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 about
sexually transmitted diseases.
In most 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. However, you may have to make a few
minor adjustments to accommodate any physical limitations you may have or the
effects of certain illnesses or medications.
Common Physical Changes in Men
A man's sexual response begins to slow down
after age 50. However, a man's sexual drive is more likely to be affected by
his health and his attitude about sex and intimacy than by his
age.
It may take longer for a man to get an erection, and more time
needs to pass between erections.
Erections will be less firm.
However, a man who has good blood flow to his penis will be able to have
erections that are firm enough for sexual intercourse throughout his entire
life. For more information, see the topic
Erection Problems.
Older men are able to
delay ejaculation for a longer time.
Common Physical Changes in Women
Most physical changes take place after
menopause and are the result of decreased estrogen
levels. These changes can be altered if a woman is taking
hormone therapy.
It may take longer for a woman to become
sexually excited.
A woman's skin may feel more sensitive and
irritable, making caressing and skin-to-skin contact less
pleasurable.
The walls of the vagina become thinner and drier and
are more easily irritated during sexual intercourse.
Orgasms may be
somewhat shorter than they used to be, and the contractions experienced during
orgasm can be uncomfortable.
Not all women experience these problems. Those who do can
experiment to find ways to enjoy sex despite these physical changes.
Cultural and Psychological Factors
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 as well. 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.
Physical and 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. However, if you choose to continue enjoying your sexuality, you deserve
support and encouragement. You may still find uncharted sensual territories to
explore.
Use It or Lose It: Staying Sexual
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.
Here are some additional considerations:
To enhance sexual response, use more foreplay
and direct contact with sexual organs.
The mind is an erogenous
zone. Fantasy and imagination help arouse some people. Try setting the mood
with candlelight and soft music, or whatever else "turns you
on."
Many medications, especially high blood pressure medications,
tranquilizers, and some heart medications, inhibit sexual response. Ask your
doctor about these side effects. Your doctor may be able to reduce your dosage
or prescribe different medications. Do not stop taking prescription medications
without consulting your doctor first.
Colostomies, mastectomies,
and other procedures that involve changes in physical appearance need not put
an end to sexual pleasure. Communicating openly about your fears and
expectations can bring you and your partner closer together and help you
overcome barriers. If necessary, a little counseling for both of you can help
you adjust.
People who have heart conditions can enjoy full,
satisfying sex lives. Most doctors recommend that you abstain from sex for only
a brief time following a heart attack. If you have
angina, ask your doctor about taking nitroglycerin
before you have sex. Do not take Viagra if you are using
nitroglycerin.
If arthritis keeps you from enjoying sex, experiment
with different positions. Try placing cushions under your hips. Also try home
treatment for arthritis pain. For more information, see the topic
Osteoarthritis.
Use a water-based vaginal lubricant, such as Astroglide, K-Y
Jelly, or Replens, to reduce vaginal dryness or irritation. Do not use
petroleum jelly. A doctor can also prescribe a vaginal cream containing
estrogen, which will help reverse the changes in the vaginal tissues.
Drink alcohol only in moderation. Small amounts of alcohol may
heighten your sexual responsiveness by squelching your inhibitions. Larger
amounts of alcohol may actually decrease your sexual
performance.
Prescription medications that can enhance the sexual
response are available. Some people find that herbs such as
ginkgo biloba and ginseng enhance their sexual
function. Both prescription drugs and herbal remedies carry the risk of side
effects. Your health professional can help you decide whether these options are
right for you.
Other Aspects of Sexuality
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
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.
Get a massage. Professional massages are
wonderful, but simple
shoulder and neck rubs feel great, too. Find a friend
who will trade shoulder rubs with you.
Look for hugs. Everybody
needs them. Some people are a little shy about hugs, but it's okay to ask,
"Would you like a hug?"
Consider getting a pet. Caring for a pet
can help meet your needs for touch. Some studies have shown that older people
who have pets to care for live longer.
Affection
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
Intimacy is the capacity for a close physical or emotional
connection with another person. Intimacy is a great protector against
depression.
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:
Turn to your children, siblings, or old and
new friends.
Look for another person who is in the same situation
as you are. One of the richest benefits of
support groups is that members often find intimacy
with one another.
Be available to others. Just as you need people,
there are people who need you, too.
Sexually Transmitted Diseases
Sexually transmitted diseases-also known as STDs or venereal
diseases-are infections passed from person to person through sexual
intercourse, genital contact, or contact with semen, vaginal fluids, or blood.
Many of these diseases can also be spread by sharing needles and
other items that may be contaminated with infected blood or body fluids.
STDs can affect anyone, no matter what his or her age. Talk openly
with your partner about STDs and take whatever precautions are necessary to
protect yourself before you engage in any form of sexual contact. If you
think you may have an STD, see your health
professional.
This site is a clearinghouse for sexually transmitted disease (STD) treatment guidelines, personal questions, and fact sheets.
Organization
National Institute on Aging
Building 31, Room 5C27
31 Center Drive, MSC 2292
Bethesda, MD 20892
Phone:
(301) 496-1752 1-800-222-2225, Information Center
Fax:
(301) 496-1072
TDD:
1-800-222-4225 (TTY)
Web Address:
www.nih.gov/nia
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 information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
