Sexual health and aging: Keep the passion alive

Date Updated: 10/01/2020

Sexual health is important at any age. And the desire for intimacy is timeless. As you age, sex may not be the same as it was in your 20s, but it can still be very fulfilling. Discover which aspects of sexual health are likely to change as you age — and how you and your partner can adapt.

Communication is key

To maintain a satisfying sex life, talk with your partner. Set aside time to be sensual and sexual together. When you're spending intimate time with your partner, share your thoughts about lovemaking. Help your partner understand what you want from him or her. Be honest about what you're experiencing physically and emotionally.

Sexual health and safe sex

Women can become pregnant until they've reached menopause — defined as 12 straight months without a period. If you're sexually active, use birth control consistently until menopause. Ask your health care provider for guidance if you're not sure which type of birth control is right for you.

People of all ages should know how to practice safe sex. If you're having sex with a new or different partner, always use a condom. Also talk with your doctor about other ways to protect yourself from sexually transmitted infections.

If you're in a long-term monogamous relationship and you've both tested negative for sexually transmitted infections, you probably don't need to worry about protection. Until you know for sure, however, use a condom when you have sex.

Aging and men's sexual health

Testosterone plays an important role in a man's sexual experience. Testosterone levels vary greatly among men. In general, however, older men tend to have lower testosterone levels than do younger men. Testosterone levels gradually decline throughout adulthood — about 1% each year after age 30 on average.

As a man ages, the penis may take longer to become erect, and erections may not be as firm. It may take longer to achieve full arousal and to have orgasmic and ejaculatory experiences. Erectile dysfunction also becomes more common. Several medications are available to help men achieve or sustain an adequate erection for sexual activity.

Aging and women's sexual health

As women approach menopause, their estrogen levels decrease, which may lead to vaginal dryness and slower sexual arousal. Emotional changes can increase feelings of stress, which also can change your interest in sex.

While some women may enjoy sex more without worrying about pregnancy, naturally occurring changes in body shape and size may cause others to feel less sexually desirable.

Medical conditions, medications and sexual health

Any condition that affects your general health and well-being may also affect your sexual health. Illnesses that involve the cardiovascular system — such as high blood pressure, diabetes, hormonal problems, depression or anxiety — can pose challenges to being sexually active.

The medications used to treat these conditions also can inhibit your sexual response. Certain high blood pressure medications, for instance, can affect your ability to become aroused. Other medications can make it more difficult to have an orgasm.

If you think you are experiencing sexual side effects from a medication, consult your doctor. It may be possible to switch to a different medication with fewer sexual side effects, or to add an additional medication that reduces sexual side effects.

Surgery and sexual health

Any surgical procedure that affects your pelvis and your central nervous system may have significant impact on your sexual response. The body, however, is resilient. Given time to heal and some loving attention, most people can often become sexually responsive again.

When one partner becomes ill

If you're ill, your sexuality may temporarily take a back seat to other needs. Pain, discomfort, medications or worry can overshadow your sexual desire. Talk with your partner about other ways to be close during this time.

If you're the caregiver, the demands of caring for your partner may take a toll on your sexual desire. Find a way to set aside the caregiver role from time to time, and be a partner instead — so that you can relax and feel nurtured by your partner. That way, you can enjoy a mutually satisfying sexual encounter.

Dealing with differences in desire

Differences in libidos are common among couples of all ages. Couples can become stuck in a pattern where one person initiates contact while the other avoids it. If you mainly avoid sex, consider taking charge of some engagement. If you usually initiate sex, try talking with your partner about what you need.

If you're worried about hurting your partner's feelings, talk about your experience using "I" statements, such as "I think my body responds better when …." In turn, try to understand your partner's needs and desires. Together you can find ways to accommodate both your needs.

Looking forward not back

Many couples want to know how to get back to the sexual arousal and activity levels they experienced in their 20s, 30s and early 40s. Instead, find ways to optimize your body's response for sexual experiences now. Ask yourselves what's satisfying and mutually acceptable.

Many books are available about how to maintain a healthy sex life as you get older. In addition, many couples find consulting with an expert helpful. Your doctor may be able to provide useful suggestions or refer you to a specialist.