Sex & the Older Couple

Growing older brings many changes in life that require adjustment — you may change jobs or retire from work, relocate to a less stressful environment, or learn to adapt to changes in your health and physical well-being.

Likewise, many people may find they need to make adjustments to their sex lives. But one thing they do not need to do, stresses Maggie Syme, PhD, MPH, an assistant professor at Kansas State University Center on Aging, is give up intimacy.

“Sex is not something that has an expiration date. We engage in, need and enjoy sexual intimacy throughout our lives,” says Dr. Syme, also a counseling psychologist who recognizes that this topic is one many healthcare practitioners are failing to address with older patients. She developed a questionnaire that helps healthcare providers — be they doctors, nurses, psychologists or anyone else working with older adults — raise and discuss sexuality issues with seniors more comfortably.

For example, doctors are encouraged to begin by saying something such as, “A lot of my patients are interested in improving their intimate lives. Is there anything that you need to discuss in this area?” Dr. Syme says this “normalizes the issue for older adults, which is important because a lot are ashamed to discuss their sex lives. That’s because in our society, we act as if older adults are not allowed to have a sex life.”

This is partially due to negative images in the media and advertisements that send the message that sexuality is something reserved for the young and beautiful, says Dr. Syme, adding that television and other media are full of characters who reinforce the myth that seniors cannot or should not be sexually active.

“There’s the Dirty Old Man, the Old Bitty, the Cougar. We’ve made older adults asexual in our portrayals of them or we’ve made sex dirty or a joke. If you get exposed to that across your lifetime, you internalize that and start to feel embarrassed or ashamed of your sexual feelings when you get older.”

Dr. Syme says she tells her patients that “there’s no need to be embarrassed about your wants. You’re normal. Giving up sex would leave a big, gaping hole in your life if you decided to just cut it out, if it’s been something that’s important to you throughout your life.”

The most common sexual issues older adults encounter include erectile dysfunction for men (ED) and vaginal dryness for women. ED can often be treated with medication and dryness can be treated with over-the-counter lubricants. However, it’s important to discuss these issues with your healthcare provider to explore potential causes and ensure you are getting the appropriate treatment.

In addition to the normal aging process, illnesses, disabilities, depression, medication side effects and surgery may impact a person’s ability to enjoy intimacy. Relationship issues can affect intimacy at any age. Chronic pain may make it difficult to enjoy certain sexual positions. Dr. Syme says she encourages patients to communicate with their partners and be open to discussing new ways of finding satisfaction that allow them to continue to enjoy an intimate relationship.

Maintaining a satisfactory sex life remains important to the vast majority of adults — both men and women — as they grow older, according to a 2009 study conducted by the University of Chicago Center on Aging. The study found that 71 percent of women and 76 percent of men ages 57 to 64 reported that satisfactory sex was an essential element to maintaining a good relationship. The percentage rose slightly for women ages 75 to 85 (to 73 percent) and fell slightly for men in this age-group (71 percent). The study also found that while fewer adults were sexually active in their later years, those who were active reported having sex fairly often — at least once or twice a week.

In fact, the National Institute on Aging advises that many older adults actually find sex more satisfying, because they have fewer distractions, more time and privacy with their partners along with no worries about unwanted pregnancies. However, the agency also stresses that age does not protect against sexually transmitted diseases, and encourages older adults to continue to practice safe sex.

Finally, Dr. Syme notes that even when physical limitations may make certain levels of sexual activity difficult or impossible, couples can still enjoy other practices that allow them to remain intimate: “Cuddling, kissing, holding hands, gazing into each other’s eyes, masturbating — whatever it is, there are many ways for couples to express these feelings and find satisfaction.”