While the frequency of sex often declines with age, many older adults—of course—can and do have sex. In fact, roughly 40 percent of men and women ages 65 to 80 are sexually active, according to a 2017 survey, and women in their 70s often express more satisfaction with sex than women in their 40s.
That said, and even though sexual activity is considered an important measure of the quality of life for the majority of older adults, there are a number of problems that can arise with age.
While treatments have improved for conditions such as erectile dysfunction in men and vaginal dryness, incontinence, and uterine prolapse in women, people may not bring these concerns to their doctor’s attention. To add to the problem, far too few doctors ask.
Understanding more about what sex in older age can be like, what else may be affecting your sex life and how to address it, and ways to maintain or even jumpstart this kind of intimacy can go a long way in you being able to continue to enjoy this part of your life.
Until recently, there have been relatively few studies and surveys that have looked into how often older adults are having sex, and the results have been surprising to some.
A 2017 National Poll on Healthy Aging conducted in association with the University of Michigan confirmed what some earlier studies have found with regard to sexual activity in older adults:
- Among men and women ages 65 to 80, 40 percent were still having sex.
- Among those who were in romantic relationships, the rate rose to 54 percent.
- An even higher percentage of men (but fewer women) claimed they were still very interested in sex.
- Despite this gap, more women than men reported that they were sexually satisfied.
- For those who had concerns, only a relatively small number admitted to talking to their doctors about their sex lives.
Similar findings were noted in the British Longitudinal Study of Aging, though older men were much more likely to be sexually active than older women. In this study, 31 percent of British men between the ages of 80 and 90 reported masturbating and having sex, with just under 60 percent of men ages 70 to 80 being sexually active. Meanwhile, only 14 percent of women between the ages of 80 and 90, and 34 percent of women ages 70 and 80 regularly engaged in sex or masturbation.
Despite less sex in older women than men, a study by the National Commission on Aging (NCOA) found that women over the age of 70 reported sex to be more physically satisfying than in their 40s. Sex was also shown to be more emotionally satisfying for both genders.
Sexual Problems in Older Adults
From the normal aging process to medical conditions to the partner gap, there are many changes that can affect whether older adults are having sex or feeling satisfied with their sex lives.
Normal Aging of Sexual Organs
The normal aging process can lead to changes in sexual organs, and sex and intimacy often need to be redefined to remain a fulfilling part of life. As a woman ages, her vagina can shorten and narrow, her vaginal walls can become thinner and stiffer, and she will experience less vaginal lubrication. As men get older, impotence (also known as erectile dysfunction, or ED) becomes more common.
Conditions That May Interfere With Sex
Chronic medical conditions become more common with age and can add to the normal aging process to cause sexual problems. Some of these include:
- Chronic pain
- Arthritis: Sore joints can make certain sexual positions very uncomfortable.
- Cancers: Cancer, in general, can reduce sexual interest, with cancers such as breast cancer and prostate cancer affecting body image as well.
- Heart disease (see below)
- Obesity: Obesity appears to interfere with sex for older women but not older men.
- Stress incontinence: Some women are afraid to let go as they may pass urine with orgasm.
- Neurological conditions: Conditions such as Parkinson’s disease, multiple sclerosis, strokes, and Alzheimer’s disease can affect sex in many ways.
- Substance abuse
- Medications: Drugs such as some antidepressants, some blood pressure medications, and many more can lead to erectile dysfunction in men or an inability to have an orgasm for women.
One of the important factors in looking at the statistics about sex with aging is that fewer older women than men have partners. In addition, for women who do have partners, it’s more common for the man to be older, and therefore more likely to have conditions that interfere with sexual activity.
In other words, the lower rate of sexual activity in older women may not be due to lack of interest or changes that make sex uncomfortable, but rather a perceived lack of opportunity.
Maintaining or Jumpstarting Your Sex Life
There are many physical and emotional benefits of having sex as you age. It seems fairly obvious that a healthy sex life would improve intimacy in older couples, and research backs that up. A 2017 study of older Irish adults found that more frequent sexual activity was correlated with less strain in the relationship. So where can you begin if your sex life has become stagnant, or even if you just fear it will with age?
In order to maintain a fulfilling sex life as you grow older, it can be crucial to rethink what sexual intimacy means to you and your partner. What felt good on some parts of your younger body may not feel so good as your body ages. Likewise, there may be some things you enjoy now that you didn’t like in the past. Do you still enjoy the same things in bed, or is it time to try something new? This concept applies to many areas of sexuality. A sexy nightgown that was once a turn-on, may do the opposite now, but that doesn’t mean something is lost. Instead, that more “superficial” turn-on may now be replaced with something much deeper, but no less sexual.
Could it Be Even Better?
If you are mourning the excitement of young love and young bodies, it may feel like the best sex is a thing of the past. Accepting that sex will be different now is important; the fountain of youth has yet to be found, and if you’re focused on what was, you will be disappointed. It’s hard to move forward and appreciate the present if you’re remembering the greener grass on the other side of the fence.
This letting go is important, because sex cannot only be as good, it can be better! Sex isn’t just physical but an emotional expression of intimacy. And with older adults, that intimacy has often been nourished and developed over decades. Many people look back and remember amazing sex, but forget the inhibitions of their younger years. Older adults have the advantage that they are more self-aware (they know their body and what excites them) and more self-confident—attributes that not only improve desire but can spark a partner’s desire as well.
Research has also found that the definition of sexual activity in older adults is broader than that of younger adults, offering more options instead of less with age. With children gone, and fewer daily demands on time, there is often more time and privacy to explore and be creative.
Fake It ‘Till You Make It
Many sex therapists recommend that older couples “just do it,” instead of waiting for the desire. In other words, you may need to “fake it ’till you make it” at first, especially if your sex life has become very stagnant. This recommendation makes sense from an emotional standpoint. We know from research looking at habits, that “just doing it” or getting started is often the most difficult step. Even if you’re not in the mood, having sex can set the pace for more frequent sex in the future.
But there are physical reasons to just do it as well. Decreased vaginal lubrication is the norm in women as they age, and having sex actually increases lubrication in time. It also increases vaginal elasticity, leading to greater comfort with sex in the future. Orgasm releases oxytocin in both men and women, a hormone that not only aids in sleep (and getting enough sleep is important in desire), but induces a sense of calm (and stress is a sex life killer). You can even consider sex as a “workout,” knowing that physical activity improves desire. It may feel forced and artificial at first, but give it some time.
Good sex begins with good communication. If your partner doesn’t seem to be interested in sex, talk about it. That sounds very simple, but in reality, it is not. Communicating about sex can be challenging at any age, but when you have been with someone for many years, it’s easy to “assume” what they are thinking rather than ask. Nobody, however, can read minds. You may assume that your partner has no interest or isn’t turned on by you when in reality he or she has great interest but is afraid of “performing” well enough to please you.
The level of intimacy shared with a long-term partner is a factor that can make sex better than it was in younger years, but continually building intimacy is important even in old age. Just as you may need to “just do it” when it comes to the physical act of sex, you may need to “just do it” when it comes to expressing intimacy in non-sexual ways. Candles, fine wine, and music aren’t just for the younger crowd.
Treatment of Sexual Problems Related to Aging
Even though it appears that older people talk to their doctors about sexual problems only infrequently, those questions exist. A quick look online finds people wondering how to raise desire in a 75-year-old woman, or how to arouse a man who is 80. Where should you begin if you and/or your partner are experiencing sexual problems?
Types of Sexual Dysfunction
The first step in looking at sexual problems is to learn what phase or phases of the sexual response cycle are of most concern. These five phases include:
- Desire or libido
- Arousal (excitement)
A person may have normal desire and arousal, but be unable to have an orgasm, or instead, arousal and orgasm may occur, but there is little desire to initiate sex. Certainly, there are many combinations, and dysfunction can affect both members of a couple in some way.
Visit Your Doctor
Regardless of the type of dysfunction, you are experiencing, a good first step is to see your doctor. Understanding what phase of sex is most problematic can help your doctor better evaluate the potential causes. For example, there are many causes of low libido in women that may be affecting desire. Sometimes an emotional issue may be at play, but other times it may be an easily treatable medical condition such as thyroid disease (thyroid disease is associated with a low sex drive).
Common Sexual Problems in Women
Many of the issues that can lead to sexual problems in women are treatable. Common problems include:
- Vaginal dryness: There are many options for vaginal dryness including lubricants and moisturizers, topical and oral hormonal treatments, and non-hormonal treatments. There are also plant-based supplements that may have estrogenic effects on the vaginal tissues, but these should be used with caution in women who have had or are at risk for breast cancer. Vaginal dryness also tends to improve with more frequent sexual activity.
- Pelvic floor muscle dysfunction: Weakened pelvic muscles can lead to incontinence, which in turn can make sex embarrassing. More than one out of five older women quoted fear of urine loss as a reason for avoiding sex. Treatment can significantly improve sexual function. For those who have uterine prolapse, surgery can improve sexual function.
Erectile Dysfunction in Men
For men who are experiencing erectile dysfunction, it’s important to first make an accurate diagnosis, as there can be different causes. Erectile dysfunction treatments include medications (such as Viagra, Levitra, and Cialis), hormonal treatment, pumps, and implants. There are also simple measures that can help with mild erectile dysfunction, such as having the woman on top.
Problems With Desire
There is a broad range of concerns that could lower libido for either a man or a woman. Life changes, such as retirement, empty nesting, and fears about the future are common. Depression can greatly reduce desire. Concerns about body image, weight gain, and other changes associated with aging may also play a role. As noted, medical conditions (such as hypothyroidism) can also lead to a lack of desire, and scheduling a physical is important even if you believe emotional factors are the reason. Working with a therapist is sometimes invaluable in addressing psychological issues, either alone, or as a couple. Working with a sex therapist can also be very beneficial.
Addressing Medical Concerns
If you have a medical condition you believe is contributing to sexual problems, talk to your doctor. With many conditions, research has looked into how the illness may affect sexuality, as well as what may be done to help. For example, the sexual side effects of Parkinson’s disease may be different from those associated with another condition, like lymphoma, and your doctor may have helped others with the disease cope with similar issues. There are many research studies in progress specifically addressing sexual side effects of many diseases.
There might be simple suggestions that could make a difference with some concerns, but your doctor needs to know you are experiencing problems so she can help you. For example, there are sexual positions that commonly cause back pain and others that usually don’t.
Medications are a common culprit in sexual dysfunction, but there are often alternatives available. For example, serotonin-reuptake inhibitors (drugs such as Prozac, Zoloft, and Paxil) can cause significant sexual dysfunction in both men and women. Other antidepressants, such as Wellbutrin or Remeron may offer the same benefits for depression, but without the erectile dysfunction or inability to have an orgasm.
Concerns About Heart Disease
Though it’s seldom a topic of conversation, it’s not uncommon for people to worry that sex could cause a heart attack. After all, it’s a form of exercise that’s been described (by cardiologists) as equivalent to climbing stairs. Ask yourself honestly if this is a concern for you, and if it is, see a cardiologist.
It’s true that sexual activity may stimulate a heart attack in people at risk, but this doesn’t mean your sex life is done. A cardiologist can look at your medical history and family history and determine if any testing (such as a stress test) is needed. The bottom line is that talking to a doctor to make sure your heart is OK for sex might actually be a silver lining. There are many activities that could stimulate a heart attack. By making an appointment you can either learn if you are at risk (and if so, receive treatment that could be life-saving), or learn that you can stop worrying and enjoy your time in the bedroom. If you have a history of heart disease, your cardiologist can also tell you when it’s safe to have sex after a heart attack. An interesting finding is that for people who have sex regularly, the risk of a heart attack is greatly diminished relative to those who have sex infrequently.
We would be remiss not to add a note that—even as an older adult—safe sex practices are important. You no longer need to fear an unplanned pregnancy, but sexually transmitted diseases can affect anyone of any age.
A Word From Tips For Healthy Living
Both the interest and ability to have sex may decline with age, but many people in their 70s, 80s, or even 90s still enjoy a little afternoon delight. If you have concerns, speak up when you see your doctor. If you don’t, the adage “use it or lose it” carries some truth. You don’t need to be a millennial to have awesome sex, and after a lifetime of learning about yourself and loving your partner, it might just be better.