How does aging affect sexuality?

Sexuality is the desire and ability to have sex. Aging brings emotional, social, and physical changes that may affect sexuality.

What are the positive changes?

• Many older people feel relieved that they no longer have to worry about using birth control when they have sex.
• Older adults know more about what gives them pleasure sexually. They may be more willing to let a partner know what pleases them.
• 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.

How do social and family changes affect sexuality?

Examples of social and family changes that might affect sexuality in older adults are:

• Trouble adjusting to retirement
• Worry about children, your partner’s health, finances, or life choices
• Illness and disability
• The death of friends or family members

Empty nest syndrome refers to the loss that parents may feel when their children move away from home. Empty nest syndrome can affect both parents, but women seem to be most affected. Once the last child moves out, the mother may feel more alone than ever before and unsure of what her future may hold. She may get sexually assertive for the first time. Her partner may either welcome the change or feel threatened by it.

How do relationship changes affect sexuality?

Many older couples feel a sense of sameness and boredom in their relationship. This can affect sexual interest.

The quality of your relationship depends on how well you communicate. Good communication means that you are not afraid to express what you really think and feel and that your partner trusts you the same way. This can help your relationship stay satisfying for both of you.

Loss of interest in sex may be a sign of depression. Therapy, medicine, and sexual therapy may help. Couples may benefit by seeing a therapist together.

How do physical changes affect sexuality?

Physical problems can affect the sex lives of older adults. It is important to talk with your partner to prevent confusion about what you are feeling. For example, you may stop having sex because of a physical problem. If you don’t talk about it, your partner may feel rejected.

• Alcohol and medicines: Heavy use of alcohol can cause sexual problems. Medicines, such as drugs used to treat arthritis, high blood pressure, or depression, can cause problems with erections. Some medicines may lower sexual desire.
• Smoking: Men who smoke are more likely to have problems with erections than those who do not.
• Arthritis: Joint pain from arthritis may make sex uncomfortable. The fear of pain may also keep you from wanting to be close to your partner.
• Diabetes: Diabetes may cause trouble having an erection or keeping it firm enough for sex (erectile dysfunction).
• Obesity: Men who are obese are more likely to have erectile dysfunction (ED) than men with healthy weights.
• Heart disease: If you or your partner has a heart problem, you may be afraid that sex will cause a heart attack. Sex puts less of a strain on the heart than most people think. Sex is a normal and healthy part of relationships and is important to self-esteem. Most people can start having sex again 12 to 16 weeks after a heart attack.
• 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 sex to allow for body weakness or paralysis.
• Treatment for medical problems: Some medicines, chemotherapy, or surgeries may also affect your sex life.
• Hormonal changes:
  • Male hormone (testosterone) levels decrease with age. Men over 60 have less rigid erections and have erections less often than younger men. Older men take longer to ejaculate. It’s also harder for them to know when they are about to ejaculate. The ejaculation itself is not as forceful as it used to be.
  • As women age, the walls of the vagina get thinner. This may cause tenderness or bleeding during sex. It takes longer for the vagina to get wet in women over 40. Some women have pain or cramping during sex.

What can I do to help myself?

Talking with your partner may be the most important part of a healthy sexual relationship. Open and effective communication can go a long way in solving sexual problems. Other things that can help include:

• Talk to your healthcare provider if you have a problem with alcohol or if you think that a medicine you take is affecting your sex life. Your provider may prescribe a medicine that is less likely to cause the sexual problems.
• If you have arthritis, exercise, rest, and warm showers may help. Trying different positions during intercourse may also help. For example, you may find that lying on your side when you have sex puts less stress on your joints.
• If you have diabetes, high blood pressure, or high cholesterol, treating those problems may help with erectile dysfunction. Lose weight if you are overweight.
• If you smoke, try to quit.
• 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. Share a romantic dinner, dance, or give each other a massage. Cuddling, kissing, and sharing fantasies can be healthy and satisfying even without intercourse. Tell and show your partner what feels good and how you like to be touched.
• For vaginal dryness, using a water-based lubricant may help. Ask your healthcare provider if estrogen vaginal creams are right for you.
• If you have sex with a new partner, use latex or polyurethane condoms during foreplay and every time you have sex. Pregnancy may not be a concern, but you can still get sexually transmitted infections (STIs) if you don’t practice safe sex.
• If you have problems with erectile dysfunction, your provider may prescribe medicines to treat the problem.

Some short-term sexual problems are common. You need not worry about sexual problems if they only last a short time. However, if you continue to have problems, talk with your healthcare provider.