Seniors and Sexual Health: What Older Adults Should Know
There’s no retirement age for desire.
By Lisa Esposito, Staff Writer | March 16, 2016
Older people have sex for the same reasons anyone else does: pleasure, intimacy, excitement, togetherness and fun. Some health concerns don’t change, like the need to practice safe sex. Physical limitations and medical conditions can pose challenges as people reach their 60s, 70s and 80s, but workarounds exist.
Whether you’re a baby boomer or beyond, you should feel comfortable talking to doctorsabout sex-related matters – and they should feel comfortable talking to you. And since sex starts in the mind, an open attitude and healthy dose of self-esteem can go a long way toward a satisfying sex life at any age.
What People Want
In 2014, the American Sexual Health Association collaborated on a survey of some 3,000 adults ages 40 to 74 who were in a committed relationship. Two-thirds said that their sex life influenced their overall satisfaction more than time spent on themselves or the quality of their friendships. And the majority said they felt happy and healthy when their sex life was healthy.
However, nearly half of those surveyed said they’d like to increase frequency of sex. While participants reported having sex an average of five times a month, men said they’d to prefer to have sex 10 times a month; for women, eight was the magic number.
“Based on survey responses, men and women had different priorities on improving sexual intimacy,” says Fred Wyand, director of communications for ASHA. “Women, for example, said their priorities were improving the ability to have an orgasm, emotional bonding with their partners and just a general enjoyment of sex.”
“Men were much more likely to focus on the physical ability to have sex, where the functioning aspect was more important to guys,” Wyand says. “And also being able to experiment and try new things.”
STDs at Any Age
Older isn’t necessarily wiser when it comes to preventing sexually transmitted diseases. Condom use for vaginal intercourse is lowest among the oldest adults, according to the National Survey of Sexual Health and Behavior, conducted by Indiana University researchers. Among adults age 61 and older who were surveyed, only 5.1 percent of men and 7.4 percent of women used condoms during recent sex.
“Part of it is because for older people, the sexual-health disaster of their generation was an unwanted pregnancy,” Wyand says. “They may not be thinking about protection when in fact seniors are just as susceptible to STDs as anybody else.”
It’s not surprising that seniors are less aware of the risks. “If you go to an STD clinic and look at the brochures around AIDS or around chlamydia and gonorrhea, they don’t have people with wrinkles and gray hair on the front of those brochures,” Wyand says. “And they need to.”
Health care providers who prescribe erectile dysfunction drugs to older men and topical hormones and vaginal lubricants to women after menopause don’t always counsel them on safe sex and STD precautions.
Older women should feel empowered to talk to their partners about safer sex, Wyand says, and insist on condom use if they want it. The female condom is another option, he notes. “That’s something we don’t talk about a lot, but it’s a woman-controlled barrier method of contraception.”
Obstacles and Options
It’s undeniable that seniors can face certain challenges to a satisfying sex life. “Chronic illness is one of the leading problems, especially for older adults,” says Sallie Foley, a sex therapist, sex educator and sex therapy supervisor. Diabetes, prostate surgery after cancer, severe arthritis, memory issues or a partner’s dementia can all affect someone’s sex life. Heart disease and medications to treat them may have sex-related side effects.
Older men with erectile issues should talk to their physicians about solutions, says Foley, who teaches in the University of Michigan graduate school of social work and is the director of the University of Michigan Sexual Health Certificate Program. Doctors may be able to substitute for certain medications that can cause problems with erections.
Anyone who’s ever turned on a TV knows about erectile dysfunction pills like Viagra and Cialis. But men may not know about self-injection drugs for ED, which can produce better erections than pills, Foley says. The short-needle injection, given in the shaft of the penis, causes no more discomfort than a similar injection in the upper arm, she adds.
Late or delayed ejaculation is a bigger problem, Foley says, with fewer ready solutions. Fatigue can be part of the cause, she says, along with neurologic issues due to chronic illness.
When people are distressed about their sex lives, it’s time to seek professional help, she says, starting with a doctor who’s comfortable talking about sex.
A gynecologist can help women with sexual problems related to menopause. A urologistcan determine the causes for men’s sexual issues, while a sex therapist can help couples find ways to work around any limitations and continue to enjoy sex. The American Association of Sexuality Educators, Counselors and Therapists can help you locate a specialist in your area.
Time and Space to Relax
Juggling multiple career and family responsibilities can cramp people’s sex lives, Foley says. She’s heard from people in their 60s and 70s who want to enjoy sex in a relaxed, private atmosphere, but they can’t get their millennial kids out of the basement, and they’re caring for their 94-year-old mother-in-law who’s living upstairs.
People in their 60s and 70s don’t have as much physical energy in reserve as young or middle-aged adults, Foley says, and they’re more vulnerable to fatigue. “So they have to take good care of their bodies, and that requires time,” she says. “A lot of times, the first thing to go is time for pleasurable sex. People in their 40s can actually push through fatigue much easier than people in their 70s can.”
In some ways, sexuality can improve once a woman is done with menopause. “Postmenopausal women feel a kind of surge of energy,” Foley says, sometimes described as “postmenopausal zest.” With menopause out of the way, she says, energy returns along with a new ease of attitude. “Women often feel like, ‘This is the body I’m in. I’m not going to try to get into 3-inch stilettos anymore. And I’m comfortable with who I am,’” she says.
That’s consistent with what’s seen among long-term, older couples, Foley says: “Even though their bodies have changed, they’re much more interested in the engagement and vitality people bring to life when they’re in their 60s and 70s.”
The extent of certain changes from aging, such as hormonal shifts, can be overstated. “There’s a tendency to dwell on that,” Foley says, noting that if a woman still has her ovaries, she continues to make testosterone well into her 80s. “Older adult women are very vital,” she says. “They continue to be orgasmic well into their 90s.”
Moving Past Misconceptions
Negative cultural stereotypes can inhibit sexuality for some older women, Foley says. “They sometimes withdraw from enjoying their bodies, getting dressed in the clothes they like, enjoying life,” she says. For older women who want to find partners but don’t feel desirable, she says, “If they can get into counseling and get into exercise so they can feel strong and good in their bodies, they usually increase their self-esteem.”
One of the biggest misconceptions about older adults is that they lack passion, Foley says. “Some people have had this extraordinary long-term partnership where they remain very passionate,” she says. “And other people who are widowed or divorced, when they fall in love and they’re in their 70s or their 80s, they feel the same way as people who fall in love in their 20s. They’re gaga for the person. And their sex is great.”