Sexual health in the older adult

27 March 2014

People may assume that as we become older sexual desires diminish, but this isn’t always the case. Everyone will have their own sexual desires and needs.

Good physical and mental health, along with a positive attitude to sex in both parties enables continued sexual activity.

It might seem difficult to discuss sexual problems and activities with your family doctor. You can always see if there’s another doctor in the practice that you feel more comfortable talking about this topic with.

Your doctor or another doctor in the practice can giSTI's ve you support, advice, guidance and reassurance.

Certain factors may have an effect on sexual desire and activity such as stress, psychological or emotional factors, illness, side-effects of medical treatments, depression, changes in appearance and hormonal changes.

If you wish to continue to have sexual activities as an older adult with your partner, adaptive coping strategies may be needed to help you to achieve this.

Enjoying sex in this new chapter of your life

Women 55 and over

Without the concern of falling pregnant, many women find sex following the menopause more enjoyable. However, as a woman’s hormone levels become lower, this can cause vaginal tissue to become thin and dry. Sex can then be undesirable due to the fact it’s uncomfortable.

The use of a lubricant can help. These can be bought without prescription over the counter and in the medicine aisle of the supermarket. But it’s always advisable to talk to your GP if symptoms are severe as they may consider oestrogen replacement or hormone replacement therapy. Learn more about the menopause.

Vaginal pH levels rise in the vagina as oestrogen levels decrease as a consequence of the menopause. This increases your risk of vaginal infection. If you’re prone to this:

  • Avoid using soap in the vaginal area.
  • Look for a cleanser that has the same pH levels as a healthy vagina instead (normal pH level in the vagina is between 3.8 and 4.5).
  • Passing urine after sex will help wash away any bacteria and can also help to prevent urinary tract infections.

Men 55 and over

Even though men may not be able to perform as they used to in their 20’s, sex can still be rewarding and satisfying into the later years of your life.

Erectile Dysfunction (ED)

Erectile dysfunction is the inability to get and maintain an erection to enable satisfactory sexual intercourse. It can be said to affect at least half of men to some degree between the ages of 40 to 70 years.

In older men this can be related to stress, depression, a physical cause (for example  heart disease, high blood pressure, diabetes) or even a side effect to prescribed medications.

A discussion with your GP is advisable so that they can determine the cause, give advice and discuss possible treatment. A physical examination is usually carried out which will include examining the penis and testicles to check for any abnormalities that could lead to ED. A rectal examination may be done to assess the prostate. Blood tests may also be arranged.

ED can affect relationships as well as causing distress and depression in men.

Other factors that can increase the risk of ED are:

  • Smoking
  • Excessive alcohol consumption
  • Obesity
  • Inactive lifestyle

Treating erectile dysfunction (ED)

Your GP will give you lifestyle advice about stopping smoking, reducing alcohol consumption, weight reduction and exercise as appropriate.

ED can be treated with medications called phosphodieterase type 5 (PDE5) inhibitors.  These essentially increase the flow of blood to the penis. Example medications which could be prescribed by your GP are:

  • Sildenafil (commonly known by the brand name of Viagra)
  • Tadalafil (commonly known by the brand name of Cialis)
  • Vardenafil (commonly known by the brand name of Levitra)

Other less common treatments for ED include:

  • Surgical implants
  • Use of external devices such as vacuum pumps
  • Injections to promote the blood flow to the penis
  • Transurethral alprostadil

Find out more about Erectile Dysfunction.  

Information for both men and women aged 55 years and over

Take things slow

As we get older it may take longer for both parties to get aroused for intercourse. Foreplay is a very important element to achieve arousal.

Take your time with foreplay so you’re both ready for the next step. This will also reduce any risk of injury.

Foreplay can also be effective in helping both parties enjoy the experience more, to build up your sexual desire together.

Making it work for you

Having intercourse doesn’t have to be just a night-time pursuit. You might have more energy earlier in the day. So it might be more beneficial for you to have sex in the morning.

Trying different positions may be helpful, especially if you suffer from arthritis, back pain or other conditions that make traditional positions painful or difficult to carry out.

Protection against sexually transmitted infections (STIs)

Whilst the post-menopausal woman is not able to fall pregnant, you’re still at risk of contracting an STI. This was previously known as an STD (sexually transmitted disease).

To avoid contracting an STI it’s best to use a condom. It’s important to remember that condoms are made from latex and can only be used with water based lubricants. Oil based lubricants, for example Vaseline, can break down the latex which could cause the condom to fail.

Find out more about STI's.