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Sexual health and aging: Keep the passion alive
Sexual health is important — at any age. Find out how aging can affect sexuality and what you can do to maintain a fulfilling sex life after 50.
By Mayo Clinic staff
Dr. Janice Swanson
Though movies and television might tell you that sex is only for the young and beautiful, don't believe it. The need for intimacy is ageless. Sex may not be the same as it was in your 20s, but it can still be as fulfilling as ever.
What aspects of sexual health are likely to change as you and your partner get older? How can you both adapt? Janice Swanson, doctor of psychology, licensed psychologist and sex therapist at Mayo Clinic in Rochester, Minn., has some answers.
How can you maintain a satisfying sex life as you age?
When confronted with the physical and emotional changes of aging, you may feel as ill-prepared and awkward about sex as you did during your first sexual experiences. To maintain a satisfying sex life, talk with your partner. Set aside time to be sensual and sexual together. When you're spending intimate time with your partner, share your thoughts about lovemaking. Tell your partner what you want from him or her. Be honest about what you're experiencing physically and emotionally.
Many couples want to know how to get back to the sexual arousal and activity levels they experienced in their 20s, 30s and early 40s. Instead, find ways to optimize your body's response for sexual experiences now. Ask yourselves what's satisfying and mutually acceptable.
How does aging affect men's sexual health?
Testosterone plays a critical role in a man's sexual experience. Testosterone levels peak in the late teens and then gradually decline. Most men notice a difference in their sexual response by age 60 to 65. The penis may take longer to become erect, and erections may not be as firm. It may take longer to achieve full arousal and to have orgasmic and ejaculatory experiences. Erectile dysfunction also becomes more common. Drugs such as sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) can help men achieve or sustain an adequate erection for sexual activity.
How does aging impact women's sexual health?
As a woman approaches menopause, estrogen production decreases. As a result, most women have less natural vaginal lubrication, which can affect sexual pleasure. Women may experience emotional changes as well. While some women may enjoy sex more without worrying about pregnancy, naturally occurring changes in body shape and size may cause others to feel less sexually desirable.
What medical conditions can cause sexual health concerns?
Any condition that affects general health and well-being also affects sexual function. Illnesses that involve the cardiovascular system, high blood pressure, diabetes, hormonal problems, depression or anxiety — and the medications used to treat these conditions — can pose potential sexual health concerns.
High blood pressure, for instance, can affect your ability to become aroused, as can certain medications used to treat high blood pressure.
What can you do if medications negatively affect your sexual health?
Certain medications can inhibit your sexual response, including your desire for sex, your ability to become aroused and your orgasmic function. If you're experiencing sexual side effects from a medication, consult your doctor. It may be possible to switch to a different medication with fewer sexual side effects.
Don't let embarrassment keep you from asking your doctor for help — and don't stop taking prescribed medication before discussing it with your doctor. If you take several medications, each of which can have a different effect on your sexual function, try varying the type of sexual activity you engage in and how you approach it.
Sexual health and aging: Keep the passion alive
How can surgical procedures affect your sexual health?
Any surgical procedure that affects your pelvis and your central nervous system will have a temporary — but often significant — impact on your sexual response. The body, however, is resilient. Given time to heal and some loving attention, you can become sexually responsive again.
What do I need to know about aging and safe sex?
People of all ages must be vigilant about practicing safe sex. If you're having sex with a new or different partner, always use a condom. Also talk with your doctor about other ways to protect yourself from sexually transmitted diseases.
If you're in a long-term monogamous relationship and you've both tested negative for sexually transmitted diseases, you probably don't need to worry about protection. Until you know for sure, however, use a condom when you have sex.
What advice do you have for partners who have different libidos?
Differences in libidos are a major concern for many couples. Couples can become polarized — one person initiates contact while the other avoids it. If you mainly avoid sex, take charge of some engagement. If you usually initiate sex, tell your partner what you need. If you're worried about hurting your partner's feelings, speak about your own experience. Use "I" statements — such as "I think my body responds better when ... " — to open up to your partner.
If you're in a heterosexual relationship, try to understand how your partner's body works so that you can appreciate his or her desires. Seek ways to accommodate both your needs.
How can a couple adjust sexually when one partner becomes a caregiver to the other because of illness?
If you're ill, your sexuality may take a backseat to treating your illness. Pain, discomfort, medications or worry can overshadow your sexual desire. If you're the caregiver, your sexual desire might be compromised by the stress of dealing with the demands of caring for your partner.
As a caregiver, be aware of your changing role. Find a way to set aside the caregiver role from time to time, and be a partner instead — so that you can relax and feel nurtured by your partner. That way, you can enjoy a mutually satisfying sexual encounter.
Where can a couple find helpful resources about sexual health?
Look for books about sexuality during the second half of life. If you and your partner can't resolve a concern, consult a doctor. Your doctor may be able to provide useful suggestions or refer you to a specialist.
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