Sex and Intimacy in Later Life

Sex and Intimacy in Later Life

Hello, Cliff here:
You probably think you know a lot about sexuality in old age. Here’s the list of what I think you think you know: People lose interest in sex as they age. Men have less frequent and less rigid erections. Post-menopausal women have vaginal dryness that makes intercourse uncomfortable. People are self-conscious about age-related changes in their bodies. Sex becomes routine and lacks excitement in long term relationships. Loss of spouses and partners through divorce, separation or death may leave people without sexual partners. Health problems in old age make sex too dangerous.

That’s quite a depressing litany of negative associations with sex in old age and there’s some truth to everything on that list. But like everything having to do with aging, not everyone experiencing these things, and of those that do, many find ways around the challenges.

Let’s take them one by one. “People lose interest in sex as they age”. This is a half-truth. Libido (“sex drive”) may wane in mid-life but some people (especially women) experience a second adolescence with a renewed sex drive. And a healthy libido can persist into late life in both men and women. Unfortunately, not all older couples are well matched in the sex drive arena. We may have to address that one in a later column.

So a robust libido is not uncommon in older adults, but alas, the body may not keep up with the mind in this department. Changes in genital sexual response (erectile dysfunction in men, vaginal dryness in women) can make sexual intercourse challenging and infrequent. But there are ways to deal with these issues, including medications and external lubricants. But when sexual intercourse isn’t possible, there are options that may remind people of their earlier sexual experiences: petting and oral sex. For others, hugging, kissing and caressing are completely satisfying. Many older adults crave intimacy more than orgasm.

“People are self-conscious about age-related changes in their bodies”. Another half-truth. Many people experience a tremendous sense of freedom with their bodies in old age. They accept their bodies for what they are and expect others to do the same. They don’t care about image or pretense. But then again, there’s nothing wrong with keeping the lights dim, either!

What’s next on that depressing list? “Sex becomes routine in long-term relationships”? I suppose that can be a “full-truth”. But even this is not always true. Couples can be very creative in this department and keep sex playful and inventive. An active imagination, a willing spirit and maybe some inspiration from books and movies may help. It takes “two to tango” though and if one person in a couple isn’t willing to try new things, then that’s that. The reluctance to try new things should be discussed and explored, but in the end, it has to be respected.

The next thing on that list is that older adults are frequently on their own, due to divorce, separation or death of one’s spouse or partner. Loneliness and lack of opportunity to have a sex partner are, sadly, all too common in old age. But I’m always surprised at the courage and optimism people show in this regard, being open to dating and new friendships.

The last thing on the list? Health problems make sex too dangerous? This is a “no truth”. Sex doesn’t have to involve a high intensity work-out or heavy lifting, although I know it can! But when painful conditions, heart disease, shortness of breath or just plain old “deconditioning” (i.e. being out of shape) limit wild sex play, there is still fun to be had in gentle, slow-paced intimacy that can be savored like fine wine. Just be careful, read up on the subject of sex with a disability and of course, speak with your health care provider. If they say you’re up to it, I’d recommend a sensible aerobic exercise routine, yoga and some resistance training for “safe sex” and better physical, emotional and cognitive health.

So, that’s what I have to say on this subject. Let’s see if Len agrees with me and what he can add.

This is Len.

You did good Cliff – smashing many of the destructive myths that have been unfortunately adopted when it comes to the public’s view of older adults and sex. Allow me to add some additional thoughts on the subject.

It strikes me that recent news reports that speak to the fact that for the first time more Americans 50 years and older are divorced than widowed and that the numbers of “gray divorcees” are growing given that baby boomers are living longer serves to make issues surrounding age and sexuality all the more timely. The data indicate that the divorce rate among people 50+ has more than doubled since 1990 (jumping from 10% to 28%) while the divorce rate for people overall has leveled off and even slightly declined. I’m thinking this trend among aging boomers toward severing their marital ties speaks volumes to the continued significance that sex and intimacy play in the lives of older adults.

The fact is, the basic need for sex and intimacy are central to the human experience regardless of age. With many healthy years remaining for growing numbers of people in their 60s, it should not be surprising that married baby boomers are increasingly choosing not to remain in bad and even mediocre relationships. We want to be in a satisfying relationship and that includes our fair share of romance and both physical and emotional passion. Unfortunately, if that passion is not found at home we often choose to look elsewhere.

Maintaining a passionate relationship at any age is hard work but perhaps especially in our later years given the potential for long-term relationships to gradually lose their freshness and excitement.

I think the best way in which to conceive of sexual intimacy and sexuality in later life is from multiple perspectives including not only the physical dimension but the psychological, emotional, and social dimensions as well. While being sexually involved with another individual is usually central to achieving a satisfying intimate adult relationship, we should never downplay the importance of a series of other facets of intimacy including trust, mutual respect and concern for our partner, and both open and honest communication as well as maintaining shared goals and expectations. The combination of all these factors probably becomes increasingly important as we grow older and seek increased stability and security, and, taken together, are essential in feeling genuinely connected with another person.

The good news is that research on the emotional lives of older adults suggests that our capacity for intimacy improves with age. An international study that involved 29 countries discovered that it is the 40 to 80 year olds who said they had the best time during sex. The researchers theorized that middle-aged and older adults were less concerned about sexual performance compared to younger people and more concerned about intimacy. Other research suggests that in later life we learn to better manage our emotional lives by avoiding experiences that are likely to hurt or irritate us. It seems to me that these are all qualities that can improve our intimate relationships as we grow older. Maybe that is why so many late-life lovers say that love, like wine, improves with age.

As Cliff noted, the bad news is that various combinations of complacency, physical changes in our bodies, and decline in our physical and psychological health can create challenges that we may need to be prepared to overcome or at least adapt to in order to maintain satisfying levels of intimacy with our partners.

The bottom line, in my view, is that as we grow older we need to be willing to assume responsibility for doing everything in our power to hold up our end of the bargain in maintaining the magic and mystery that comprises the intimate relationship(s) we are a part of. That frequently means consciously fighting the inclination to become complacent and lazy by making concerted efforts to continuously rediscover and display our romantic selves (i.e., by giving our partners surprise gifts when it is not their birthdays and holding hands when out running errands). It also means caring about our appearance and staying well groomed (which, by the way, I can tell you from personal experience, can pay off handsomely on the romantic front).

Of course there are forces working against older adults in our quest for romance and intimacy. We must not, for example, allow our kids’ “inner ageism” deny us a sex life. We remain sexual beings regardless of our age and don’t let anyone tell you otherwise. And, furthermore, we all could benefit from remembering that good sex is not just about orgasms or marathon sessions in the sack. Sexual intercourse is just one form of sexual intimacy. As Cliff says, don’t discount the pleasure that comes from longing gazes into another person’s eyes, intense kissing, hugging, sexual touching, and cuddling. Good stuff, indeed!

If a physical condition is getting in the way of you having a satisfying intimate relationship, confront it head on by talking with your physician. Many of those conditions can be treated and even reversed including low levels of testosterone, erectile dysfunction, and decreased vaginal elasticity and lubrication. Other illnesses and disabilities (for instance, arthritis, chronic pain, diabetes, heart disease, incontinence, and stroke) as well as surgeries and medications can have a negative impact on our ability to engage in and enjoy sex. For these conditions, too, a wide range of treatments and procedures are available to enable us to enjoy a fulfilling sex life – yet another reason to talk with your health care provider. Sometimes, all that is needed is for us to be in less of a hurry given that it is perfectly normal for older adults to require more time to become sexually stimulated. While medications may be helpful, more foreplay may be just what the doctor ordered and for those whose kids have grown and left the house you may have the time and privacy (finally!) to take your time.

Len Kaye

About Len Kaye

Dr. Lenard W. Kaye is Professor of Social Work at the University of Maine School of Social Work and Director of the UMaine Center on Aging.