Aging and Sexuality

By: Dr. Regina Koepp, Member of the PLTC Communication Committee

Sexual health is an essential part of mental and physical health. Sadly, stereotypes about aging, ageism, and lack of education about sexual health in older adulthood for older adults and professionals create a perfect storm keeping older adults from getting their sexual health questions answered.

People all throughout their lives enjoy sex and intimacy. In fact, a recent survey¹ of more than 1,000 adults between 65-80 years old, found that 50.9% of men and 30.8% of women reported being sexually active. Yet, in this same survey, when it came to discussing sexual health with health care providers, only 17.3% of adults aged 65–80 reported speaking to their health care provider about sexual health in the past two years and of those, the vast majority (60.5%) initiated the conversation.

Researchers² have found that sex among older adults is often viewed as stereotypically “shameful, disgusting, laughable, and nonexistent”, which can lead to internalized stigma and increased sexual problems for older adults.

It’s time we shift the narrative about aging and sexuality toward a more accurate and holistic view. There are many benefits to sexual relationships over 50, including physical, cognitive, relational, psychological, and spiritual³. The sooner we can remove negative beliefs about aging from conversations around intimacy and sexual health, the better.

While sex drive is known to change throughout adulthood due to hormonal changes for both men (due to andropause) and women (due to menopause) as well as medical and mental health problems, there are many things we CAN DO to boost our sex drive as we age.

• Maintain a healthy diet: the healthier your body and mind, the healthier your sex life. A healthy diet rich with fruits and vegetables and void of processed foods is key for a healthy libido
• Exercise: Studies show that exercise correlates with a higher sex drive and better sexual function
• Manage your stress. It’s easier to get in “the mood” from a relaxed state
• Communicate with your partner: if you are noticing changes in your body, so, too is your partner. It can help to talk about it.
• Talk with your doctor if you have a problem that affects your sex life. If you’re over 65, based on research, you may be the one who has to initiate the conversation.
• Set yourself up for success. Identify when you are at your best (physically, emotionally, energetically), and prioritize intimacy during these times.
• Continue to have sex especially during and after menopause. This is an important point as sexual activity helps to prevent vaginal atrophy. Vaginal atrophy frequently affects menopausal and postmenopausal women. It’s a condition where the lining of the vagina gets drier and thinner from a lack of estrogen and can create a host of other problems (e.g., burning, itching, spotting and pain with sex, frequent urination, urinary tract infections)
• Adjust your “sex”pectations. Shifting your expectations about what sex “should” look like can help and changing your focus from what your body “cannot” do to what your body “can” do will help. For example, I have worked with couples who were no longer able to have penetrative intercourse, which was their primary method of sexual intimacy. When we looked out what their bodies were able to do and broadened the view of what sexual intimacy included (e.g., oral sex, fondling, touch, fantasy talk), they had a more opportunities.
• Get creative I have worked with people with physical disabilities and life altering medical conditions for decades. There’s a saying that people who have disabilities make more creative lovers. So, become playful, don’t take each sexual encounter so seriously and enjoy the process of finding a new more creative love making experience.
• Get professional mental health care if needed. This can be especially helpful if changes in sex drive are due to a mental health or medical condition. Living with a medical condition that affects your sexual health is quite a big adjustment. It takes some time to come to terms with the medical condition and all of the physical and emotional changes that come with it. At times it can help to get some professional support, so please don’t hesitate to reach out for mental health care when you need it.

Above all- Don’t give up. Instead…

Talk with your doctor if you have a problem that affects your sex life and/or see a therapist who specializes in sexual health and couples therapy. Remember: If you’re over 65, based on research, you may be the one who has to initiate the conversation.

1. Nnenaya Agochukwu-Mmonu, Preeti N. Malani, Daniela Wittmann, Matthias Kirch, Jeff Kullgren, Dianne Singer & Erica Solway (2021) Interest in Sex and Conversations About Sexual Health with Health Care Providers Among Older U.S. Adults, Clinical Gerontologist, 44:3, 299-306, DOI: 10.1080/07317115.2021.1882637
2. Syme, M. L., & Cohn, T. J. (2016). Examining aging sexual stigma attitudes among adults by gender, age, and generational status. Aging & mental health, 20(1), 36–45. https://doi.org/10.1080/13607863.2015.1012044

About the Author:

Dr. Regina Koepp is a board certified clinical psychologist, clinical geropsychologist, and founder of the Center for Mental Health & Aging (www.mentalhealthandaging.com), which offers online continuing education courses to psychologists and other mental health providers. 

Dr. Koepp is creator and host of the Psychology of Aging Podcast and is a contributing writer at Psychology Today and has been featured in the Chicago Tribune, Baltimore Sun, Katie Couric Media, and Insider. She is a sought-after speaker and educator on the topic of sexual expression in the context of dementia. She is frequently invited to present on this topic by the Alzheimer’s Association, LeadingAge, American Parkinson’s Disease Association, (APDA) and long-term care and senior living communities.