Sexuality refers to how we express and experience ourselves in sexual ways. It involves emotions, wishes, actions, and identity. And it can cover many different kinds of physical touch or stimulation.
Intimacy is a sense of closeness and belonging in a relationship that can happen with or without a physical element. As you grow older, you may face life changes that will allow you to redefine what sexuality and intimacy mean to you.
Some older adults want both a sexual and intimate (close) relationship. Some are happy with one without the other. And others may prefer to avoid both kinds of connections all together.
But no matter your age, if you want to, you can continue to have a healthy and fulfilling sex life. In fact, research shows that many older adults find their sex lives to be more satisfying and pleasurable than ever before. And a satisfying sex life can strengthen your bond with your partner or spouse by enhancing feelings of closeness and intimacy.
How sex can improve your health?
Research into the health benefits of sex over 65 is ongoing. But some findings suggest it may help:
- Boost activity and fitness levels
- Improve sleep by raising levels of oxytocin and prolactin
- Support a healthy immune system
- Boost strength in your pelvic floor muscles
- Deepen your bond with your partner or spouse by building trust and intimacy
- Boost your mood and self-esteem
- Support healthy blood pressure levels
- Support brain and heart health
Some studies have even found that, over the long-term, having no sex life may lead to poorer health outcomes.
Changes as you age
Aging slows the processes in the body, from digestion to brain function. For older adults, sexual function may also slow down. These changes may alter desire and function. Some older adults who face these changes, may sometimes give up on having a sex life.
But there are other choices. Research shows that if you live a healthy, active life, having a fulfilling sex life beyond the age of 65 is a realistic goal.
Hormone levels
The slowing of the body’s functions as you grow older is in part due to age-related decreases in hormone levels. Hormones have a major effect on all the systems in your body. That means your reproductive system, too. And this is true for men and women both. Your doctor may have solutions, but living an active life can also have benefits. Let’s explore some signs of natural changes in hormones for both men and women as they get older.
Hormonal changes in women
Reduced estrogen in older women may cause vaginal dryness. Lower estrogen can also cause the vaginal walls to narrow, shorten, and stiffen. These changes can result in less pleasure or even pain with intercourse.
You can ask your doctor about using water-soluble lubricants or low-dose vaginal estrogen creams. They may help with these changes. Lower testosterone levels may also affect your desire as a woman. Ask your doctor for advice on how to maintain a healthy lifestyle to help counteract a decline in libido due to lower testosterone levels.
Hormone changes in men
Lower testosterone can lower a man’s sex drive and function , but it should not cause a complete loss of them. Loss of sexual function in men is often associated with erectile dysfunction (ED), which is most often caused by an underlying health problem.
Erectile dysfunction (ED)
Having trouble getting or keeping an erection can become more common as men age. Talk with your doctor about any health problems or medicines that may be causing your ED. You may also want to ask your doctor about medications that are used to treat ED.
But be sure to ask about any side effects, and if they might interact with other medicines you are taking. Also, if ED is a problem for you, try to be open to other forms of intimacy. Intercourse is not the only way to create a good sex life. Cuddling, hugging, caressing, kissing, sensual massage, and other kinds of intimate contact may be just as fulfilling to you and your partner.
Limitations
As mentioned, a slowing of sexual function due to lower hormone levels or other causes is common in older adults. But this doesn’t mean there is a complete loss in the ability (or desire) to have sex.
Sexual dysfunction can often indicate a more severe health issue that is causing it. It may also be due to surgery or other medical treatments. But these underlying causes can often be treated or managed. Here are some health problems that may underlie sexual dysfunction:
- Less blood flow to sexual organs
- Circulatory or vascular problems
- Heart disease
- Diabetes
- High blood pressure
- Infection
- Multiple sclerosis
- Nerve or spinal cord injury
- Hysterectomy
- Chronic pain or disease
- Incontinence
- Certain medications
- Depression
- Arthritis pain
- Smoking or alcohol and drug abuse
Talk with your doctor if one or more of these conditions is impacting your overall health and/or your sex life.
Prostate cancer
Cancer can sometimes adversely affect the sexual health of your relationship. Sexual dysfunction typically follows radical prostate surgery. Because the organ responsible for ejaculate has been removed, sexual function is adversely affected in men.
Sometimes recovery can take up to 2 years. This can affect your relationship. Men can lose sexual desire and even withdraw from intimacy. But the good news is that men can also return to a healthy sex life. Ask your doctor about possible pathways back to an active sex life.
Breast cancer surgery and sex
Breast cancer surgery and breast cancer treatment can affect sexual function. The physical changes involved may change how you see your body and make you feel shy or worried about your body image. These feelings can make sex less enjoyable.
Also, breast surgery can cause pain in your breasts and other parts of your body, which can make sex feel uncomfortable. And other breast cancer treatments, such as chemotherapy and hormone therapy, may cause drops in estrogen that result in vaginal dryness.
However, there are ways to help you feel better about yourself and improve your sexual health. Giving yourself time to fully heal from breast cancer surgery, and/or chemotherapy and radiation, is a good first step.
Talking to a therapist or counselor can also be helpful, especially if you have lasting body-image issues that impact your self-worth or sense of desirability. A sexual health specialist can also suggest different positions, vaginal moisturizers, or other tips to help you cope with any pain or discomfort.
Childhood trauma and its effects on libido
Studies have shown that women who faced 4 or more negative events in their childhood were almost 2 times more likely to avoid sexual activity as adults. And they were twice as likely to experience sexual problems. This included issues with sexual desire, in addition to pain, that can be tied to personal distress in a woman. Seeking help through a therapist is one way to address these issues and mitigate their symptoms.
Mind and mood
Mental health problems, such as depression, can cause you to lose interest in activities you used to enjoy, including sex. Emotional issues within a relationship may also be a culprit. Stress and anxiety often make it hard to relax, which can inhibit arousal.
Speak to your doctor about seeing a counselor or changing your habits in healthy ways to support your mental health. You can also inquire about mental health medications that have little or no impact on your sexual function.
Relationship problems
Difficulties with your spouse or partner can lower trust, passion, closeness, and sexual function. These issues might include a breakdown in communication with your spouse. Or problems might occur if either one of you is feeling unappreciated by the other. Consider working with a couple’s therapist if you think that problems within your relationship might be affecting intimacy or sexuality.
Chronic pain
Chronic pain can disrupt your sex life—but it can also be treated. Keep in mind that some pain medicines may alter sexual function. Talk with your doctor about the options for painkillers that do not cause such side effects.
Sex may be uncomfortable, painful, or impossible if you have arthritis or other kinds of joint pain. Ask your doctor whether physical therapy, ice packs, warm baths, and pain medicines can help.
Incontinence
The loss of bladder control is more common with age. This problem happens more often in women than men, but it can affect both. Talk with your doctor about treatments and pelvic floor exercises that may help. Try positions that limit or prevent pressure on the abdomen during sex. Orgasm can help strengthen pelvic floor muscles, too. Losing weight, if needed, can also help.
Chronic health conditions
As mentioned, diabetes, heart disease, stroke, and other conditions may lessen desire and function. Talk with your doctor about ways to manage these and other health problems that might affect your sexual health. Ask whether doing so can help lessen their effects on your sex life. Also ask if any of the medications you are taking for your health problems have sexual side effects.
If you have heart disease or have had a heart attack or stroke, talk with your doctor before you become sexually active again. You’ll want to first make sure that doing so is safe. Most doctors will tell you that if you can work out hard enough to break a light sweat, without symptoms, sex should be safe for you.
Medications
Some medicines may lead to ED or trouble ejaculating in men. And some can lessen desire or cause vaginal dryness in women. Some meds that may cause problems are:
- Drugs for treating blood pressure
- Antihistamines
- Antidepressants
- Tranquilizers
- Appetite suppressants
- Drugs used to treat mental health conditions
- Drugs used to treat ulcers
If you take any of these and are having problems, talk with your doctor about changing your medicines.
Dementia
Some older adults who have dementia may experience a decline in their sexual desire. Others may have more interest but not be able to distinguish between proper and improper sexual behavior. They may also have problems with their sexual performance.
Seek advice from a doctor, nurse, or social worker who has expertise in treating or caring for older adults with dementia. They may be able to provide suggestions, adaptations, coping strategies, or even medications that may help.
Habits that can help
A healthy sex life can be impacted by the choices you make. These habits may help support healthy sexual function:
- Stick with a workout routine
- Eat healthy foods
- Come up with strategies to handle stress
- Quit smoking
- Avoid or limit alcohol and recreational drugs
Practice safe sex
You can be at risk of sexually transmitted diseases (STDs) at any age. If your partner is new, or if either of you has more than one sex partner, take the right precautions. If you have sex, protect yourself. If you don’t take precautions, you can put yourself at risk for:
- HIV or AIDs
- Gonorrhea
- Syphilis
- Hepatitis B
- Genital warts
- Chlamydia and other STDs
Talk with your doctor about safe sex practices, such as condoms, routine exams, and tests for STDs.
The main takeaway
Even though you’ve left your more youthful years behind, that doesn’t mean that sex won’t be fulfilling as you grow older. Sex may be even more pleasurable and rewarding—especially if you embrace and adapt to the normal changes that come with age.
Share your feelings and worries with your partner openly and respectfully. Creating a bond of trust and love with your partner can enhance your relationship satisfaction. Above all, don’t feel afraid or embarrassed to talk with your partner or your doctor about any problems with your sex life.
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This information is not intended to take the place of regular medical care or advice. Please check with your doctor before using this information or beginning any self-care program. Images used for this article do not depict any members of the Silver&Fit program.
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This article was written by Kim Reynolds, edited by Gail Olson, and clinically reviewed by Elizabeth Thompson, MPH, RDN, on April 23, 2024.
