What are the normal signs of ageing?
Research shows that a growing number of people are enjoying an active sex life as they age. Many more would like to maintain sexual intimacy, but struggle to access practical advice and health services to support their sexual well-being. We look at how to make the most of sex in later life.
Although it's natural for libido and sexual function to change as we grow older, we have the right to enjoy sexual intimacy at any age regardless of societal taboos that may suggest otherwise. A 2017 study by Manchester University and partners highlighted the importance of sex to quality of life in older people, and showed that clinicians' handling of sexual health in the 'over-50s' needs improvement. According to one European study, around 62% of men and 37% of women over the age of 65 are sexually active, and Natsal-3 research has indicated that it is often lack of a partner in old age and unresolved health issues that are key factors in curtailing sexual fulfilment.
Researchers in this area - and charities and organisations that represent older people - often refer to the 'over-50s' as blanket terminology for 'the older generation', yet the range in sexual function from early fifties to 80 and beyond is vast. Sexual behaviour varies widely between individuals at any age; what's important is easy access to health resources that support our sexual choices wherever we are in our lives.
The benefits of maintaining an active sex life
"Evidence suggests an association between active sex in older age and slower cognitive decline, better quality of sleep, and lower rate of cardiovascular disease and prostate cancer in men," he says.
Lesley Carter, clinical lead at Age UK agrees: "It continues to be important to maintain sexual intimacy as we age as it brings with it positive physical and emotional advantages. There are many ways to enjoy intimacy and pleasure and it may be different to what we have experienced before. It can be non-penetrative or involve positions that are more comfortable, or be just about touch and closeness - whatever feels good for you."
Overcoming later life health issues
Erectile dysfunction is a common part of the ageing process and affects up to 4.3 million men in the UK. Sildenafil (Viagra) has become the popular go-to treatment for impotence and is now available to buy from some pharmacies without prescription, but is contra-indicated with certain health conditions. Your pharmacist is fully trained to advise when it's not appropriate to take, but if in doubt you may want to ask your GP.
"Sexual desire can lessen or change if we feel embarrassed or uncomfortable with changes in our bodies, but keeping fit, eating a healthy diet and maintaining a positive outlook can be beneficial," continues Carter. "Physical and hormonal changes can greatly impact on desire and performance, and vaginal dryness (atrophy) is a common problem for women that can make sex painful and lessen desire. Using an organic, pH-balanced lubricant can be helpful, and topical oestrogen or systemic hormone replacement therapy (HRT) are options, as is experimenting with sex toys and medical devices."
It is also important for women in later life to be aware of the symptoms of conditions such as vulvodynia, lichen sclerosus and gynaecological cancers, which can be more prevalent after menopause. Other common issues such as urinary tract infections, thrush and bacterial vaginosis can also occur more frequently and may need a long-term treatment plan.
In terms of general health as we age, various chronic conditions can adversely affect sexual well-being.
"Individuals with comorbidities such as diabetes, cardiovascular disease, chronic airway disease, or chronic inflammatory conditions (rheumatoid arthritis, osteoarthritis, SLE, etc) are more likely to report difficulty in having an active sexual life," explains Manavi.
"A significant proportion of adults report lack of interest in sex with ageing and this is normal," continues Manavi, "but having said that, it is important that older adults do not dismiss their difficulty with sexual activity as part of the 'ageing' process. It is always best to discuss concerns and difficulties with a doctor to ensure nothing else is causing the problem."
With mid- and later-life divorce on the rise, and online apps a now a popular means of dating, many people in their fifties and beyond are leading more active and carefree sex lives than ever before. However, this has contributed to a rise in sexually transmitted infections (STI) in this age group.
"Unfortunately, now the risk of pregnancy is over, older people aren't always practising safe sex,” says Carter. “This may be because all the sexual health messages are targeted at a much younger audience, there is a lack of useful information available, and health professionals do not feel knowledgeable enough offering advice to older people.”
Manavi agrees: “Not all older adults may see themselves at risk of STI and may therefore not be screened. We have witnessed a continuous rise in the rates over the past five years.”
"We need to reduce the possible stigma associated with older adults seeking sexual health services," says Manavi. "Many people, including the older generation, may believe that old people should remain asexual. Improving the knowledge and skills of clinicians on this issue, particularly GPs and physicians in care of the elderly, is important. And while psychosexual services currently provide most of the support for adults with sexual dysfunction, they are not commissioned in many areas in England."
How to seek help
Your GP and the sexual health clinic at your local hospital can advise on sex-related health issues, whether physical or emotional. Age UK offers information and advice about sex in later life, and sex toy companies that value and understand older people, such as Jo Divine, are another useful resource.
"We advise women and men in their seventies, eighties and nineties who still want to enjoy sexual intimacy and pleasure," says former nurse Samantha Evans, Jo Divine's managing director and founder. "Some may be widowed and miss sex so buy a vibrator; others want to explore new ways to enjoy orgasms or may be looking for help with a medical problem. Often their GP has told them to buy one!"