It is common knowledge that older adults continue to be sexually active if they have a partner and are in good health. But what does “good health” mean in an aging adult?  In my clinical experience, many older clients, particularly men, complain that they are in “good shape,” that is, they exercise and eat a healthful diet—why then are they struggling to stay sexually active?  One answer is hormones, the messengers that direct organs in the body to perform certain functions.  The effects of dropping hormone levels may seem invisible or superficial, but they can create sexual problems for people of all genders.  Also, almost any chronic condition can contribute to sexual problems, conditions that are more common as people age, e.g., high blood pressure or arthritis that are associated with growing older. 
   

Unfortunately, research has demonstrated that healthcare providers are not asking aging adults about their sexual health.  In a survey of doctors, nurses, and physician assistants in the US, only 28% routinely asked aging adults about their sexual health, and half of them reported that they found it “difficult” to administer such an assessment (Harding & Manry, 2017).  Providers most frequently listed lack of time, patient discomfort, lack of training, lack of an assessment tool, and sexual health not being a top medical priority.  

However, one study suggests that a person’s perception of their sexual health may be as or more important than their actual health status (Lindau & Gavrilova, 2010). Thus, a man with diabetes who feels fit enough for sex, even though his body is showing signs of damage to the penis and flagging erections, is more likely to adapt in ways that allows him to remain sexually active.  This is supported by additional findings that while subjective feelings about aging did not impact frequency of sex, the older the study participant felt, the less likely they were to enjoy sexual activity (Estill, Mock, & Schryer, & Eibach, 2017).  This suggests that although sexual issues are often attributed to physiological changes, psychological and interpersonal factors cannot be overlooked when assessing sexual function in aging adults (Træen, 2017).

How one ages is a complex, varied process depending on many factors.  For example, lesbian women, with their experiences of sensual and erotic touch and a de-emphasis on penetration, may view menopause differently than heterosexual women.  They are less likely to adhere to the medical model of menopause, or “medicalization,” in which menopause become an unnatural condition to be treated with a variety of hormones and other chemicals (Tiefer, 2007). 
 

This complexity has an impact on couples and their sexual relationship, as partners may experience aging at different rates and in different ways.  That is why we are very fortunate to have Dr. Barry McCarthy explaining what we need to know in his course, “The Keys to Couple Sexuality after 60.”  Watch this 2-hour course LIVE on November 13, 2020 or watch the recording whenever it’s convenient for you by enrolling here.