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Sex and ageing

No one is too old for an enjoyable sex life, and many surveys have confirmed that older people continue to enjoy sexual activity into their 80s and 90s. According to a report in the Independentnewspaper (19 May 2000), a survey has shown that over-65s in the UK spend more time making love than younger people. Some 44% of the over-65s said that they spent more than 2 hours a week making love, compared with 15% of those aged 16–25 years and fewer than 26% of those aged 25–64 years.

On the other hand, for many older people, sex assumes less importance than it did during their younger years.

How ageing can affect sex

Good points
  • Reduced frequency of sexual desire
  • Likely to have more leisurely lifestyle, with more time for sex
  • Likely to know each other very well, so greater understanding of each other’s sexuality
  • Although less frequent, sex may be more enjoyable
Bad points
  • Reduced frequency of sexual desire
  • Arousal takes longer, and needs more genital stimulation
  • Reduced lubrication (women)
  • Poor body image (a feeling of being unattractive and undesirable)
  • Erections less hard and ejaculations less powerful (men)
  • More likely to be taking medication for other medical conditions (for example, blood pressure) which may affect their erections (men)
  • More likely to have conditions that can affect sexual activity or cause anxiety about having sex
  • Emotional ‘baggage’
  • Lack of privacy if not living in own home
  • More difficult to find a new relationship

Common problems for women as they get older

Vaginal dryness and soreness is the most common physical problem for women and makes intercourse uncomfortable (look at the section on dry vagina). Sexual stimulation no longer causes a sudden increase in lubricating secretions. And because more and more older men are now using effective medications for impotence, many older women are having sex again after a break of several years. This can be problematic, as the vagina can feel uncomfortable and sore. Thrush is another possible reason for vaginal soreness.

Tenderness of the clitoris, so that friction easily makes it sore, is another common problem.
 
Symptoms of cystitis. Bruising of the urethra (the opening through which urination occurs) during sex is more likely in older women because their skin tissue is thinner. This can lead to a burning sensation when urine is passed after sex, and the woman may also feel she needs to pass small amounts of urine frequently. This is known as ‘urethral syndrome’. Although it feels like cystitis, it is not caused by an infection.
 
Less desire for sex occurs in some women after the menopause. In all premenopausal women, the ovary secretes ‘female’ hormone (oestrogen), and also a small amount of ‘male’ hormone (androgen). The androgen is important for sexual desire (libido). After the menopause, the levels of both types of hormone fall. The fall in androgen level may be one reason why some women feel less desire for sex in later life.
 
Loss of self-esteem may also lead to less desire for sex. If you feel despair over lost youth and slimness, and believe that some of your sexual attractiveness has gone, it may be hard to respond to a partner.
 
Worries about your partner. You may also worry that your partner is not really up to it, particularly if he has angina or has had a heart attack – some women are terrified that their partner will die during sex and this, unsurprisingly, puts them off.

Common problems for men as they get older

Men have different problems to contend with as they get older. Some sexual slowing down is natural.
  • For older men to become aroused, the penis needs to be fondled – sexy thoughts are not enough.
  • Waking with an erection becomes less common.
  • Erections may take longer to develop and be less hard.
  • If the erection is lost before ejaculation, it is less easy to regain.
  • Ejaculation becomes less powerful, with a smaller volume of semen produced, and more difficult to control.
  • It usually takes longer to become aroused again after orgasm.

This slowing down is a long way from impotence, but it can cause panic. You may fear that you are going into a speedy sexual decline and will soon be unable to perform at all. Some men take any slight reduction in their body's response – however marginal, and whatever its cause – as the first sign of the onset of impotence. In fact, almost any illness will interfere with sexuality for a while, but the danger is that this ‘performance anxiety’ will take over, so the fear becomes a self-fulfilling prophecy.

With increasing age, men are more likely to be taking drugs for high blood pressure (hypertension); many of these can cause problems with erections. You are also more likely to have a condition, such as diabetes, which can affect erection and ejaculation.
 
Some men also have a fixed idea that sex means vigorous, thrusting intercourse with the man on top (the ‘missionary position’). But as a man gets older, he may find this more and more difficult, or a heart condition may make him frightened to try. So he may start to regard himself as a sexual failure and give up, instead of experimenting with new positions and new ways of gaining satisfaction.

Common problems for men and women as they get older

Other illnesses. For both men and women, other illnesses can interfere with sexual enjoyment. For example, breathlessness from a chronic chest problem, lack of mobility from arthritis or from a stroke, or simply obesity can make sex difficult.
 
Emotional ‘baggage’. A relationship that has been poor for years may become worse as the older couple find themselves spending more time together.
 
Finding a partner. Older people are often on their own, and finding a partner may be difficult.

How you can help yourself

Remember that a sex life is not compulsory. The point of your sex life is to bring greater happiness to you and your partner. If you both feel happy and relieved not to continue with your sex life, that is fine. But equally, if you both wish to have an enjoyable sex life there is no reason why you should not. Sex is not just for the young and beautiful!
 
Share your expectations. If one partner has needs or expectations that are not being met by the other, sort the problem out rather than let resentment, anger or guilt take over. Counselling (these are listed in the Useful contacts can be very helpful in this situation.
 
Try to avoid becoming 'performance conscious'. Do not interpret natural sexual ‘slowing down’ as being near to impotence. In fact, the natural slowing down of your sexual responses may make you more in tune with your partner’s needs, because it may mean that stroking and cuddling become more important.
 
Sort out relationship problems. You may feel that your relationship with your partner has been unsatisfactory for so many years that it is pointless to try to do anything about it. In fact, it is never too late to try to improve things, particularly as you and your partner may have many years ahead in which you will be increasingly in each other’s company.
 
Ignore setbacks. If you have a sexual setback, do not assume it is the ‘beginning of the end’ of your sex life. It is natural for an illness, or a period of depression, to make you lose the desire for sex, the ability to perform sexually or the ability to respond to your partner. When you or your partner feel better, your sex life will improve again. If it does not, talk to your doctor as there may be a simple explanation (for example, you may have been put on some medication that is affecting your sexuality).
 
If you are worried that sex could damage your heart, or that you or your partner might have a heart attack during sex, talk to your doctor. If you have had a heart attack or heart surgery the hospital should have given you advice about when to resume your sex life.
 
If impotence is the problem, see your doctor. Do not accept impotence as being just a normal part of growing old. If you can not get an erection that is sufficient for intercourse, discuss it with your doctor, no matter how old you are. There may be a reason that can be put right and there are various methods of improving erections (look at the section on impotence). Viagra is as safe in elderly men as it is in younger men. A study of Viagra in the over-65s reported a 69% improvement (Journal of Gerontology 2001;56:M113–M119).
 
Use lubricants. Whatever a woman’s age, sex should not be painful. If it is, it is important to find out why. If a dry vagina is making sex uncomfortable, special lubricants or hormone treatment will help (even if it is many years since the menopause). Apply the lubricant generously over and around the clitoris and urethra, as well as the vagina, to relieve clitoral soreness and prevent urethral syndrome. Similarly, if you are using a hormone cream, apply a small amount to the clitoris and around the urethra. For more information, look at the section on vaginal dryness.
 
Try more foreplay. Remember that older women need more foreplay to become aroused. Inserting the penis before the woman is fully lubricated (perhaps because the man secretly worries that he will lose his erection) will cause discomfort or even pain.
 
New partners. If you have a new partner, be aware that you need to practise safe sex to avoid the risk of sexually transmitted infection, whatever your age. In the past 5 years in the UK, the numbers of people with chlamydia, gonorrhoea and syphilis have increased three-fold in the over-65s.
 
 
Dr Phil Hammond discusses painful sex, vaginal dryness and urinary tract infections in his Expert guide to After the menopause
 

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Friday, February 1st 2013

 


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Comments on this article

Posted by Optional on 29/11/2013 at 12:13

I don't feel valued by my husband. Having sex seems one sided. My husband takes a drug just to get aroused & thinks I should be ready for sex. Total turnoff. Amazing that men still think that sex starts with their hard ons!

Posted by raja on 19/10/2013 at 03:18

very interesting things u have given and helpful

Posted by Optional on 15/10/2013 at 03:22

Good sex at age 77 2 or 3 times per wk

Posted by Optional on 12/08/2013 at 03:23

when I ejaculates there is a bad pain my upper legs and lower back

Posted by Optional on 31/07/2013 at 12:16

Over five years ago my wife cut me off, citing vaginal dryness. When I mentioned using lubricants, she then complained that I caused yeast infections, and that she needs occasional stretching of her urethra which caused pain. Recently she increasing allowed more foreplay until recently allowed me to have intercourse. After that length of abstinence, I expected her to be much tighter but she was looser than I can ever remember. Should her vagina been tighter?

Posted by David on 15/07/2013 at 04:40

I have survived chemo and I am having problems having sex. Can't cum, please help

Posted by Diane kingl on 28/04/2013 at 08:14

Can she have sex

Posted by louie on 14/04/2013 at 08:30

i am a genuine single 55yo guy who always fancy the elderly women

Posted by Optional on 22/02/2013 at 08:21

I have been a widow for 15 years and still have much sexual desire . I masturbate every night but would so much prefer sharing my body with a gentleman my age. I am attractive but find so many men my age just do not need sex with a woman . I have no interest in marriage , want a good friend with sexual benefits . I get frustrated in trying to find an appropriate relationship but still want sex

Posted by Optional on 04/01/2013 at 04:19

I had not engaged in sex for almost 15 years. I thought I would never have sex again. One year ago I met a wonderful man. He has brought me back alive. I enjoy sex at least two or three time a week. He wants to have sex every day. He is in his early sixties. He is very understanding and loves me very much. He wants to take me on trips all of the time. He enjoys shopping with me, for me. I am very happy, but I don't want to have sex all of the time. He is very understanding, but if we are watching TV, he can't keep his hands off me and we eventually have sex. I am in very good physical shape for me age. He does not believe I am as old as I say. I don't love him as much as he loves me. What can I do?

Posted by Optional on 02/12/2012 at 08:45

My new man is wonderful with foreplay and for the first time i have multiple orgasams, he is not as big as my ex and I think i'm also big inside. I worry he is not getting the stimulation from the thrusting,although i kiss and stroke his penis and he's erect he sometimes doesn't come and he seems to be moving his penis about so he touches the sides of me as if he's not gripped enough to reach his climax.As a fantastic lover he tells me he gets so much pleasure from my enjoyment that he doesn't mind if he doesn't climax. I do mind though, i want him to enjoy as much as me and want to help him achieve that. He has diabetes2 and is also on blood pressure tablets but we are both slim and active and he never loses his erection. Is there anyway I can make more of a tighter fit for him as I feel I may be the problem? I have had 3 children, the last one 30 yrs ago. Anyone out there with advice for me?

Posted by biodun on 28/11/2012 at 10:53

if it has been a long time a guy has had sex can it cause stomach ache

Posted by Optional on 27/11/2012 at 04:03

lost my wife in 2008, never had any problems apart from the very odd brewers droop situation when i was too pissed to realise. met a fabulous lady since and now live together but over the last 12 months since taking blood pressure tablets and water tablets, my sex drive has nose dived. never wake up with a hard on, can't manage a hard enough dick to have sex and am basically pissed off. been to my doctor and explained only to have blood tests and suggestions of mayby chainging my blood pressure tablets or drop taking my water tablets to see if that improves the problem. desperate now, can't wank and come. just feel totally useless

Posted by Optional on 28/08/2012 at 08:01

i cant get an erection even with nviagra

Posted by Optional on 31/03/2012 at 07:42

My husband had a penile prosthesis ( 3 way) @ age 64. He wants to do it all the time.i am dry and sore. He has big ejaculations. I am finding difficulty coping. Do you have any advise that will help

Posted by Optional on 13/10/2011 at 05:11

Recently widowed,no sex with late spouse for over 20 years. New Partner,but after 20 years use it or lose it comes into the play.Little or no erection.Tried all the items on market including muse.New Partner widow for 20 years, estrophy is the a problem,but I can't erect enough to penetrate.Lubricants tried, but can't penetrate. I have the new pump,works fine, but makes the penis too large now.Would like to have sex, but perhaps too late. I have labito pluss, but totesterone low. Limited ejaculation. Muse loses it's effect if you lay down.My partner is the same age,not as easily aroused as I. Any suggestions?

Posted by lynda on 09/08/2010 at 11:27

My vagina seems to have shrunk or contracted or tightened after meno pause. I dont seem to have trouble lubricating although the clitoris and nipples can be hyper sensitive without really feeling very turned on. I am interested in becoming sexually active again after 7 years not in a relationship. (is lack of use the problem when one is post menopausal?)I cant seem to find any psychological reason for this occurring and if you think that is all it is I am keen to know. Could it be hormonal? thanks

Posted by Anonymous on 05/02/2009 at 10:55

Recently my husband, also 70, has tried Levitra as an aid in having longer erections. They need to be taken 1 hr. before having sex.He does not tell me when he takes it and as I am unaware I may just fall asleep at night or get out of bed in the morning. Any ideas for giving unmistakeable signals would be helpful.

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