Age,
Sex &
You

Promoting better sexual health in older adults

Age,
Sex &
You

Promoting better sexual health in older adults

Evidence based information for older adults

Information you can trust

Dr Sharron Hinchliff
Reader in Psychology and Health
The University of Sheffield

Normal sexual changes with age

Our bodies change as we get older. Naturally, then, we may experience changes in our sexual lives: our thoughts, desires, and needs. When we know about the sexual changes that can come with older age, it can help us to understand our bodies and decide if we want to seek professional help. But we need to bear in mind that what is normal for one person may not be normal for another. There can be huge differences in people’s levels of sexual activity, and in what they find sexually desirable. Some people have no interest in sex but enjoy acts of intimacy, whereas others prefer no physical contact at all.

Common changes in women

Women can experience physical sexual changes with age. Due to hormonal changes that come with the menopause, it can take longer for the vagina to lubricate, and vaginal tissues can become thinner. This can make penetrative sexual activity painful (dyspareunia) and in turn affect sexual desire. Orgasms can also change, and become less intense or take longer to reach.

During the menopause transition, women may experience symptoms that have an impact on their sex lives. The daily difficulties associated with menopause, such as hot flashes, brain fog, and tiredness, can be stressful. The disrupted sleep from night sweats can be exhausting. All of these can affect mood which in turn affects interest in sex. It is not unusual for women to lose sexual desire at this time, but the reason may be a combination of emotional and physical factors. For example, women might have caring duties which can be tiring, particularly if they are still in work.

Some physical changes are less common but can still affect women’s sex lives. For example, vaginal prolapse as a result of decreased muscle tone, again related to changing hormone levels. And some women find that their orgasms have become painful, which can be due to spasm of the uterus.

Common changes in men

It is not uncommon for men to notice changes in their erections as they get older. Some men find that their erections are less firm, and that they take longer to achieve. Some men find that they cannot get an erection, while others cannot maintain an erection for very long.

Changes to orgasm and ejaculation can also occur. In particular, there can be reduced semen at ejaculation, and the chances of experiencing non-ejaculatory orgasm (dry orgasm) increases with age. The ejaculation itself may feel less forceful, and the urgency to orgasm can reduce. The recovery period after orgasm extends which means there is a longer period between orgasms.

Men may experience physical changes that are less common including prostate disease. Some men undergo prostatectomy which can affect their ability to get an erection.

Emotional issues

Emotional issues are important to our sexuality. Factors such as stress or relationship difficulties can influence our sex lives at any age: our desire, arousal, and satisfaction with sex. Also, relationships can change over time, along with our priorities, and adults may find that they place less importance on sex as they get older.

Depression and anxiety can affect our sex lives in different ways. They can make us lose interest in sex, and can cause erection problems. Sexual changes themselves can impact psychological well-being, and some women describe feeling less of a woman because they do not desire sex, and some men feel de-masculinised when they cannot get an erection.

As adults we can feel differently about our bodies as we get older, especially if we have a visible difference caused by illness or disability. A changed appearance, including the general changes to physical appearance that come with older age (baldness, grey hair, weight gain) can affect self-esteem which in turn can affect interest in sex.

Health conditions and disability

Many health conditions can have an impact on our sex lives, including those we are most likely to encounter as we get older (e.g. dementia, stroke, heart disease). Health conditions can affect our sexuality in physical and emotional ways. For example, we may experience a disability that limits the sexual positions we can hold, and feel fatigue due to illness which then affects sexual desire.

Many prescribed medicines, including those for long-term conditions and common cancer treatments, can have sexual side-effects in women and men. For example, they can cause erection problems, ejaculation difficulties and vaginal dryness. They can also prevent arousal orgasm and reduce sexual desire.

Sexually transmitted infections

We can get a sexually transmitted infection (STI) at any age. It is important to protect yourself during sex, especially if you do not know your partner’s sexual history. Condoms create a barrier to STIs and should be used during oral, anal, and vaginal penetrative sex. Common STIs include HIV, chlamydia, syphilis, and gonorrhoea.

Dr Sharron Hinchliff

Reader in Psychology and Health
The University of Sheffield

Sharron leads a programme of research which explores ageing, sexual health, sexual well-being, intimate relationships, and psychological factors of health. Established in 2001, the aim is to better understand these issues so that we can improve patient quality of life and inform healthcare practice.

Sharron’s work sits within a framework of sexual rights. She is the founder of #SexRightsAge: a national campaign to recognise the sexual rights of older adults.

Age, Sex and You is the first website in the UK dedicated solely to adults aged 50 and older.

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Tel: +44 (0) 114 222 2045

Email: s.hinchliff@sheffield.ac.uk

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