Are there special concerns?

When it comes to older adults, most people don’t realize that they have active sex lives, just like younger people. The connection and intimacy this provides are important. However, are there special considerations that seniors should be worried about? Should their families be aware of anything?

Sex is typically associated with reproduction, youthful attractiveness, and power. As a result, sexual intimacy among older Americans isn’t a subject that’s talked about. However, there’s no age limit on sexuality and sexual activity. Sexuality, sexual expression, and the urge for physical intimacy is a vital part of every adult person’s life. The frequency and ability to perform sexually generally declines as individuals experience the normal physiological changes that accompany aging. Despite this, reports show that most men and women between the ages of 50 and 80 are still enthusiastic about sex and intimacy. In fact, a Duke University study shows that around 20% of people over 65 have sex lives that are better than ever before. This number will only increase because, by the year 2030, the US Census Bureau estimates that one in every five Americans will be 65 or over.

Basic human psychology shows that people need people. Numerous studies have demonstrated that married people live longer. The more intimate the connection, the more powerful the effects. It’s vital to understand that sex good for your physical and emotional health. It causes the release of good brain chemicals, such as norepinephrine, serotonin, oxytocin, vasopressin, nitric oxide, prolactin, and endocannabinoid. A survey from AARP found that the majority of men and women over 45 say a satisfying sexual relationship is essential to the quality of life. For those 45 to 59, around 56% said they had sexual intercourse once a week or more. Among 60- to 70-year-olds, 46% of men and 38% of women have sex at least once a week. Of those 70 or older, 34% had sex at least once a week. Similar findings came out in a survey conducted by the National Council on the Aging (NCOA).

As we age, our relationships take on increased importance as children and careers take a backseat. Sex is a meaningful way to connect. Many older couples find greater satisfaction in their sex lives than they did when they were younger. This often results from fewer distractions, having more time/privacy, no worries about getting pregnant, and greater intimacy with a lifelong partner. Another benefit is older people often have a great deal more self-confidence and self-awareness. Also, they’re freed from the unrealistic ideals of youth and the prejudices of others. This independence and self-confidence can be desirable to your spouse or potential partners.

Although your interest in sexual activity continues as you age, people tend to have less intercourse as they get older. Normal aging causes changes that can affect sexual function and interest. Some of these changes are physical and can affect a person’s ability to have and enjoy sex. Others are our mental responses to these changes. Some older adults don’t feel comfortable with their aging bodies and worry that their partners will no longer find them attractive. If you can accept these changes, you’ll not only feel better, but you’ll be more confident, making you more attractive to others.

For women, physical changes, usually related to menopause, can make sex less enjoyable. Menopause is 12 straight months without a period. As women approach menopause, their estrogen levels decrease, leading to vaginal dryness and slower sexual arousal. Also, a woman’s vagina will shorten and narrow, and the vaginal walls become thinner and stiffer. Combine this with less vaginal lubrication; it’s not surprising that the idea of vaginal penetration is less desirable because it’s more painful. This doesn’t mean that women can’t enjoy sex after menopause; it just means it might take longer to achieve enough vaginal lubrication to be ready for sex. You can try using water-based lubricating jelly or lubricated condoms. Another option is using toys or devices with a partner. Emotional changes associated with menopause can increase feelings of stress, which can alter your interest in sex. Women and their partners need to be aware of the role this plays. It’s critical to note that some women using hormone therapy to treat hot flashes or other menopausal symptoms may want to have sex more often than they did before.

An issue that older women face more than men is finding a partner. The AARP study discovered that only 32% of women 70 or older have partners, compared with 59% of men in the same age group. The trend occurs for two reasons. The first is women live longer than men. The second is healthy older men tend to pair up with younger women. This gap significantly inhibits women’s social and sexual activity as they reach their senior years.

For men, testosterone levels gradually decline throughout adulthood. It decreases about 1% each year after 30. This can result in erectile dysfunction (ED), which is the loss of ability to have and keep an erection. As men age, it becomes more common. Close to two-thirds of men over 70 have ED. Not only does it take longer for men to achieve an erection, but their erections also usually aren’t as firm, it takes longer to achieve orgasm, and they have a longer refractory period. This can be worsened by many age-related conditions and the medications used to treat them, such as high blood pressure, atrial fibrillation, pain, enlarged prostate, prostate cancer, stomach ulcer, depression, and anxiety.

Any medical condition that affects your general health and well-being can also affect your sexual health. These can include arthritis, chronic pain, diabetes, heart disease, incontinence, depression, stroke, dementia, and Parkinson’s. Arthritis causes joint pain that can make sexual contact uncomfortable. Some easy ways to overcome this is resting, warm baths, and changing the position or timing of sexual activity. Diabetes can trigger ED in men and vaginal yeast infections in women. Heart disease causing narrowing and hardening of the arteries throughout your entire body, so blood doesn’t flow freely. This makes it harder for both men and women to become aroused. Incontinence is the loss of bladder control or leaking of urine. It’s more common as people, especially women, grow older. The extra pressure on the stomach during sex can cause this to occur. To prevent it, try changing positions or emptying your bladder before and after sex. Depression causes a lack of interest in activities you used to enjoy. This can include intimacy and sexual activity. Dementia can be problematic for a couple of reasons. Some people with dementia show increased interest in sex and physical closeness, but they can’t judge appropriate sexual behavior. For instance, they might not recognize their spouse or partner and seek sexual contact with someone else. Parkinson’s disease produces stiffness, slowing, and trouble with the autonomic nervous system, which is involved in erections and orgasm. Certain surgeries, like hysterectomy or mastectomy, may cause some women to lose their sexual interest or leave them feeling less desirable or attractive to their partners. Men can experience a similar situation with a prostatectomy. Obviously, if you’re ill, your sexual desire may take a back seat because pain, discomfort, medications, or worry can overshadow it. If you’re the caregiver, the demands of caring for your partner can affect your sexual desire.

The key to maintaining a satisfying sex life throughout your entire life, not just as you age, is communication. Set aside time to talk to your partner about what you’re feeling physically and emotionally. It’s helpful to be honest while not placing blame. An excellent way to do this is by using “I” statements. Use humor, gentle teasing, and even tickling to keep the mood light. Also, listen to your partner’s needs and desires. Together you can find ways to accommodate both your needs. If you’re having trouble talking to your partner, you may find it helpful to speak with a therapist, either alone or with your partner. Sex therapists are professionals with additional training in sex therapy. They usually come from a background of social work, psychology, nursing, or medicine. Most will explore root causes of difficulty and provide practical strategies/techniques (ex. positioning, use of aids) to improve your experience. It’s vital to note that they rarely offer sex surrogacy or have sexual contact with the client.

It’s vital to keep in mind that there are many different ways to have sex and be intimate, such as cuddling, kissing, hugging, and stroking. This is referred to as outercourse. It’s about pleasure and connectedness, not penetrative sex. Also, many people get immense gratification from sharing sexual fantasies and reading erotica together. In addition, try stretching your experience by starting with a romantic dinner, or breakfast, and participating in an activity that brings you closer before trying to engage in sex. During this time, hold hands, touch your partner often, and encourage them to do the same.

If you have physical concerns impacting your sex life, don’t be afraid to talk with your doctor. Many studies show that only a small portion of seniors who could be treated for sexual problems actually seek medical help. Don’t be alarmed if your doctor seems reluctant to talk about sex with you. A survey in the Journal of Clinical Gerontology and Geriatrics reveals that only 58% of geriatricians occasionally ask about sexual function in their patients, and the rest never do. When you consider the number of elderly individuals who are sexually active, this leaves a gap in the comprehensive care of older adults. It also makes it harder to recognize the symptoms of some sexually transmitted infections. Age doesn’t protect you from them. You’re at risk if you or your partner has more than one sexual partner, if you are having unprotected sex, or if either you or your partner is sharing needles. To prevent an infection, go for regular checkups and always use a condom unless you’re in a long-term monogamous relationship and you’ve both tested negative for sexually transmitted infections.

There are some considerations for staying sexually fit. Individuals, both men and women, who experience frequent genital stimulation are more easily aroused. One way to do this is to masturbate, which is a normal part of a healthy sex life. For those who find certain positions uncomfortable, rearrange pillows or look into purchasing specialized foam wedges. If you’re concerned about being “fit” enough for sex, most doctors recommend remembering that if a person is fit for exercise, they’re also fit for sexual activity. Doctors also suggest limiting alcohol because too much can cause erection problems in men and delay orgasm in women.

Many people want and need to be close to others as they grow older. For some, this includes the desire to continue an active, satisfying sex life. Typically, this means adapting sexual activity to accommodate physical, health, and other changes. Some choose not to engage in sexual activity, and that’s normal too. The key to a great sex life is finding out what works for you at the moment.