While there are some age-related sexual changes in both men and women, the ability to have and enjoy sex usually continues into old age.
Both the sexual experience and the intimacy it provides remain important. But there is no doubt that there are changes going on, starting right in midlife. While every person is different (for example, some women go through menopause in their 40s, while others don’t reach menopause until their late 50s), there are certain common physical changes that happen as men and women age. Understanding these changes will allow you to discuss them with your partner, to make changes that keep you sexually active, or to consult a doctor or health-care practitioner if you are unsure about the cause.
The most common and most noticeable changes are:
Decreased desire. Desire is both physical and emotional. It is triggered, in both men and women, by the hormone testosterone, which decreases with age. Although desire tends to decrease with age, this decrease shouldn’t result in radical changes in your sexual activity. So if a decrease in desire is affecting your sex life, you might want to make some changes that will spice up your relationship as you enter middle and old age. If that doesn’t help, you may want to consult your doctor or health-care practitioner to make sure that there isn’t some other health-related problem that is affecting your level of interest and desire.
Less lubrication. Many women are slower to lubricate during sex.
Slower, softer erections. Many men find that their erections are not as automatic as they used be. When they do happen they are not always as hard and they take longer to firm up. Many men also find that their orgasms are not as strong and they need to wait longer before getting another erection or having another orgasm. This should not be confused with impotence.
As we age, our bodies change and we may encounter health issues that affect our sexual activity. In some extreme cases, being sexually active is no longer possible, but in many cases being sexually active may even help you cope with the health challenges you now have to negotiate. Most sexual problems do start out being purely physical, but if you don’t deal with them or talk about them, they will affect how you feel about sex and then what you do about sex. And it’s these psychological causes – such as fear and anxiety, loss in confidence, stress, relationship problems – that can take their toll on your sex-life. But armed with a little bit of information and a lot of openness, you can get (and keep) your sex-life on track as you continue to grow older and wiser.
Remember that your doctor or health-care professional is there to help you. You might find it difficult to talk about the problems you are facing, but if you are open and honest you can make sure that the issue is dealt with. Don’t leave sex out of your discussions. Your doctor is the best resource for helping you to find solutions, and you are not the only one who has encountered sexual challenges because of illness or chronic disease. Many organizations and health professionals are familiar with the impact certain diseases and medications have on sexual interest and function and they are ready to help you with solutions.
Depression is common among aging adults and it can have a dampening effect on all your interests and activities, including sex. As we age, we may experience many changes in our work (retirement), family (death of a spouse) and personal lives (ill health) that can be difficult to deal with and may cause depression. Sometimes we withdraw from social contacts and stimulation (including sexual activity). For someone who has had a good sex life, lack of sexual activity makes the depression more real. If you or your partner is suffering from depression, talk to your doctor or health-care professional and seek help.
Arthritis and Osteoporosis
Conditions like early arthritis and osteoporosis are a reality for many people, even in their middle years. If either of these are an issue for you:
- Try out new sexual positions that may make sex more comfortable.
- Do a little “hands-on” research and explore different ways of giving each other pleasure.
- Try putting a pillow or a cushion under your hips.
Heart and Circulatory Conditions
Having sex takes up about as much energy as walking up two flights of stairs, so sex is rarely dangerous, even if you have a heart condition or have had a stroke.
- Many heart patients have learned, the easy way, that having heart disease, a heart attack or heart surgery doesn’t mean an end to sex. In fact, a study done by a team of Harvard researchers found that heart attack patients who were sexually active actually had a reduced risk of future heart attacks.
- Some of the physical changes associated with a stroke can interfere with intimate relations. You may not have feeling on one side of your body, or you may have problems speaking. Some men have difficulty getting an erection or discharging semen. Women may have less feeling in the vagina and more dryness. Returning to a satisfying sex life may require some changes as both you and your partner adjust to the physical changes in your body. Accepting these changes may take time, effort and honest communication.
- If you or your partner is being treated for a heart or circulatory condition, talk to your doctor about risk factors.
Cancer or cancer surgery may have a negative physical and emotional impact on a person’s ability to have sex. Radiation therapy and certain drugs may make you feel ill. Surgeries, such as breast removal, can cause depression and seriously harm a woman’s sense of herself as a sexual being.
People with dementia continue to need loving, safe relationships and caring touch. However, dementia will affect each person differently. Some people with dementia may become demanding and insensitive to the needs of others, and less able to provide caring support for their family and friends. They may also experience changes in the expression of their sexuality. Some people continue to desire sexual contact while others may lose interest in sexual activity. Others may display inappropriate sexual behaviours.
Many medications have an impact on desire and performance. Drugs that control high blood pressure, for example, can reduce desire and impair erection in men and lubrication in women. Antihistamines, antidepressants and acid-blocking drugs can also affect sexual function. Talk with your doctor about how your medications will affect your sexual activities and what you can do to minimize the side effects.
When sex just isn’t possible
There are many circumstances where sex just isn’t possible. You may no longer be with your partner, they may have died or either one of you may be undergoing treatment for an illness that makes sex just out the question. You can always consider masturbation or nurture other forms of intimacy that allow you to communicate with each other and share your love and passion.