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Sex and sexuality communicate a great deal:
affection, love, esteem, warmth, sharing, and bonding. These gifts are as much
the right of older adults as they are of those who are much younger.
Three aspects of sexuality are covered in this topic: the changes that
come with aging, suggestions on how to adjust to these changes, and information
sexually transmitted infections.
healthy adults, pleasure and interest in sex do not diminish with age. Age
alone is no reason to change the sexual practices that you have enjoyed
throughout your life. But you may have to make a few minor adjustments to
accommodate any physical limitations you may have or the effects of certain
illnesses or medicines.
Most physical changes
are the result of gradually decreasing
testosterone levels. These changes affect energy,
strength, muscle and fat mass, bone density, and sexual function.
changes take place after
menopause and are the result of decreased estrogen
levels. These changes can be altered if a woman is taking
Not all women experience these problems. Those who do can
experiment to find ways to enjoy sex despite these physical changes.
In addition to
physical changes, there are cultural and psychological factors that affect
sexuality in later years. For example, in our culture, sexuality is equated
with youthful looks and youthful vigor. Too many people seem to think that as a
person ages, he or she becomes less desirable and less of a sexual being. Older
adults may accept this stereotype and buy into the notion that they are not
permitted or expected to be sexual.
Joy in sex and loving knows no
age barriers. Almost everyone has the capacity to find lifelong pleasure in
sex. To believe in the myth that older people have no interest in sex is to
miss out on wonderful possibilities.
Being single through choice,
divorce, or widowhood can present a problem also. As you get older, you may
not have as many people in your age group to choose from for partners. Women
and men who are single may not know how to deal with their sexual feelings.
Generally speaking, it is better to express your desires than to suppress them
until you are no longer aware that they exist.
emotional needs change with time and circumstance. Intimacy and sexuality may
or may not be important to you. The issue here is one of choice. If you freely
decide that sex is no longer right for you, then that is the correct decision.
It is possible to live a fulfilling life without sex. But if you choose to
continue enjoying your sexuality, you deserve support and encouragement. You
may still find uncharted sensual territories to explore.
Just as exercise
is the key to maintaining fitness and health, having sex on a regular basis is
the best way to maintain sexual capacity.
And just as it's never
too late to start an exercise program, it's never too late to start having sex.
Many older people who have been celibate for years develop satisfying sexual
practices within new loving relationships. For others, self-stimulation
(masturbation) is common and poses no health risks or side effects.
You may have sexual changes as you get older. But some changes may be the
first sign of a medical problem. So talk with your doctor about any changes
that concern you. He or she may be able to recommend treatments that will help
Here are some other considerations:
Sexuality goes far beyond
the physical act itself. It is part of who we are. It involves our needs for
touch, affection, and intimacy.
Touch is a wonderful and needed sensation.
Babies who are not touched do not thrive. Children who are not touched develop
emotional problems. Touch is important to older adults as well. Touch helps us
feel connected with others and enhances our sexuality.
To give and receive affection is a
wonderful feeling. If you like someone, be sure to let them know. If someone
seems to like you, appreciate it. It is never too late to make new friends and
strengthen bonds with longtime companions.
Intimacy is the capacity for a close
physical or emotional connection with another person. Intimacy is a great
Talking with a confidant can
help ease life's problems. When you lose a loved one, intimacy may be what you
miss most. You may not find someone to fully replace a loved one who died, but
you can begin to rebuild intimacy in your life in the following ways:
Sexually transmitted infections—also known as STIs or
venereal diseases—are infections passed from person to person through sexual
intercourse, genital contact, or contact with semen, vaginal fluids, or
Older people may think of STIs as a problem that affects
only young people. But because of physical changes related to age, older adults
who are exposed to STIs may be more likely than young people to get STIs.
As you age, your immune system is not as strong, so it's harder to
fight off disease. And women who are past menopause have thinner vaginal walls
and less vaginal moisture than they did before menopause. Using a lubricant,
such as K-Y Jelly, may keep you from getting a sore or a tiny cut on your penis
or inside your vagina. This can reduce your risk of getting STIs or
Practice safer sex. For older adults,
this means always using
condoms and lubricants until you are in a monogamous
relationship and know your partner's sexual history and HIV status.
STIs can affect anyone, no matter what his or her age. Talk openly with
your partner about STIs, and take whatever precautions are needed to protect
yourself before you engage in any form of sexual contact. If you
think you may have an STI, see your doctor.
For more information, see:
The National Center for HIV/AIDS, Viral Hepatitis, STD,
and TB Prevention is a branch of the Centers for Disease Control and Prevention
(CDC). Its website provides information and updates on sexually transmitted
diseases (STDs), human immunodeficiency virus (HIV), and tuberculosis (TB). You
can also find fact sheets on these health topics.
The National Institute on Aging (NIA), one of the
centers of the U.S. National Institutes of Health, leads a broad scientific
effort to understand the nature of aging and to extend the healthy, active
years of life. The NIA funds research and provides information about health and
research advances to the public and interested groups.
This website for older adults offers aging-related
health information. The website's senior-friendly features include large
print, simple navigation, and short, easy-to-read segments of information. A
visitor to this website can click special buttons to hear the text aloud, make
the text larger, or turn on higher contrast for easier viewing.
site was developed by the National Institute on Aging and the National
Library of Medicine, both part of the National Institutes of Health
(NIH). NIHSeniorHealth features up-to-date health information from NIH. Also,
the American Geriatrics Society provides independent review of some of the
material found on this website.
Other Works Consulted
Agronin ME (2009). Sexual disorders. In DG Blazer et al., eds., American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th ed., pp. 357–373. Washington, DC: American Psychiatric Publishing.
American Geriatrics Society (2011). Safe sex for seniors. Available online: http://www.healthinaging.org/resources/resource:safe-sex-tips-for-seniors.
Centers for Disease Control and Prevention (2008). What Persons Aged 50 and Older Can Do. Available online: http://www.cdc.gov/hiv/topics/over50/protection.htm.
Johnson LE, Alline KM (2007). Sexual health. In RJ Ham et al., eds., Primary Care Geriatrics, 5th ed., pp. 401–407. Philadelphia: Mosby Elsevier.
Potter J (2009). Female sexuality: Assessing satisfaction and addressing problems. In EG Nabel, ed., ACP Medicine, section 16, chap. 22. Hamilton, ON: BC Decker.
May 29, 2012
Anne C. Poinier, MD - Internal Medicine & Carla J. Herman, MD, MPH - Geriatric Medicine
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