Published on Monday, July 10, 2023
By Monica Blair, RPN
Grey Bruce Health Unit
Sexual intimacy among seniors need not be a taboo topic.
Although aging can introduce new challenges in the bedroom, it is possible – and healthy – for people of all ages to have fulfilling intimate relations.
Sexuality is the way in which we experience and express ourselves sexually. It involves feelings, desires, actions, and identity, and can include many different forms of physical touch or stimulation.
Intimacy is a feeling of closeness and connectedness in a relationship that can occur with or without a physical component. 1
Research shows that human connection improves mental health and well-being and can boost immune system function.3
Sex can be a part of this connection for many people, including seniors.
According to a study by the American Association of Retired Persons, 46% of men and 38% of women aged 60 to 70 with partners have sex at least weekly, as do 34% of those aged 70 and older.5
Canadian research also shows that older adults are interested in sex, have sex, and find sex pleasurable, according to a Sexual Health Brief by The Sex Information & Education Council of Canada.
“Sexual health and well-being are associated with better relationships, quality of life, and physical health among adults of all ages,” the report says.
“Older adults view their sexuality as an important aspect of their lives and consider sexual well-being to be a key component of their overall happiness and well-being.”
The report says attitudes towards sexuality – particularly sexuality in later life – have changed dramatically in recent years.
Gone are the days when seniors discussing sexuality was taboo. Today’s baby boomers have more positive and permissive attitudes towards sexuality in their later years than previous cohorts.
Sex can even become more enjoyable later in life, as couples enjoy more alone time, have fewer responsibilities, and no longer have to worry about pregnancy. With this extra time to focus on their personal relationship, their emotional connection may also deepen, allowing their intimacy to be even more satisfying. They may also become more knowledgeable about what feels good for them and comfortable communicating these things to their partner.
LIFE’S CHANGES
As people age, physical changes, body image issues, health problems, and other factors may impact sexuality and intimacy.
But the good news is, many of these factors can be addressed or mitigated.
Some common physical changes can cause sex to feel less comfortable later in life.
As women age, they may produce less vaginal fluid due to lower levels of estrogen, which can cause friction and irritation during sex. This is a normal post-menopausal change and there are many lubricants on the market that can help with this.1
For men, most commonly those over age 60, erectile dysfunction (ED) can be distressing. ED can be caused by several physical, psychological, or social factors, including heart conditions, diabetes, metabolic, or neurologic conditions, anxiety, depression, stress, obesity, or substance use. This can be very normal and may last several months to years, but it is often treatable by a healthcare provider.2
Although these physical changes may be distressing, they can allow couples to be less preoccupied with performance, giving them the chance to focus more on closeness and connection and find other ways to express their affection.5
Some older adults may also feel less comfortable with their body image as regular physical changes occur. Body image is “a subjective picture of one's own physical appearance, established both by self-observation and by noting the reactions of others.”4
In older adulthood, changes related to weight, skin elasticity, muscle tone, stamina, hair loss, and body odour, among other things, in addition to cultural perceptions of what is “attractive,” can impact how people feel about their bodies and this apprehension can impact one’s ability to relax and enjoy sex.
IMPACTS OF HEALTH ON SEXUALITY
Aside from the normal, expected changes of aging, many people may experience a decline in their health and new illnesses may crop up that can also impact their ability to have sex.
Some factors that can impact sexuality and intimacy include:
Chronic Pain: Chronic pain and arthritis can make sex more uncomfortable. Pain should not be just “accepted” as a normal part of aging. There are many medications and strategies that can help with pain issues.
Obesity: Obesity is a known cause of erectile dysfunction and can also cause decreased stamina.
Diabetes: Diabetes is another known cause of erectile dysfunction. Diabetes that is not well-controlled can lead to other health and wellness concerns.
Heart Disease: Narrowing of the arteries can cause limitations with blood flow, making it more difficult to obtain or maintain an erection. Some people may also be nervous about engaging in sexual activity after a heart attack out of fear it could happen again.
Stroke: Stroke can cause partial weakness or paralysis, which can be limiting for many aspects of one’s life.
Surgery: It can be uncomfortable and anxiety-provoking to return to pre-surgery activities. However, most people are able to return to a similar level of activity.
Depression: Signs of depression include a lack of interest or pleasure in activities that a person once enjoyed and a lack of energy. Depression can lead to a decreased sex drive.
Medications: Certain medications, including some blood pressure medicines, antihistamines, antidepressants, sedatives, medications for Parkinson’s disease or cancer, appetite suppressants, and anti-ulcer drugs can cause side effects that impact sex or sexual desire. Individuals can talk to their local pharmacist or healthcare provider who may be able to provide suggestions or alternatives1;
Dementia: As the brain changes in the process of dementia, a person may become either more or less interested in sexual activity. They may also begin to express their sexuality in ways that are not generally accepted as social norms. Some people with dementia may also forget or not recognize their partner and may seek intimacy or sexual activity with others. The Canadian Alzheimers Society has many resources to help partners and caregivers to understand and manage these changes.6
OTHER CONSIDERATIONS
Older adults may also begin to explore gender identities or a sexual orientation they felt they had to hide in the past.
Homosexuality was decriminalized in Canada in 1969,8 so many of today’s seniors lived their formative years at a time when only heteronormative lifestyles were accepted. Many older adults may still feel that discrimination or stigmatization and fear “coming out” to their peers, family, caregivers, or healthcare workers.
Alternatively, some LGBTQ2S+ older adults may feel a greater sense of safety with the changing times and increased acceptance. This can sometimes be difficult for families or peers to accept and may lead to greater social isolation. The Government of Canada has developed a toolkit (Social Isolation of Seniors, Volume II: Ideas Exchange Event Toolkit) that outlines some strategies that can be used by individuals or organizations to help decrease the social isolation of LGBTQ2s+ seniors.7
As stated above, intimacy and sexuality provide many positive benefits, however, everyone who is sexually active may be at risk of acquiring a sexually transmitted infection, regardless of their age.
Older adults may be less inclined to use condoms to protect against STIs due to difficulties related to normal physical changes, not being concerned about unplanned pregnancies, and dementia. In addition, similar to gender identity and sexual orientation, condoms were considered a taboo topic during the formative years of many older adults. It was forbidden to advertise condoms on television or in print until the 1980s when HIV emerged as a sexually transmitted infection, so the importance of using this protection for sexual activity was not something that many of these individuals recognized throughout most of their sexual lives.8
Seniors may also begin dating again after losing a long-term partner. Since condoms were not a focus of their previous relationship, they may not be considered in a new relationship.
STI rates among seniors remain relatively low compared to their younger counterparts, but testing rates in this age group may also be low. Healthcare providers may not discuss safer sex or regular STI testing with their older patients because seniors are not necessarily viewed as sexual beings and because the most common STIs may not exhibit any symptoms or they may have symptoms that mimic other common health conditions.
However, Health Canada reports that between 2005 and 2015, syphilis rates rose by 5%, chlamydia cases rose by 142% and Gonorrhoea cases rose by 87% in people 60 years of age or older.9
Despite the unique factors that impact healthy sexuality for seniors, the need for intimacy and connection remains a constant for humans throughout the lifespan. These needs can be met in various ways, including through fulfilling sexual relations at any age.
Grey Bruce Public Health’s Sexual Health Clinics offer services for people of all ages. For more information, visit publichealthgreybruce.on.ca.
Categories: Your Health, Sexual Health
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