talking to a therapist may also be a great option. This can be done with or without your partner, and it can help you navigate ageing and all the changes that come with it. Talking to your doctor about any sexual health issues is also important. Depending on the issue, medication can be prescribed to help, such as prescribed lubricants to help having sex be a more comfortable experience.
In order to end the misconceptions and stereotypes, there needs to be more awareness around senior sexual health. Better awareness can help be achieved through programs and organizations. Awareness and conversation are important aspects of sexual health in all age groups, not just young adults.
References:
1. Freak‐Poli, R. (2020). It’s not age that prevents sexual activity later in life. Australasian Journal on Ageing, 39(S1), 22–29. https://doi.org/10.1111/ajag.12774
2. Harvard Health. (2010, December 1). Sex in the second half. https://www.health.harvard.edu/newsletter_article/sex-in-the-second-half
3. Kuhle, C. L., Zhang, X., & Kapoor, E. (2021). Misconceptions About Sexual Health in Older Women. Mayo Clinic Proceedings, 96(4), 866–869. https://doi.org/10.1016/j.mayocp.2020.09.037
4. Banke-Thomas, A., Olorunsaiye, C. Z., & Yaya, S. (in press). “Leaving no one behind” also includes taking the elderly along concerning their sexual and reproductive health and rights: a new focus for Reproductive Health. Reproductive Health.
5. National Institute of Health. (2017, November 30). Sexuality in Later Life. National Institute on Aging.
6. Rezasoltani, P., Merghati-Khoei, E., Pirak, A., & Yazdkhasti, M. (2016). Sexuality and elderly with chronic diseases: A review of the existing literature. Journal of Research in Medical Sciences, 21(1), 136.
Contributors:
Author: Sophie Gangi
Editors: Lauryn Agron and Terin Buckley
Health scientist: Dora Sow