Institute on Aging -People seem to want and need to be close to others.
As we grow older, many of us also want to continue an active,
satisfying sex life. But the aging process may cause some changes.
What Are Normal Changes?
Normal aging brings physical changes
in both men and women. These changes sometimes affect one’s ability
to have and enjoy sex with another person. Some women enjoy sex more
as they grow older. After menopause or a hysterectomy, they may no
longer fear an unwanted pregnancy. They may feel freer to enjoy sex.
Some women do not think things like
gray hair and wrinkles make them less attractive to their sexual
partner. But if a woman believes that looking young or being able to
give birth makes her more feminine, she may begin to worry about how
desirable she is no matter what her age is. That might make sex less
enjoyable for her.
A woman may notice changes in her
vagina. As she ages, her vagina shortens and narrows. The walls
become thinner and also a little stiffer. These changes do not mean
she can’t enjoy having sex. However, most women will also have less
vaginal lubrication. This could affect sexual pleasure.
As men get older, impotence becomes
more common. Impotence is the loss of ability to have and keep an
erection hard enough for sexual intercourse. By age 65, about 15 to
25% of men have this problem at least one out of every four times
they are having sex. This may happen in men with heart disease, high
blood pressure, or diabetes—either because of the disease or the
medicines used to treat it.
A man may find it takes longer to get
an erection. His erection may not be as firm or as large as it used
to be. The amount of ejaculate may be smaller. The loss of erection
after orgasm may happen more quickly, or it may take longer before
an erection is again possible. Some men may find they need more
What Causes Sexual Problems?
Illness, disability, or the drugs you
take to treat a health problem can affect your ability to have and
enjoy sex. But, even the most serious health problems usually don’t
have to stop you from having a satisfying sex life.
Joint pain due to arthritis can make sexual contact uncomfortable.
Joint replacement surgery and drugs may relieve this pain. Exercise,
rest, warm baths, and changing the position or timing of sexual
activity can be helpful.
In addition to arthritis, pain that continues for more than a month
or comes back on and off over time can be caused by other bone and
muscle conditions, shingles, poor blood circulation, or blood vessel
problems. This discomfort can, in turn, lead to sleep problems,
depression, isolation, and difficulty moving around. These can
interfere with intimacy between older people. Chronic pain does not
have to be part of growing older and can often be treated.
Many men with diabetes do not have sexual problems, but this is one
of the few illnesses that can cause impotence. In most cases medical
treatment can help.
Narrowing and hardening of the arteries known as atherosclerosis can
change blood vessels so that blood does not flow freely. This can
lead to trouble with erections in men, as can high blood pressure (hypertension).
Some people who have had a heart attack are afraid that having sex
will cause another attack. The chance of this is very low.
Mostpeople can start having sex again 3 to 6 weeks after their
condition becomes stable following an attack, if their doctor agrees.
Always follow your doctor’s advice.
Loss of bladder control or leaking of urine is more common as we
grow older, especially in women. Stress incontinence happens during
exercise, coughing, sneezing, or lifting, for example. Because of
the extra pressure on your abdomen during sex, incontinence might
cause some people to avoid sex. The good news is that this can
usually be treated.
The ability to have sex is rarely damaged by a stroke, but problems
with erections are possible. It is unlikely that having sex will
cause another stroke. Someone with weakness or paralysis caused by a
stroke might try using different positions or medical devices to
help them continue having sex.
What About Surgery and Drugs?
Many of us worry about having any kind of surgery—it is especially
troubling when the genital area is involved. Happily, most people do
return to the kind of sex life they enjoyed before having surgery.
is surgery to remove the uterus. It does not interfere with sexual
functioning. If a hysterectomy seems to take away from a woman’s
ability to enjoy sex, a counselor may be helpful. Men who feel their
partners are “less feminine” after a hysterectomy may also be helped
is surgery to remove all or part of a woman’s breast. Your body is
as capable of sexual response as ever, but you may lose your sexual
desire or sense of being desired. Sometimes it is useful to talk
with other women who have had this surgery. Programs like the
American Cancer Society’s (ACS) “Reach to Recovery” can be helpful
for both women and men. Rebuilding of the breast (reconstruction) is
also a possibility to discuss
with your surgeon.
About 1500 American men develop
breast cancer each year. In them the disease can make their bodies
make extra “female” hormones. These can greatly lower their sex
is surgery that removes all or part of a man’s prostate. Sometimes
this procedure is done because of an enlarged prostate. It may cause
urinary incontinence or impotence. If removal of the prostate gland
(radical prostatectomy) is needed, doctors can often save the nerves
going to the penis. An erection may still be possible. Talk to your
doctor before surgery to make sure you will be able to lead a fully
satisfying sex life.
Some drugs can cause sexual problems. These include some blood
pressure medicines, antihistamines, antidepressants, tranquilizers,
appetite suppressants, diabetes drugs, and some ulcer drugs like
ranitidine. Some can lead to impotence or make it hard for men to
ejaculate. Some drugs can reduce a woman’s sexual desire. Check with
your doctor. She or he can often prescribe a different drug without
this side effect.
Too much alcohol can cause erection problems in men and delay orgasm
Am I Too Old To Worry About Safe Sex?
Having safe sex is important for
people at any age. As a woman gets closer to menopause, her periods
may be irregular. But, she can still get pregnant. In fact,
pregnancy is still possible until your doctor says you are past
menopause—you have not had a menstrual period for 12 months.
Age does not protect you from
sexually transmitted diseases. Young people are most at risk for
diseases such as syphilis, gonorrhea, chlamydial infection, genital
herpes, hepatitis B, genital warts, and trichomoniasis. But these
diseases can and do happen in sexually active older people.
Almost anyone who is sexually active
is also at risk for being infected with HIV, the virus that causes
AIDS. The number of older people with HIV/AIDS is growing. One out
of every 10 people diagnosed with AIDS in the United States is over
age 50. You are at risk if you have more than one sexual partner or
are recently divorced or widowed and have started dating and having
unprotected sex again. Always use a latex condom during sex, and
talk to your doctor about ways to protect yourself from all sexually
transmitted diseases. You are never too old to be at risk.
Can Emotions Play a Part?
Sexuality is often a delicate balance
of emotional and physical issues. How you feel may affect what you
are able to do. For example, men may fear that impotence will become
a more common problem as they age. But, if you are too concerned
with that possibility, you can cause enough stress to trigger
impotence. A woman who is worried about how her looks are changing
as she ages may think her partner will no longer find her
attractive. This focus on youthful physical beauty may get in the
way of her enjoyment of sex.
Older couples face the same daily
stresses that affect people of any age. But they may also have the
added concerns of age, illness, and retirement and other lifestyle
changes. These worries can cause sexual difficulties. Talk openly
with your doctor, or see a counselor. These health professionals can
Don’t blame yourself for any sexual
difficulties you and your partner are having. You might want to talk
with a therapist about them. If your male partner is troubled by
impotence or your female partner seems less interested in sex, don’t
assume they don’t find you attractive anymore. There can be many
physical causes for their problems.
What Can I Do?
There are several things you can do
on your own to keep an active sexual life. Remember that sex does
not have to include intercourse. Make your partner a high priority.
Pay attention to his or her needs and wants. Take time to understand
the changes you both are facing. Try different positions and new
times, like having sex in the morning when you both may have more
energy. Don’t hurry—you or your partner may need to spend more time
touching to become fully aroused. Masturbation is a sexual activity
that some older people, especially unmarried, widowed, or divorced
people and those whose partners are ill or away, may find
Some older people, especially women,
may have trouble finding a partner with whom they can share any type
of intimacy. Women live longer than men, so there are more of them.
In 2000 women over age 65 outnumbered older men by 100 to 70. Doing
activities that other seniors enjoy or going places where older
people gather are ways to meet new people. Some ideas include mall
walking, senior centers, adult education classes at a community
college, or day trips sponsored by your city or county recreation
If you do seem to have a problem that
affects your sex life, talk to your doctor. He or she can suggest a
treatment depending on the type of problem and its cause. For
example, the most common sexual difficulty of older women is
dyspareunia, painful intercourse caused by poor vaginal lubrication.
Your doctor or a pharmacist can suggest over-the-counter,
water-based vaginal lubricants to use. Or, your doctor might suggest
estrogen supplements or an estrogen vaginal insert.
If impotence is the problem, it can
often be managed and perhaps even reversed. There is a pill that can
help. It is called sildenafil and should not be taken by men taking
medicines containing nitrates, such as nitroglycerin. This pill does
have possible side effects. Other available treatments include
vacuum devices, self-injection of a drug (either papaverine or
prostaglandin E1), or penile implants.
There is a lot you can do to continue
an active sex life. Follow a healthy lifestyle—exercise, eat good
food, drink plenty of fluids like water or juices, don’t smoke, and
avoid alcohol. Try to reduce the stress in your life. See your
doctor regularly. And keep a positive outlook on life.
For More Information
The following organizations and
government agencies have information that may be of help.
American Cancer Society
1599 Clifton Road, NE
Atlanta, GA 30329
American Foundation for
Urologic Disease, Inc.
1000 Corporate Boulevard
Linthicum, MD 21090
National Kidney and Urologic
Diseases Information Clearinghouse
National Institute of Diabetes and
Digestive and Kidney Diseases (NIDDK)
3 Information Way
Bethesda, MD 20892-3580
For more information on health and
National Institute on Aging
P.O. Box 8057
Gaithersburg, MD 20898-8057
800-222-4225 (TTY toll-free)
To order publications (in English or
Spanish) or sign up for regular email alerts, visit:
The National Institute on Aging
Visit NIHSeniorHealth.gov (www.nihseniorhealth.gov),
a senior-friendly website from the National Institute on Aging and
the National Library of Medicine. This simple-to-use website
features popular health topics for older adults. It has large type
and a ‘talking’ function that reads the text out loud.
National Institute on Aging
U. S. Department of Health and Human Services
National Institutes of Health
Reprint July 2005
Web page last updated:
December 20, 2005