Overview

In most healthy adults, pleasure and interest in sex remain as they age. Age alone is no reason to change the sexual practices that you have enjoyed throughout your life. But you may have to make a few minor adjustments to accommodate any physical limitations you may have or the effects of certain illnesses or medicines.

It's never too late to start having sex. Many older people who have been celibate for years develop satisfying sex lives. And self-stimulation (masturbation) is normal, common, and healthy.

You may have sexual changes as you get older. But some changes may be the first sign of a medical problem. So talk with your doctor about any changes that concern you. He or she may be able to recommend treatments that will help you.

Here are some other considerations:

• Some medicines may inhibit sexual response. This includes medicines for depression, anxiety, and seizures. Ask your doctor about these side effects. Your doctor may be able to reduce your dosage or prescribe different medicines. Do not stop taking prescription medicines without talking with your doctor first.
• Colostomies, mastectomies, and other procedures that involve changes in physical appearance need not put an end to sexual pleasure. Communicating openly about your fears and expectations can bring you and your partner closer together and help you overcome barriers. If needed, a little counselling for both of you can help you adjust.
• People who have heart conditions can enjoy full, satisfying sex lives. Most doctors recommend that you abstain from sex for only a brief time following a heart attack. If you have angina, ask your doctor about taking nitroglycerin before you have sex. If you are using nitroglycerin, do not use erection-enhancing medicine such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).
• If arthritis keeps you from enjoying sex, experiment with different positions. Try placing cushions under your hips. Also try home treatment for arthritis pain.
• Prescription medicines that can enhance the sexual response are available. Some people try natural health products. Both prescription drugs and natural health products carry the risk of side effects. Always talk to your doctor before you use any new medicines or natural health products.

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Common Physical Changes in Men

Most physical changes are the result of decreasing testosterone levels. These changes affect energy, strength, muscle and fat mass, and bone density. They can also affect sexual function.

• Your sexual response starts to slow down after age 50. But your sex drive is more likely to be affected by your health and attitude about sex and intimacy than by your age.
• It may take longer to get an erection. Also, more time needs to pass between erections.
• Erections will be less firm. But if you have good blood flow to your penis, you should be able to have erections that are firm enough for sexual intercourse throughout your life.
• As you age, you may be able to delay ejaculation for a longer time.

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Common Physical Changes in Women

Most physical changes take place after menopause. They're the result of decreased estrogen levels. Taking hormone therapy can reduce these changes.

• It may take longer to become sexually excited.
• The walls of the vagina get thinner and drier. They're more easily irritated during sexual intercourse.
• Orgasms may be somewhat shorter than they used to be. The contractions felt during orgasm can be less intense.

Not everyone has these problems. If you do have problems, you can look for ways to enjoy sex in spite of them.

Other Issues That Can Affect Sexuality

Besides physical changes, cultural and psychological factors can affect sexuality in later years. For example, in our culture, sexuality is often tied to youthful looks and vigour. Too many people seem to think that as a person ages, they become less desirable and less of a sexual being. Older adults may accept this stereotype. They may feel that they're not allowed or expected to be sexual.

There are no age limits to joy in sex and loving. Almost everyone is able to find lifelong pleasure in sex. If you believe the myth that older people have no interest in sex, you could miss out on wonderful possibilities.

Being single (through choice, divorce, or widowhood) can present a problem as you get older. You may not have as many people in your age group to choose from. People who are single may not know how to deal with their sexual feelings. In general, it's better to express your desires than to suppress them until you are no longer aware that they exist.

Physical and emotional needs change with time and circumstance. Intimacy and sexuality may or may not be important to you. You can live a fulfilling life without sex. But if you choose to enjoy your sexuality, you deserve to be supported and encouraged. You may still find uncharted sensual areas to explore.

Touch, Affection, and Intimacy

Touch, affection, and intimacy are important at any age.

Touch

Touch is a wonderful and needed sensation. Babies who are not touched do not thrive. Children who are not touched develop emotional problems. Touch is important to older adults as well. Touch helps us feel connected with others.

• Get a massage. Professional massages are wonderful, but simple shoulder and neck rubs feel great too. Find a friend who will trade shoulder rubs with you.
• Look for hugs. Everybody needs them. Some people are a little shy about hugs, but it's okay to ask, "Would you like a hug?"
• Consider getting a pet. Caring for a pet can help meet your needs for touch. Some studies have shown that older people who have pets to care for live longer.

Affection

To give and receive affection is a wonderful feeling. If you like someone, be sure to let them know. If someone seems to like you, appreciate it. It is never too late to make new friends and strengthen bonds with longtime companions.

Intimacy

Intimacy is the capacity for a close physical or emotional connection with another person. Intimacy is a great protector against depression.

Talking with a confidant can help ease life's problems. When you lose a loved one, intimacy may be what you miss most. You may not find someone to fully replace a loved one who died, but you can begin to rebuild intimacy in your life in the following ways:

• Turn to your children, siblings, or old and new friends.
• Look for another person who is in the same situation as you are. One of the richest benefits of support groups is that members often find intimacy with one another.
• Be available to others. Just as you need people, there are people who need you too.

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Sexually Transmitted Infections

Sexually transmitted infections—also known as STIs or venereal diseases—are infections passed from person to person through sexual intercourse, genital contact, or contact with semen, vaginal fluids, or blood.

Older people may think of STIs as a problem that affects only young people. But older adults can get STIs too.

Do the following things to help prevent STIs:

• Use a water-based lubricant when you have sex.

  As you age, your immune system is not as strong, so it's harder to fight off disease. And women who are past menopause have thinner vaginal walls and less vaginal moisture than they did before menopause. Using a lubricant, such as K-Y Jelly, may keep you from getting a sore or a tiny cut on your penis or inside your vagina. This can reduce your risk of getting STIs or HIV.

• Practice safer sex.

  For older adults, this means always using condoms and lubricants until you are in a monogamous relationship and know your partner's sexual history and HIV status.

• Talk openly with your partner about STIs.

  STIs can affect anyone, no matter what his or her age. Talk with your partner, and take whatever precautions are needed to protect yourself before you engage in any form of sexual contact.

If you think you may have an STI, see your doctor.

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