Info on

Sexuality

11 February 2025

Sexuality, sexual relations, and intimacy are all important aspects of life, and having sex does not end as you get older. It is time to eradicate prejudice, preconceptions, and the misunderstandings that people have about having sex later in life.

The frequency of sex may decrease, and interest may wane or change, but having sex and sexual activity are lifelong experiences.

Regular sexual life has tremendous benefits at any age and at an older age as well.

  • It strengthens your immune system
  • It releases endorphins and analgesic substances, especially in backaches or headaches
  • It boosts the mood and relieves muscle and mental stress

This article discusses three main categories of sexual challenges: emotional, physical, and difficulties associated with illnesses or side effects of medications. For most of these challenges, your family doctor can help you find solutions.

Sexuality, sexual relations, and intimacy are all important aspects of life. While some people may believe that sexuality ends at a certain age, sexual activity can continue into old age. Sexuality is a natural and normal part of life. Although its frequency may change, occasionally the interest in sex diminishes, and it may take on different forms; however, having sex and sexual activity are a lifelong experience.

Any man or woman, regardless of age, has particular tendencies and preferences. As with any other issue in life, it can also change over time.

Dr. Uri Wernik, former clinical director of the Sex Therapy Clinic in Tel Hashomer, writes that “the lifespan of sex and sensuality is the same as the lifespan in general, assuming, of course, that one’s health is good and there is a desire to continue and enjoy sexual activity”. In his book he points out that according to a 2000 study by the American Association of Retired Persons (AARP), 70% of men and women aged 60 to 74 who have had regular partners, reported having regular sexual activity at least twice a month. Two-thirds reported that they were content with their sexual interactions. The study also demonstrated that sexual experiences among older adults who were in better health, were more frequent and fulfilling. More than 50% of men and 85% of women, including spouses of both sexes over the age of 75, reported that their sexual lives have not been affected by illnesses.

Another interesting finding from the study is that spouses may not lose their attractiveness to each other as they age. In fact, they may become even more attracted to each other over time. 59% of the men and 52% of the women aged 45 to 59 gave their partners the highest rank possible for physical attraction. On the other hand, the percentage of men and women over the age of 74 who are sexually active has increased to 65% and 57%, respectively.

This study suggests that the way people experience sex and the degree of satisfaction they have with it can have a significant impact on the quality of their relationships, their attitudes towards sex, and their physical health.

Therefore, sexuality has a significance that goes beyond the physical act itself and has a significant impact on our physical and mental health.

In order for enjoyment to be complete even at an older age, it is necessary to consider all facets of sexuality, including physical health, gender differences, and potential difficulties. Older people can maintain a fulfilling sexual life by being aware of these aspects.

Safe sex in older age

It is a common misconception that, as pregnancy is not possible in older age, there is no need for contraceptives. However, this is not true because safe sex is important not just to prevent pregnancy but also to protect against sexually transmitted infections (STIs).

Sexual activity can put people at risk of contracting sexually transmitted infections (STIs). These conditions include genital herpes, hepatitis B, gonorrhea, syphilis, and chlamydia. To avoid contracting these diseases, it is essential to use a condom.

It is important to note that spermicides and various lubricants are ineffective in preventing disease.

If, after having sex, you experience any unusual symptoms, such as aches, itching, or sensitivity in your sex organs, it is important to see a doctor who specializes in sexual health. Women should see a gynecologist, and men should see a urologist, a dermatologist, or a venereal diseases specialist.

How does sex contribute to health at an older age?

It is worth knowing that sex is not just about pleasure; it also has a positive impact on our health.

Sexual activity increases the production of T-cells, which play a significant role in the immune system. Furthermore, when you have sex, the brain releases endorphins that function as painkillers and mood boosters.

A good sexual experience at any age reduces muscle tension and mental stress.

Regular sexual activity can help improve erectile function and prevent vaginal dryness and degeneration, which are common problems for older women.

Another interesting detail is that if you engage in sexual activity for twenty minutes continuously, it can have similar cardiovascular benefits to exercise.

 

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Potential challenges at an older age with sexuality

There are three types of sexual challenges at an older age:

  1. Physical challenges caused by age and functional difficulties
  2. Emotional challenges, similar to those at any other age
  3. Challenges connected with illnesses or medication side effects

Erectile problems can be caused by emotional factors such as boredom, frustration, or anger. If the problem is not emotional, it may be caused by a physical health condition.

Both physical and emotional aspects, as well as their interactions, can lead to sexual problems. Treating emotional problems can occasionally aid in the resolution of physical ones.

  • Atherosclerosis, or hardening of the arteries, can directly impact sexual function by reducing blood flow to the penis and causing erectile damage.
  • Arthritis and rheumatism are diseases that cause inflammation, pain, and stiffness in the joints and tissues that connect them. They have an indirect impact because patients may avoid physical activity, including sexual activity, due to the risk of further damage (according to the doctor’s instructions)
  • Hypertension: Men with hypertension who are not properly treated may experience erectile dysfunction due to damage to the blood vessels and because of the narrowing and widening of the blood vessels
  • Illnesses that cause pain or weakness: There are illnesses that cause fatigue, lack of energy, and low mood. These symptoms can impact sexual desire and lead to avoidance of sexual activity
  • Medications: Individuals who regularly take medications for the treatment of chronic diseases may suffer from diminished sexual desire or functioning. Women may suffer from vaginal dryness and men from ejaculation difficulties. These are common side effects that are well-known to occur with many medications.

The correlation between body and soul is evident in sexuality and sexual relations. There is no doubt that the healthier the body, the less likely a sexual impairment will occur.

Physical fitness, a balanced diet, and avoiding smoking, caffeine, fat, and alcohol, can help protect your overall health and sexual function.

  • Physical activity has a positive impact on sexual functioning both mentally and physically, as it maintains hormonal functioning and desire. It enhances pleasure and the ability to make an effort and overcome
  • Smoking: Men who smoke for 20 consecutive years are 60% more likely to develop impotence than men who do not smoke. The reason is that nicotine narrows blood vessels. Furthermore, the buildup of tar in the walls of blood vessels can restrict blood flow to the penis. Nicotine has a toxic impact that damages the sex hormones; therefore, smokers have lower levels of testosterone. This condition may cause a decrease in sexual desire
  • Nutrition: Nutrition rich in fats elevates cholesterol levels in the blood. Over the years, fat buildup causes narrowing and blocking of the blood vessels. This process accelerates among smokers. Blocked blood vessels in the pelvis cause severe erectile damage among men and decreased sexual desire among women
  • Alcohol: Excessive alcohol intake can have a negative impact on sexual function in both men and women, both in the short and long term. Alcohol is a depressant that can reduce both sexual desire and arousal, although in low doses, it can sometimes increase arousal. In the long run, its impact is even worse and can damage the nerves, liver, and hormone production. In severe cases, it can lead to testicular tissue destruction in men and ovary damage in women.

Depression, on all levels, from sadness and mild melancholy to acute depression, severely harms sexual relationships. In such a situation, people may not feel like doing many things, including having sex. This can be true for both the person who is depressed and their spouse.

The spouses become caregivers, like parental figures, and this role does not coincide with sexual desire. It is worth knowing that the risk of depression increases with age and is one of the major side effects among older people suffering from Alzheimer’s disease and dementia.

Physical contact, such as hugs, can be very welcome and helpful for people who are depressed. However, if the caregiving spouse is unable to improve their partner's mood, they may experience depression and frustration themselves.

If the situation does not improve, it is advisable to seek professional psychological advice. Sometimes, antidepressants may be recommended, but it is important to make sure that they do not have side effects that could impact sexual desire or function.

Further information on depression in older age

Physical and emotional health, which allows recognition of the physical changes as well as the desire to be sexually active, are essential for understanding sexual function. Both sexes may experience sexual problems caused by underlying conditions, medications, and other factors. This can lead to slower, more moderate sexual activity, a longer arousal process, and a difference in the intensity and duration of release.

However, as in many other areas, there are also gaps and differences between the sexes in the field of sexuality.

Hormonal changes

Hormonal changes are caused by menopause and a decrease in estrogen production, leading to changes such as an increase in wrinkles on the skin and especially in the genitalia.

As a result, the vaginal walls become thin and dry. Hormonal changes cause modifications to the blood vessels and the tissues in the pelvis and increase the risk of vaginal and urinal inflammations and infections. Consequently, there is discomfort and pain during penetration (Dyspareunia). These changes occur gradually.

Treatment: Hormonal therapy, such as medications that contain estrogen and progesterone, can help reduce the symptoms of menopause. However, it is important to consult with your gynecologist to weigh the pros and cons of this treatment before starting.

Vaginal dryness and thinning

This can lead to a decrease in vaginal secretions and an increase in the time it takes for the vaginal area to become moist.

Treatment: Lubricants, preferably water based.

Vaginal inflammation and dryness

Vaginal inflammation and dryness are common symptoms among women over 60, which can damage sexual function.

Treatment: Various medications, administered according to the physician’s instructions.

Changes to the sense of release (orgasm)

Changes to the amount and intensity of contractions in the uterus area.

Erection disorders

These are caused by a decrease in blood flow to the penis area and can result in physical issues, performance anxiety, and a decline in self-esteem.

Treatment: Medications that improve erectile function. These are prescription medications and can only be taken after consulting your family doctor, who knows you and your medical background.

Hormonal changes

In their fifth decade, men's levels of the male hormone testosterone start to decline. As a result, the testicles shrink and become limp, and sexual drive declines.

Shortening of the orgasm stage

In addition to the shortening of the orgasm stage, after ejaculation, men need a longer period of rest than before until the next time, sometimes even a day or two.

We are grateful to Eshel-Joint for their help in writing this article.

Further information on sexuality at an older age is available in Dr. Uri Wernik’s book, "Love for the Experienced: Intimacy and Sexuality Later in Life"