Sexuality and Aging

By Akwaowo Akpan

Sexuality and physical changes associated with aging can be challenging for some people. However, it is essential to understand that aging does not have to mean the end of a fulfilling sexual life. As we age, our bodies undergo significant physical changes that affect sexual health, including changes in sexual desire, response, and function. 

In this blog, Akwaowo Akpan discusses sexuality and aging, focusing on how physical changes affect sexuality and provides valuable tips on maintaining sexual health with aging.

Physical Changes Associated with Aging  

Sexual function refers to the ability to engage in sexual activity, including achieving and maintaining an erection, lubrication, and orgasm. Age-related changes in sexual function are common and can be attributed to various factors.

  • Hormonal changes occur, leading to a decrease in the production of estrogen and testosterone. As a result, women may experience vaginal dryness, resulting in discomfort and pain during sex, while men may experience erectile dysfunction.  
  • The pelvic muscles weaken, leading to a decrease in bladder and bowel control. This weakening can also affect sexual function, reducing sexual sensation and pleasure. 
  • Changes in weight, muscle tone, and skin condition occur. This may include a decrease in muscle mass and an increase in body fat, potentially affecting body image and self-esteem. These changes can lead to feelings of self-consciousness or reduced confidence, impacting intimacy and sexual satisfaction.
  • Cardiovascular changes associated with aging may lead to decreased blood flow to the genitals. The reduction can lead to decreased arousal in both men and women, making it more difficult to achieve and maintain an erection. 
  • Chronic health conditions such as diabetes, arthritis, and hypertension become more prevalent. Chronic conditions may cause discomfort, fatigue, and other symptoms affecting sexual function.

How Physical Changes of Aging Affects Sexuality 

Sexual desire, or libido, refers to the urge to engage in sexual activity. A decreased libido is a common complaint among older adults, particularly women. The decline in libido can be attributed to various factors, including hormonal changes, health conditions, medications, and stress.

For women, a decline in sexual desire may be triggered by hormonal changes during menopause. Menopause is the cessation of menstrual periods, typically around the age of 51 in most women. During this time, the levels of estrogen decrease, which can cause vaginal dryness and discomfort, leading to a decreased desire for sexual activity.

In men, a decrease in libido is often associated with declining testosterone levels, a hormone that plays a crucial role in sexual function, and decreases naturally as men age.

Other contributing factors to decreased sexual desire include health conditions such as diabetes and heart disease, medications such as antidepressants and blood pressure medications, stress, depression, and relationship issues.

Sexual response refers to the physical and emotional changes during sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution. As we age, the sexual response cycle may take longer, and the intensity of sexual sensations may decrease. 

Women may experience vaginal dryness, reduced lubrication, and decreased vaginal elasticity. These changes can make sexual activity uncomfortable or painful and increase the risk of vaginal infections. Treatment options include over-the-counter vaginal moisturizers, lubricants, and prescription medications. Men may experience erectile dysfunction, the inability to achieve or maintain an erection during sexual activity, and/or a decrease in the intensity and duration of orgasms, which are common complaints among older men. Treatment options for erectile dysfunction include medications such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis), as well as lifestyle changes such as quitting smoking, losing weight, and managing stress.

Maintaining Sexual Health with Aging  

Communication is essential to maintaining sexual health with aging. Communicate openly and honestly with your partner about changes in sexual function, desire, and pleasure. Talking about these changes and how they affect you can help your partner understand your needs and provide the support you need to continue enjoyable sexual activity. 

Manage chronic conditions effectively. Managing chronic conditions involves seeing a healthcare provider regularly and following the recommended regimen. This may include medications, lifestyle changes such as quitting smoking and excessive drinking if you engage in those habits, eating nutritious foods, and getting enough exercise. These changes can significantly improve sexual function and overall health.  

In women and men, the pelvic floor muscles support the bladder and bowel, preventing leakage of stool and urine. Regular pelvic floor exercises can help maintain pelvic muscle strength, leading to improved bladder and bowel control and better sexual function.  

Seeking help from a healthcare provider or a qualified sex therapist can provide expert guidance and help you manage sexual issues. For example, a healthcare provider can help evaluate and treat medical problems such as hormonal imbalances. At the same time, a sex therapist can provide strategies, guidance, and techniques to help manage any emotional or psychological factors affecting sexual health. 

As we age, our bodies change, but this does not mean that sexual exploration and experimentation should halt. On the contrary, continuing sexual activities and experiences safely and respectfully is crucial to maintaining a satisfying and fulfilling sexual life. 

The bottom line

Aging can significantly impact sexual function, and it is important to understand the physical changes that occur as we age. Many age-related changes in sexual function can be treated with medications, lifestyle changes, and other interventions. If you are experiencing changes in your sexual function as you age, speaking with a healthcare provider who can provide guidance and treatment options is essential. Regardless of your age, it is never too late to engage in a healthy and fulfilling sex life.

Akwaowo Akpan is a talented health writer on the topic of sexual health. You can reach him here.  

Here are some resources to learn more about intimacy and aging:

Kaiser Permanente. Sexuality and Physical Changes with Aging: https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw159186

Center for Sexuality. Sexuality & Aging: https://www.centreforsexuality.ca/learning-centre/sexuality-aging/

The Sexual Medicine Society of North America (SMSNA). How Sex Changes With Age: https://www.smsna.org/patients/blog/how-sex-changes-with-age

Your destination for online courses for healthcare practitioners practicing in AfricaThe Missing Link to Improved Health Outcomes (MiLHO) Initiative provides online CPD courses that recognize and consider Africa’s unique medical practice environment by developing relevant evidence-based content. The initiative aims to expand opportunities for CPD to assist healthcare practitioners in staying current with evidence supporting patient care in their local setting. Courses are certified by the CPD Certification Service. Visit the MiLHO Initiative to learn more.