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Chronic medical conditions become more common as a person ages. Many of these can interfere with an older person's sex life.
Arthritis and Chronic Pain
Arthritis and other chronic pain conditions are common among older adults and can make sex very difficult. Depending on the cause, doctors may recommend physical therapy to strengthen muscles and improve flexibility.
Nonsteroidal anti-inflammatory drugs (NSAIDs), both over-the-counter and prescription, can be taken before sex to help ease the pain. Opioid drugs, while effective as a pain reliever, can cause a drop in testosterone and contribute to ED.
If the pain only occurs in certain sexual positions, let your partner know and try different positions. Bolstering your bodies with pillows and cushions can also help.
Best Positions for Sex With Back Pain
Diabetes
In the United States, almost one-third of adults over 65 have diabetes. Approximately half of these are undiagnosed.
Diabetes can cause sexual dysfunction in both men and women. This can be due to circulation problems, medication side effects, or nerve damage. Problems include:
The best way to reduce the impact of diabetes is to gain control of your blood sugar. Speak with your doctor if you have difficulty managing your blood sugar, and be sure to mention any sexual health problems you may be having. It's important for your doctor to know.
Heart Disease
Older age is the greatest risk factor for heart disease. Heart disease causes problems as arteries start to narrow and harden (referred to as atherosclerosis). This reduces blood flow throughout the body, including the pelvis and genitals, resulting in sexual dysfunction in both men and women.
Heart disease is one of the leading causes of erectile dysfunction in men. It can also cause women to have difficulty achieving orgasm due to the decreased blood flow to the genitals.
There is no one way to resolve these issues, but there is evidence that statin drugs used to reduce the risk of heart disease can improve erectile dysfunction in some men.19 Some studies suggest that similar approaches may improve sexual function in women with heart disease.
People with heart disease may also be nervous about sex due to fear of a heart attack. While sexual activity is generally safe, talk to your health provider if you are concerned.
Navigating Sex After a Heart Attack
Obesity
Today, more than 40% of adults over 65 meet the definition of obesity. Research shows that women who are obese are more likely to experience sexual dysfunction than non-obese women. In addition, obesity increases the odds of erectile dysfunction in men.
These issues may be directly related to higher rates of diabetes among people who are obese as well as reduced blood circulation due to atherosclerosis.
Weight loss, achieved with a healthy diet and routine exercise, is considered the best strategy to overcome obesity. It may also improve a person's self-image and sense of well-being while making sex easier to navigate.
Urinary Incontinence
Urinary incontinence is the loss of bladder control. This becomes more common with age, especially in women.
Incontinence can be embarrassing and make sex awkward. Women who experience stress incontinence may be afraid to orgasm. Extra pressure on the abdomen during intercourse can also cause urinary leakage.
If you have incontinence, empty your bladder before sex. Changing sexual positions can help prevent urinary leakage by avoiding the compression of the bladder. Pelvic floor exercises can also help strengthen the muscles that aid with urine control.
Medications
Some medications used in older adults can cause sexual dysfunction in both men and women. These include:
If you are having sexual difficulties, let your doctor know and advise them of any drugs you are taking, including over-the-counter, prescription, or recreational.
Lifestyle and Mental Health
Lifestyle and mental health issues can also contribute to sexual problems in older adults. These issues can be just as difficult—and sometimes even more difficult—to overcome than physical ones. If you are faced with any of these issues, there are things you can do to turn them around.
Alcohol
For some people, drinking a glass of wine helps them relax and get in the mood. However, too much alcohol can end up impairing sexual function. According to the National Institute on Drug Abuse, alcohol is the most-used drug among older adults, with 65% of people 65 and older reporting high-risk drinking.
Alcohol can impair a man's ability to get an erection, cause premature ejaculation, or delay orgasm. In women, too much alcohol can make it difficult to climax.
Reducing the amount you drink can help, but if you are unable to control your alcohol use, speak to your doctor about treatment options.
Depression
In the United States, between 5% and 10% of adults over 65 are estimated to be depressed. This can lead to many health concerns, including sexual dysfunction.
In people with depression, neurotransmitters—chemical messengers that send signals between the brain and body—are out of balance. This can affect sexual desire, arousal, and orgasm. Ironically, medications used to treat depression can have the same effects.
While the benefits of antidepressants often outweigh the risks, therapy and counseling may offer a reasonable option for those with mild depression.
Stress
Stress can be a contributing factor to sexual dysfunction. Financial worries and health concerns are just some of the common stresses affecting older adults.
To relieve stress (and the effect it has on your sex life), consider stress management techniques like mindful breathing, tai chi, yoga, and meditation. Research shows practicing mindfulness and meditation can ease the effects of stress and improve overall feelings of well-being. This alone may help improve sex.
In addition, seek professional assistance from financial advisors, health advocates, and social workers to help better deal with the other stresses in your life.
Relationship Issues
Lack of sexual intimacy is often related to relationship problems. If you are and your partner are not connecting emotionally, it can lessen your desire to be intimate.
On the flip side, studies show that older couples who engage in sexual intercourse with their partner are likely to share a closer relationship. Moreover, closeness to one’s partner has been shown to increase overall well-being.
While this issue is not unique to older couples, many people find talking to a marriage counselor can help them work through relationship issues and rekindle sexual feelings and attraction.
Self-Image
With age can come weight gain and other body changes that may affect one's sense of physical attractiveness. Self-consciousness can spill over into the bedroom and affect a person's confidence during sex.
A 2019 study among older women found that those who were self-conscious about their bodies reported less sexual satisfaction. By contrast, those who had greater self-acceptance of their bodies irrespective of weight or aging-related changes had a more satisfying sex life.
Self-acceptance is ultimately the key. Working with a therapist, either alone or as a couple, can help you discuss your feelings openly and find a way to embrace a more positive self-image.
The benefits of maintaining your sex life as you age are physical and emotional. Being sexually active is associated with a lower risk of medical conditions and a longer life. It's also associated with a greater sense of happiness and overall well-being.
If your sex life has become stagnant and you'd like to rev it back up, here are a few things you can do.
Communicate
Good sex begins with good communication. Couples who have been together a long time often think they know what the other is thinking. But no one is a mind reader.
Talk to your partner about any concerns you have. You may feel as though your mate is no longer attracted to you because sex has become infrequent, when in fact they are experiencing a decline in sexual interest.
In addition, as sex organs change with age, what felt good before may no longer feel good or may even be painful. Be open with your partner about these changes.
Communicating about sex can be challenging at any age, however. If you and your partner struggle to talk about sex, consider seeing a sex therapist.
Redefine Sex
Sex, as you get older, may need to change. But different can still be good, if not better. With an empty nest and possibly retirement, there’s more time and privacy to explore.
Research shows older adults have a broader definition of sexual activity than younger adults. In other words, they better understand that there is more to sex than just intercourse. Foreplay on its own can be quite satisfying.
Be creative and willing to try new things.
Rethink Intimacy
Sex isn't just physical. It’s an emotional expression of intimacy. As you grow older, sexual intimacy changes. What this means to you and your partner may need to be redefined.
Emotional intimacy can be expressed through non-sexual physical touch. Examples of non-sexual physical touch include:
Another non-sexual way to build emotional intimacy is spending quality time together. Things you can do:
Just Do It
Instead of waiting for the desire to strike, experts recommend that older adults just go for it. This is because sex has physical and emotional benefits. Orgasms release oxytocin, a hormone that induces a state of calm and improves sleep.
Even if you’re not in the mood, having sex can set the stage for more sex in the future. This is especially true for women. Having sex regularly helps increase natural lubrication and vaginal elasticity. It may also improve erections in men.
Summary
Older age can lead to sexual problems in different ways. Age alone increases the risk of erectile dysfunction, delayed ejaculation, low libido, vaginal dryness, and pelvic organ prolapse. Medical conditions like arthritis, diabetes, heart disease, obesity, and incontinence can also directly or indirectly interfere with sex.
Lifestyle and emotional issues that can impair sexual function in all ages can become even more profound in adults 65 years and older. These include stress, depression, negative self-image, relationship problems, and alcohol abuse.
By working with a doctor or therapist, you can overcome many of these concerns and improve not only your quality of life but your sex life as well. Keeping open lines of communication and embracing change as a natural part of life can also help keep your sex life fresh as you approach your later years.
By Mark Stibich, PhD for Very Well Health
This post is part of the How To Sex podcast. Subscribe in your favorite apps.
By Steamy StoriesChronic medical conditions become more common as a person ages. Many of these can interfere with an older person's sex life.
Arthritis and Chronic Pain
Arthritis and other chronic pain conditions are common among older adults and can make sex very difficult. Depending on the cause, doctors may recommend physical therapy to strengthen muscles and improve flexibility.
Nonsteroidal anti-inflammatory drugs (NSAIDs), both over-the-counter and prescription, can be taken before sex to help ease the pain. Opioid drugs, while effective as a pain reliever, can cause a drop in testosterone and contribute to ED.
If the pain only occurs in certain sexual positions, let your partner know and try different positions. Bolstering your bodies with pillows and cushions can also help.
Best Positions for Sex With Back Pain
Diabetes
In the United States, almost one-third of adults over 65 have diabetes. Approximately half of these are undiagnosed.
Diabetes can cause sexual dysfunction in both men and women. This can be due to circulation problems, medication side effects, or nerve damage. Problems include:
The best way to reduce the impact of diabetes is to gain control of your blood sugar. Speak with your doctor if you have difficulty managing your blood sugar, and be sure to mention any sexual health problems you may be having. It's important for your doctor to know.
Heart Disease
Older age is the greatest risk factor for heart disease. Heart disease causes problems as arteries start to narrow and harden (referred to as atherosclerosis). This reduces blood flow throughout the body, including the pelvis and genitals, resulting in sexual dysfunction in both men and women.
Heart disease is one of the leading causes of erectile dysfunction in men. It can also cause women to have difficulty achieving orgasm due to the decreased blood flow to the genitals.
There is no one way to resolve these issues, but there is evidence that statin drugs used to reduce the risk of heart disease can improve erectile dysfunction in some men.19 Some studies suggest that similar approaches may improve sexual function in women with heart disease.
People with heart disease may also be nervous about sex due to fear of a heart attack. While sexual activity is generally safe, talk to your health provider if you are concerned.
Navigating Sex After a Heart Attack
Obesity
Today, more than 40% of adults over 65 meet the definition of obesity. Research shows that women who are obese are more likely to experience sexual dysfunction than non-obese women. In addition, obesity increases the odds of erectile dysfunction in men.
These issues may be directly related to higher rates of diabetes among people who are obese as well as reduced blood circulation due to atherosclerosis.
Weight loss, achieved with a healthy diet and routine exercise, is considered the best strategy to overcome obesity. It may also improve a person's self-image and sense of well-being while making sex easier to navigate.
Urinary Incontinence
Urinary incontinence is the loss of bladder control. This becomes more common with age, especially in women.
Incontinence can be embarrassing and make sex awkward. Women who experience stress incontinence may be afraid to orgasm. Extra pressure on the abdomen during intercourse can also cause urinary leakage.
If you have incontinence, empty your bladder before sex. Changing sexual positions can help prevent urinary leakage by avoiding the compression of the bladder. Pelvic floor exercises can also help strengthen the muscles that aid with urine control.
Medications
Some medications used in older adults can cause sexual dysfunction in both men and women. These include:
If you are having sexual difficulties, let your doctor know and advise them of any drugs you are taking, including over-the-counter, prescription, or recreational.
Lifestyle and Mental Health
Lifestyle and mental health issues can also contribute to sexual problems in older adults. These issues can be just as difficult—and sometimes even more difficult—to overcome than physical ones. If you are faced with any of these issues, there are things you can do to turn them around.
Alcohol
For some people, drinking a glass of wine helps them relax and get in the mood. However, too much alcohol can end up impairing sexual function. According to the National Institute on Drug Abuse, alcohol is the most-used drug among older adults, with 65% of people 65 and older reporting high-risk drinking.
Alcohol can impair a man's ability to get an erection, cause premature ejaculation, or delay orgasm. In women, too much alcohol can make it difficult to climax.
Reducing the amount you drink can help, but if you are unable to control your alcohol use, speak to your doctor about treatment options.
Depression
In the United States, between 5% and 10% of adults over 65 are estimated to be depressed. This can lead to many health concerns, including sexual dysfunction.
In people with depression, neurotransmitters—chemical messengers that send signals between the brain and body—are out of balance. This can affect sexual desire, arousal, and orgasm. Ironically, medications used to treat depression can have the same effects.
While the benefits of antidepressants often outweigh the risks, therapy and counseling may offer a reasonable option for those with mild depression.
Stress
Stress can be a contributing factor to sexual dysfunction. Financial worries and health concerns are just some of the common stresses affecting older adults.
To relieve stress (and the effect it has on your sex life), consider stress management techniques like mindful breathing, tai chi, yoga, and meditation. Research shows practicing mindfulness and meditation can ease the effects of stress and improve overall feelings of well-being. This alone may help improve sex.
In addition, seek professional assistance from financial advisors, health advocates, and social workers to help better deal with the other stresses in your life.
Relationship Issues
Lack of sexual intimacy is often related to relationship problems. If you are and your partner are not connecting emotionally, it can lessen your desire to be intimate.
On the flip side, studies show that older couples who engage in sexual intercourse with their partner are likely to share a closer relationship. Moreover, closeness to one’s partner has been shown to increase overall well-being.
While this issue is not unique to older couples, many people find talking to a marriage counselor can help them work through relationship issues and rekindle sexual feelings and attraction.
Self-Image
With age can come weight gain and other body changes that may affect one's sense of physical attractiveness. Self-consciousness can spill over into the bedroom and affect a person's confidence during sex.
A 2019 study among older women found that those who were self-conscious about their bodies reported less sexual satisfaction. By contrast, those who had greater self-acceptance of their bodies irrespective of weight or aging-related changes had a more satisfying sex life.
Self-acceptance is ultimately the key. Working with a therapist, either alone or as a couple, can help you discuss your feelings openly and find a way to embrace a more positive self-image.
The benefits of maintaining your sex life as you age are physical and emotional. Being sexually active is associated with a lower risk of medical conditions and a longer life. It's also associated with a greater sense of happiness and overall well-being.
If your sex life has become stagnant and you'd like to rev it back up, here are a few things you can do.
Communicate
Good sex begins with good communication. Couples who have been together a long time often think they know what the other is thinking. But no one is a mind reader.
Talk to your partner about any concerns you have. You may feel as though your mate is no longer attracted to you because sex has become infrequent, when in fact they are experiencing a decline in sexual interest.
In addition, as sex organs change with age, what felt good before may no longer feel good or may even be painful. Be open with your partner about these changes.
Communicating about sex can be challenging at any age, however. If you and your partner struggle to talk about sex, consider seeing a sex therapist.
Redefine Sex
Sex, as you get older, may need to change. But different can still be good, if not better. With an empty nest and possibly retirement, there’s more time and privacy to explore.
Research shows older adults have a broader definition of sexual activity than younger adults. In other words, they better understand that there is more to sex than just intercourse. Foreplay on its own can be quite satisfying.
Be creative and willing to try new things.
Rethink Intimacy
Sex isn't just physical. It’s an emotional expression of intimacy. As you grow older, sexual intimacy changes. What this means to you and your partner may need to be redefined.
Emotional intimacy can be expressed through non-sexual physical touch. Examples of non-sexual physical touch include:
Another non-sexual way to build emotional intimacy is spending quality time together. Things you can do:
Just Do It
Instead of waiting for the desire to strike, experts recommend that older adults just go for it. This is because sex has physical and emotional benefits. Orgasms release oxytocin, a hormone that induces a state of calm and improves sleep.
Even if you’re not in the mood, having sex can set the stage for more sex in the future. This is especially true for women. Having sex regularly helps increase natural lubrication and vaginal elasticity. It may also improve erections in men.
Summary
Older age can lead to sexual problems in different ways. Age alone increases the risk of erectile dysfunction, delayed ejaculation, low libido, vaginal dryness, and pelvic organ prolapse. Medical conditions like arthritis, diabetes, heart disease, obesity, and incontinence can also directly or indirectly interfere with sex.
Lifestyle and emotional issues that can impair sexual function in all ages can become even more profound in adults 65 years and older. These include stress, depression, negative self-image, relationship problems, and alcohol abuse.
By working with a doctor or therapist, you can overcome many of these concerns and improve not only your quality of life but your sex life as well. Keeping open lines of communication and embracing change as a natural part of life can also help keep your sex life fresh as you approach your later years.
By Mark Stibich, PhD for Very Well Health
This post is part of the How To Sex podcast. Subscribe in your favorite apps.