Older people and sex…

Stereotypes can be very powerful. One of the enduring stereotypes of the modern age is that older people are not interested in sex and don’t engage in sexual relations. Sex between consenting adults is fine but not if they are both above a certain age. Sex is for young healthy and attractive people. The notion of grandparents doing it is revolting. Or so the stereotype goes.

The great danger with stereotypes is that people begin to accept them as being true. We live in a society that idealises the thin athletic body of youth. Television and various forms of advertising all promote the concept of the body beautiful. Tall thin and leggy is in but the fuller figure is definitely out. It is not just the vulnerable adolescent that can feel alienated in the modern world. We know from our experience with young people that self-esteem and body image are closely related and can be a source of deep unhappiness if the young person perceives that they are very different from their peers. But self-esteem and body image can also be very important for the older person as age related change imposes its own challenges.

Physical changes

Older people look in the mirror too. They may fear being less attractive to their partners as their hair recedes, the wrinkles increase and the varicose veins start to get bigger. The person is also challenged by the physical changes they observe in their partners. Some couples learn to accept these physical changes and focus on wider aspects of their relationship and can continue to enjoy physical intimacy to an advanced age. Others are less successful in making this transition with great personal loss to themselves.

The menopause is an important time of change for most couples and it can be a make or break time. It is a time of transition that is not just simply a question of hormones. A successful transition through the menopause can ensure the continuation of a satisfactory sexual relationship for many years to come. For some couples the menopause can be a time of great sexual liberation as they are at last free of the worry of pregnancy. It can also be the first time in years that the couple have had the house to themselves without the fear of intrusion during lovemaking.

Sex drive

Some women may even experience an increase in sex drive because the oestrogen levels begin to fall thereby allowing androgens to play a more powerful role in physical arousal and sexual response. Readers may be surprised by that previous comment since androgens are known to be male hormones however, both men and women have certain amounts of both male and female sex hormones in their bodies. It is the altered ratio of androgen to oestrogen in the menopausal female that causes the sexual effect.

However, a decrease in sexual desire with advancing age is perhaps more common in both men and women. Sexual response may also take longer. Men may begin to experience erectile failure and this may cause considerable difficulties in self-esteem especially if it is a new experience for the man. One of the most positive spin offs from the recent availability of treatments for erectile failure is that men are at last beginning to feel that they can now talk about this difficulty to the doctor because something can be done about it.

I had an amusing experience when viagra first became available in Ireland. A woman came to see me one day in order to get a supply of the drug for her husband because the drug had not yet been launched in the country where she now lived. The drug was on her shopping list of things to bring home with her along with the Aran jumpers, the brown bread and the smoked salmon.

Some medications can affect sexual response.


I digress! Women may experience soreness during intercourse because of thinning and drying of the vaginal tissues. This happens as a result of the decrease in oestrogen. These physical changes in the vagina may cause discomfort for both partners and they may resort to the use of lubricants to compensate for lack of vaginal moisture. If a couple do resort to using lubricants it is best to use a water based item such as KY jelly rather than petroleum jelly, which quickly loses its lubricating effect during intercourse. Prescription vaginal creams containing oestrogen may be an even better option for the problem of vaginal dryness and thinning.

There may also be issues concerning role change. This can be a particular problem for women as they struggle with several competing roles all at once. The nest is now empty but they may have to contend again with child minding as they care for their grandchildren. Some women may also have to continue working outside the home while still performing the traditional role of housewife. For some women the juggling of these various roles may allow the role of sexual partner to recede into the background.

Having negotiated their way through the menopause the couple may have to contend with physical impairment. Arthritis can make sexual intercourse more difficult but not impossible. People with cardiac or pulmonary disease may lack the actual stamina to engage in intercourse. However, changes in sexual positions may allow mutually satisfactory sexual relations to take place.


Some medications can affect sexual response. For example medication for high blood pressure can cause erectile difficulty in the male so if that happens discuss it with your GP. You don’t have to accept such side effects as part of life’s ongoing burden. Medication can be changed. Erectile failure is not an essential element in controlling people’s blood pressure!

It is important for older people to continue to eat sensibly and take regular exercise. A sedentary lifestyle accompanied by obesity, excessive alcohol consumption and cigarette smoking can all result in a diminished or absent sexual response. If you pay prudent attention to your health there is no reason why you cannot enjoy good sex while having a medical card for the over seventies and a free bus pass.

The desire for sex is a powerful, primitive and healthy drive within all of us. Older people should ignore the stereotypes of today and seek help if they are experiencing sexual difficulty. Sex is not just for the young. True sophisticates might even say that it is wasted on them.

Dr Leonard Condren is the medical editor of irishhealth.com

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