People over the age of 65 form an increasingly large proportion of our population, yet little attention has been paid to sexual dysfunction in the elderly.   And although many older people experience sexual difficulties, they are often prepared to live with the problem, feeling embarrassed to approach their GP. 

A variety of sexual changes come about with age. For example, men tend to show an increase in the time required to produce a full erection and the time erections can be maintained, as well as a decrease in the force of ejaculation.  Post-menopausal women may experience inadequate vaginal lubrication and intercourse may be painful if the vaginal walls become excessively thin - although, for many, these changes are balanced by the freedom to enjoy sex without the worry of becoming pregnant.

But although the frequency of sexual dysfunction increases with age this is mainly because of health problems rather than old age itself.   Since older people are more likely to be unwell, it is not surprising to find an increase in health-related sexual problems amongst them.  For instance, various endocrine, vascular, and neurological complaints can disrupt sexual function, as can many forms of medication and surgery.  In particular, cardiovascular disease, diabetes, dementia and arthritis can  affect sexual function, while medications such as antihypertensives, tranquilisers and antidepressants can also adversely affect erectile function and libido (although other medications can enhance it). 

Negative attitudes still exist within society concerning sexual behaviour and the elderly, influencing the thinking of older people themselves.   The notion that sexuality is a lifelong process often goes contrary to the thinking of elderly people, their children, and their health care providers. Perhaps today’s reverence for youth and good looks contributes to the expectation that older people are, or ought to be, asexual.

Fortunately, such attitudes are gradually changing. Many people who are currently classed as elderly were only middle-aged during the “sexual revolution” of the 1960s and 1970s, and  have a different perspective to that of previous generations.

To help avoid psychological problems with aging and sex, older people should bear in mind that they can learn to adjust to changes affecting sexual function and that sexual enjoyment need not be curtailed.