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. Some of the positive changes are:

• 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.

Many sexual problems in older people are caused by worry about changing circumstances or health. In men, fear of erection problems may create sexual problems or make them worse. Counseling as well as medical treatments can be very helpful in such cases.

How do physical problems 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 sexual relations with your partner 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. They may lower sexual desire. Talk to your healthcare provider if you have a problem with alcohol or if you think your medicine is affecting your sex life.
• Arthritis: Joint pain from 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, you may find that lying on your side when you have sex puts less stress on your joints.
• Diabetes: Diabetes may cause erection problems (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 be afraid that sex will cause another heart attack. In fact, most people can start having sex again 12 to 16 weeks after a heart attack. Talk to your healthcare provider if you have concerns.
• Hormonal changes: Male hormone (testosterone) levels decrease with age. Older men may need more physical contact to get an erection. Older women may have thinning of the walls in the vagina. This may cause tenderness or bleeding during sex. Using a water-based lubricant may help. If pain or bleeding persists, even with the use of a lubricant, talk with your healthcare 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 sex to allow for body weakness or paralysis.

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. Share a romantic dinner, dance, or give each other a massage.
• Cuddling, kissing, masturbating together, and sharing fantasies can be healthy and satisfying even without intercourse.

Men should use medicines to treat erectile dysfunction, such as Viagra, Levitra, or Cialis, only after being evaluated by their healthcare 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.