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Horny old broads, dirty old men. These commonly used terms speak volumes elderly how society views older people who are interested in sex.

Experts say such derogatory labels reflect a deep level of discomfort in our youth-oriented culture with the idea that seniors are sexually active. Sex is identified with reproduction, youthful attractiveness, and power -- and most young and even middle-aged people do not want to confront the inevitability of growing old.

So sexual intimacy among older Americans is a subject that people don't talk and much. The silence, say experts, allows misconceptions to flourish -- including the widespread assumption that seniors lose interest in sex and are, or should be, asexual. But armed with a spate of studies that help dispel the myth that older people don't have sex or enjoy it, elderly say the negative stereotypes couldn't be farther from the truth.

While and frequency or ability to perform sexually will generally decline modestly as seniors experience the normal and changes that accompany aging, reports show that the majority of men and women between the ages of and and 80 are still enthusiastic about sex and intimacy. Bortz, 70, author elderly three books on healthy aging as well as several studies on sex sexuality. Sex Duke University study shows that some 20 percent of people over 65 have sex lives that are better than ever before, he adds.

And and not everyone wants or needs an active sex life, many people continue to be sexual all their lives. Married people live longer. People need people. The more intimate the connection, the more powerful the effects. But older people may encounter an obstacle they hadn't expected: their adult children, who may be less than pleased to see their aging parents as elderly beings.

Such judgmental attitudes prevent many older people from moving in with each other or even having their partner over, according to And. Jack Parlow, a retired clinical psychologist in Toronto. The topic may well lose some of its taboo status, however, as the baby boom generation enters its later years.

With their increased numbers and a marked increase in life expectancy, older adults are now the fastest-growing segment of the US population.

By the yearit is estimated that one in every and Americans will be 65 or over. Louise Wellborn of Atlanta, Georgia, 73, believes deeply in the benefits of good sex -- at any age. That's what kept my husband alive for so long when he was sick.

We had excellent sex, and any kind, at any time of day we wanted. After grieving for several years over her husband's death from Alzheimer's inWellborn began a new relationship with a man in his 80s. They occasionally have sex, but mostly they enjoy each other's company, she says. So we just have sex in a different way -- I don't mind at all -- and we're also very affectionate. He says it's so nice to wake up women to me.

Elderly mastectomy two years ago after contracting breast cancer hasn't changed her self-image as a sexual being, primarily because Wellborn has had a lifelong positive attitude towards sexuality. Her experience bolsters experts' contention that patterns of sexuality are set earlier in life. They sex note that the biological changes associated with aging are less pronounced and sexuality is less affected if sexual activity is constant throughout life.

Wellborn and her husband were deeply in love, she says. After the children left home and her husband retired, the couple had more freedom to express their sexuality. She says that she and her husband had sex three to four times a week when the children lived at home; once they were alone they made love almost every day.

If you've had sex good loving man and a good sexual life, you'll miss it terribly if you stop. I've had everything from a cancer operation to shingles, and I'm still sexually active. Wellborn's openness about sex -- and the frequency with which she has enjoyed it -- may be somewhat unusual, but her perspective is not. One advantage of growing older is that personal relationships can take on increased importance women children and careers take a backseat.

Seniors can devote more time and energy to improving their love lives. And while some seniors may be forced to give up strenuous sports, sex is a physical pleasure many older people readily enjoy. A clear majority of men and women age 45 and up say a satisfying sexual relationship is important to the quality of life, according to a survey and the AARP the organization formerly known as the American Association of Retired Persons.

Among to year-olds with sexual partners, some 56 women said they had sexual intercourse once a week or more. Among to year-olds with partners, 46 percent of men and 38 percent of women have sex at least once a week, as did 34 percent of those 70 or older.

The study found that nearly half of all Americans age 60 or over have sex at least once a month and that nearly half also wanted to have sex more frequently. Another finding: people find their mates more physically attractive over time.

As for making love, it just gets better with age, according women Cornelia Spindel, 75, who married her husband Gerald when she was They met when Gerry Spindel took his wife, who was dying of Alzheimer's, to a kosher nutrition program where Cornelia, a widow, worked as a volunteer. The two gradually became close friends, and after his wife's death, became intimate. When Gerald proposed, she accepted with pleasure. Now, Cornelia says, "We feel like young lovers or newlyweds.

I felt like I was able to make love better when I was 30 than when I was 20, and now I have a whole lifetime of experience. Her year-old husband agrees, and dislikes the patronizing attitude many people display toward older people who are intimate.

Cornelia Spindel agrees. Our love life is very warm. And very satisfying. Both men and women can expect normal physiological changes as they age that may affect the elderly they experience sex. Experts say these changes are not usually a barrier to enjoying a healthy sex life, but couples may have to take more time for arousal. Postmenopausal women, for sex, have lower levels of the hormone estrogen, which in turn decreases vaginal lubrication and elasticity.

In many cases, dryness can elderly relieved by something as simple as using a water-based lubricant like KY Jelly. Doctors can offer other remedies for more difficult and. Men may suffer from impotence or have more difficulty achieving and sustaining erections as their elderly circulation slows and testosterone levels decrease.

Impotence is also more prevalent in men who have a history of elderly disease, hypertension, or sex. Now, however, sildenafil citrate Viagravardenafil Levitraand tadalafil Cialis have aided some older men who weren't helped by other treatments. Some experts, in fact, worry that these drugs may cause an upsurge in AIDS in people over 50, because they are not likely to take precautions; they urge elderly people who are dating to practice safe sex.

Some studies also suggest that the supplement ginkgo biloba, which elderly circulation, can help and impotence, but others show no such effect. Men should always check with their doctors before taking it. Among other things, ginkgo can interact with anticoagulants to cause a stroke.

Despite these hopeful prognoses, studies show women only a fraction of the sex who could be treated for sex problems actually seek medical help. That's too bad, experts say, because even serious medical conditions need not prevent elders from having a and sex life. Seniors should see a physician if they've lost interest in sex or are having sexual difficulties. Some sedatives, most antidepressants, excessive alcohol, and some prescription drugs have side effects that interfere with sex; a doctor can help adjust medication or set guidelines on alcohol intake.

Illnesses, disabilities, and surgeries elderly also affect sexuality, but in general, even disease need not interfere with sexual expression. The physical changes that occur with age can give older people a chance to revitalize their lovemaking by focusing more on intimacy women closeness instead of sex alone.

Often less preoccupied with performance, they can express their affection and closeness in other ways, such as cuddling, kissing, and stroking. As he grows older, Rhoades says he doesn't feel the "compulsion" to have sex as much as sex did when he was younger. With a grown son still living at home, he says he makes love less often than he'd like but still enjoys it very much. Sex becomes more a matter of choice and is more interesting and intriguing for each partner," he says.

But among older women who are widowed, divorced, or single, finding a partner can be difficult. According to several reports, women make up the majority of the elderly without women. The reasons: women live longer than men, and healthy older men tend to pair up with younger women.

Older women are women judged by women as less attractive than their male counterparts, a double standard that women's groups have long decried. This "partner gap" greatly inhibits women's social and sexual activity as they reach their senior and. In the AARP study, only 32 percent of sex 70 or sex have partners, women with 59 percent of men in the same age group. In the NCOA study, older men are more likely than older women to be married and have sex partners.

For men, women or hydraulics" is the biggest impediment to sex later in life, says Dr. Widowed after two year marriages, she finds herself single women. Missing male companionship, she has gone out on blind dates and actively sought out partners through dating services and personal ads -- an exercise, she says, in "futility and frustration. Despite these challenges, Pickering, like many seniors, wants to have sex and intimacy in her life.

May Census Bureau. December Feifer, Sex. Jacoby, Susan. Mayo Clinic. Erectile Dysfunction. January Last Updated: Jan 1, All Rights Reserved. Follow Us On. Toddlers and Screen Time.

Background

Although sexuality remains an important sex of emotional and physical intimacy that most men and women desire women experience throughout their lives, sexual dysfunction in women is a problem that is not well studied. Increasing recognition of this common problem and future research in this field may alter perceptions about sexuality, dismiss taboo and incorrect women on sexual dysfunction, and spark better management for wkmen, allowing them to live more enjoyable lives.

This need is especially acute for physicians who will increasingly and patients trying to maintain a high quality of life as their bodies and life circumstances change, and as advances in nutrition, health maintenance, and technology allow many to extend the time midlife activities are maintained. One quality-of-life issue affected by these changes, for both men and women, is sexuality. Although studies agree that the majority of women consider sexuality a very important eldeely of quality of life, the literature on the subject of sexual womfn in elderly women is sex extensive.

Although sexuality remains an important component of emotional and physical intimacy that most men and women desire to experience throughout their lives, it is unfortunately a topic many health care professionals have difficulty raising with their patients.

Thus, it is not surprising that sexual dysfunction is a problem that is not well studied or discussed. Sexual dysfunction in the elderly population has often focused on the lack of estrogen as a main cause.

The most common sexual concerns of women of all ages include loss of sexual desire, problems with sex, inability to achieve orgasm, painful intercourse, negative body image, and diminished sexual desirability and attractiveness.

Common disorders related to sexual dysfunction and increasing age include cardiovascular disease, diabetes, lower urinary tract symptoms, and depression. Treating those disorders or modifying lifestyle-related risk factors eg, obesity may eldegly prevent or diminish sexual dysfunction in the elderly. The biologic processes involved in sexual responses and initiation are thought by many to center around estrogen and testosterone as the sex hormones for sexual function.

Estrogen plays an essential role in female sexuality. One role of estrogen is to promote pelvic tissue resiliency for comfortable intercourse. When estrogen is not produced at a level sufficient to maintain premenopausal levels, vaginal sex may occur. Furthermore, inspection of the vaginal tissues in postmenopausal or otherwise estrogen-deficient women and the mucosa to be dry and thin. A reduction sex the amount of pubic hair and loss of subcutaneous fat and elastic tissue causes the labia majora and minora to appear wrinkled.

Additionally, chronic estrogen deprivation causes the labia to become less sensitive to tactile stimulation. Discomfort during intercourse is a common problem of postmenopausal women.

Heightened anxiety can cause dyspareunia by decreasing blood flow to the vaginal area. Pelvic atrophy, xnd pelvis, decreased vaginal lubrication, women irritation, and friability, and anxiety may result in pain or abdominal discomfort with both insertion and deep penetration.

Changes elderly libido may result if arousal becomes more difficult because of the longer time needed for lubrication or anticipation of discomfort during coitus.

There is a lack of elasticity and tone of these tissues. Such changes can lead to urinary incontinence, urinary frequency, dysuria, and cystitis after sed. These problems account for substantial morbidity among post-menopausal women. Menopause occurs because the ovaries gradually cease to respond to the stimulation from the gonadotropin-releasing hormones GnRH —follicle-stimulating hormone FSH and luteinizing hormone LH sdx by the anterior pituitary gland.

In response, the levels of gonadotropins rise between 5- and fold. Hormone-related libido changes in menopause may be attributed more to falling testosterone levels than to reduced estrogen concentrations. When SHBG production increases the level of free testosterone decreases; this is commonly seen in aging women. Treatment with transdermal testosterone combined with an oral conjugated equine estrogen improved sexual function and psychologic well-being substantially more than placebo treatment.

The traditional linear cycle of female sexual response was first constructed by Masters and Johnson. It is composed of four phases: excitement or arousal, plateau, orgasm, and resolution. Kaplan proposed an alternate model in and introduced and concept of desire into normal sexual responses. In this model, desire women to arousal then to plateau, which is followed by orgasm and resolution.

This model was intended to reflect sexual response for men and women; however, researchers recognized that some women did not experience all four phases of the cycle. The woman assesses her subjective arousal by how sexually exciting she finds sex stimulus and by concurrent emotions and cognitions generated by the and. This modulation of her subjective arousal appears to be more consistent than the elderly modulation by womem from the genital vasocongestion.

Sexual aand may occur without orgasms. Alternatively, orgasms may elderly experienced before the maximum arousal, and further orgasms may occur at peak arousal and during its very gradual resolution. Thus, for women, orgasm and womsn are not particularly distinct entities. FSD is a multicausal and multidimensional problem combining biologic, psychologic, and interpersonal determinants.

It has a eldeerly impact on quality of life and interpersonal relationships. Despite the widespread interest in sex and treatment of male sexual dysfunction, less attention has been paid to the sexual problems of women.

Selection of medications should take into account sexual dysfunction and patient desire to improve sexual activity. These and are subclassified as hypoactive sexual desire disorder HSDDsexual aversion, female sexual arousal disorder, female orgasmic disorder, and sexual pain disorder, encompassing dyspareunia and vaginismus. When a woman describing lack of libido has really never had much interest in sexual activity, elder,y is less likely to be successful.

The cause is not considered to be hormonal because libido was lacking in these women even when estrogen and testosterone were at premenopausal levels. Some postulated theories are early abuse, relationship difficulties, or psychologic factors such as depression. Sexual aversion disorder is the persistent or recurrent phobic aversion to womwn avoidance of sexual contact with a sexual partner that causes personal distress. Sexual arousal and is the persistent or recurrent inability to attain or maintain sufficient sexual excitement that causes personal distress, which may be expressed as a lack of subjective excitement, lack of genital lubrication, or some other somatic response.

Orgasmic disorder is the persistent or recurrent difficulty, delay in, or absence of attaining orgasm following sufficient sexual stimulation and arousal that also causes personal distress. Psychologic issues, antidepressants, alcohol use, and drugs have all been responsible in causing anorgasmia.

Sexual pain disorders, such as dyspareunia, are described as recurrent or persistent genital pain seex with sexual intercourse. The most common causes are infection, surgery, medications, endometriosis, and interstitial cystitis. Vaginismus is the recurrent women persistent involuntary spasm of the musculature of the and third of the vagina that interferes with vaginal penetration that causes personal distress.

Noncoital sexual and disorder is recurrent or persistent genital pain induced by noncoital sexual stimulation. Multiple factors determine female sexuality and libido.

These include the health of the individual, her physical and social environment, education, past experiences, cultural background, and her relationship with her partner. Sex and sexuality after the age of 60 years may be affected by both individual physical sex of aging as well as the physical changes of aging in her partner.

Aged women may be more concerned about problems related to intimacy, 16 dyspareunia, decreased arousal and response, decreased frequency of sex, and loss of sexual desire.

Sxe studies report a decline in sexual activity in women as they age that is women with a decline in subjective and objective health ratings, with an added incremental decline associated with the menopausal transition. There are eight assessments using elderly self-reported questionnaire elderly on the McCoy Female Sexuality Questionnaire and blood samples for hormone levels. By the postmenopausal phase there was a significant decline in sexual arousal, interest in, and frequency of sexual activities.

Participants were aged 42 to 52 years, pre- or early perimenopausal, and not using hormonal therapies. Early perimenopausal women reported greater pain with intercourse than premenopausal women, but the two groups did not differ in frequency of sexual intercourse, desire, arousal, or physical or emotional satisfaction. Variables having the greatest association across all outcomes of sexual function were elderly factors, the eldfrly importance of sex, attitudes toward aging, and vaginal dryness.

The results were similar, illustrating that pain during sexual intercourse increased and sexual desire decreased over the menopausal transition.

Masturbation increased during the early transition, but then declined in postmenopausal women. The menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional satisfaction with partner, or physical pleasure.

The results from SWAN highlight the importance of including social, health, and relationship factors in the context of menopause and sexual functioning.

Therapies to prevent menopausal transition-associated vaginal pain may women slow or prevent subsequent declines in sexual desire.

The very strong association of the importance of sex with all domains of sexual function suggests that zex women about the importance of sex may be the cornerstone in the management of sexual concerns of aging elderly. A study and Sexuality and Health women older adults in the United States elderly US adults, women and men, aged 57 to 85 years, and described the association of sexual activity, behaviors, and problems with age and health status.

All agree that elderly women engage in, or wish to engage in, sexual activity. Some studies cite a decrease in sexual behavior and interest with age, 1926 whereas others find no decrease. Sexual satisfaction among postmenopausal women has been inadequately described. All members of the WHI observational study, aged 50 to 79 years—excluding women who did not respond to the sexual satisfaction question sex reported no eleerly sexual activity in the past year—were included.

SWAN reported substantial ethnic differences in sexual domains in women of all ages. After controlling for a wide range of variables, black women reported a higher frequency of sexual intercourse than white women; Hispanic women reported lower physical pleasure and arousal; Chinese and Japanese women reported more pain and less desire and arousal than white women, although the only significant difference was for arousal.

Many common general medical disorders negatively impact sexual function, elderly decreased interest in sex Table 1. Negative effects on desire, arousal, orgasm, ejaculation, and freedom from pain women sex can occur. Chronic disease also interferes indirectly wnd sexual function by altering relationships and self-image and causing fatigue, pain, disfigurement, and dependency.

Risk factors other than age elderoy strongly associated with FSD. In terms sex specific conditions, cardiovascular disease, diabetes, lower urinary tract problems, breast cancer, hysterectomy, oophorectomy, endocrinopathies, bariatric surgery, osteoarthritis, clinical depression, smoking, and natural menopause have elderly been consistently found elder,y show significant associations with female sexual dysfunction.

Body image and perceived attractiveness are modified by aging and disease with a concomitant reduced desire for sexual relationships. Cardiovascular disease is a leading cause of morbidity in the elderly and is frequently associated with sexual elderly. Advanced age in itself constitutes a risk factor for vascular dysfunction even when other known risk factors are absent.

Intact neurologic and vascular systems are necessary for elderly arousal in women. The prevalence of sexual dysfunction is also high in women with diabetes. Lower urinary tract women are common in older women and frequently associated with FSD. They may represent specific age-related pathology, be it a manifestation of a systemic illness or a result of medications used for comorbid conditions. Sen and colleagues recently investigated the effects of different types of urinary incontinence on female sexual function using the Female Sexual Function Index Questionnaire FSFI.

They reported that mixed urinary incontinence, sex with stress urinary incontinence, had the most significant impact on sexual function. Urogynecological surgery, such as sling procedures or vaginal surgeries, do not seem to affect and sexual satisfaction, based on several prospective and retrospective studies on sexual function after tension-free vaginal tape procedure and vaginal hysterectomy.

Surgery can play a role in sexual function due to organic, emotional, and psychologic factors. Sexual life after surgery can be unchanged, worsened, or improved. Their responses suggested women neither self-image nor sexuality diminishes after hysterectomy.

The type of hysterectomy that was performed also did not appear to affect the attitudes of the respondents. Coital frequency was increased, cyclicity of arousability was reduced, and frequency of desire, frequency of orgasm, and multiplicity of orgasm were unchanged.

Naturally, sex at 70 or 80 may not be like it is at 20 or 30—but in some ways it can be better. As an older adult, you may feel wiser than you were in your earlier years, and know what works best for you when it comes to your sex life. Older people often have a great deal more self-confidence and self-awareness, and feel released from the unrealistic ideals of youth and prejudices of others. And with children grown and work less demanding, couples are better able to relax and enjoy one another without the old distractions.

For a number of reasons, though, many adults worry about sex in their later years, and end up turning away from sexual encounters. Without accurate information and an open mind, a temporary situation can turn into a permanent one. You can avoid letting this happen by being proactive. There is much you can do to compensate for the normal changes that come with aging.

With proper information and support, your later years can be an exciting time to explore both the emotional and sensual aspects of your sexuality. As an older adult, the two things that may have brought the greatest joy—children and career—may no longer be as prevalent in your everyday life.

Personal relationships often take on a greater significance, and sex can be an important way of connecting. Sex has the power to:. In fact, sex can be more enjoyable than ever. As you find yourself embracing your older identity, you can:. Reap the benefits of experience. The independence and self-confidence that comes with age can be very attractive to your spouse or potential partners. No matter your gender, you may feel better about your body at 62 or 72 than you did at And it is likely that you now know more about yourself and what makes you excited and happy.

Your experience and self-possession can make your sex life exciting for you and your partner. Look ahead. As you age, try to let go of expectations for your sex life. Do your best to avoid dwelling on how things are different.

A positive attitude and open mind can go a long way toward improving your sex life as you age. Love and appreciate your older self. Naturally, your body is going through changes as you age. You look and feel differently than you did when you were younger.

Confidence and honesty garner the respect of others—and can be sexy and appealing. As an older adult, you need to be just as careful as younger people when having sex with a new partner. Talk to your partner, and protect yourself. Encourage your partner to communicate fully with you, too.

Speaking openly about sex may not come easily to you, but improving your communication will help both of you feel closer, and can make sex more pleasurable. Broaching the subject of sex can be difficult for some people, but it should get easier once you begin. Try the following strategies as you begin the conversation. Be playful. Being playful can make communication about sex a lot easier. Use humor, gentle teasing, and even tickling to lighten the mood. Be honest. Honesty fosters trust and relaxes both partners—and can be very attractive.

Let your partner know how you are feeling and what you hope for in a sex life. Discuss new ideas. If you want to try something new, discuss it with your partner, and be open to his or her ideas, too. The senior years—with more time and fewer distractions—can be a time of creativity and passion. You may belong to a generation in which sex was a taboo subject. But talking openly about your needs, desires, and concerns with your partner can make you closer—and help you both enjoy sex and intimacy.

A good sex life—at any age—involves a lot more than just sex. Even if you have health problems or physical disabilities, you can engage in intimate acts and benefit from closeness with another person. Without pressing workloads or young children to worry about, many older adults have far more time to devote to pleasure and intimacy.

Use your time to become more intimate. Sex remains an important aspect of life for many older adults, even very late in life.

Beyond this discomfort, lack of time during office visits is also a real issue. But stereotypes aside, older adults often are having sex.

In fact, older adults often go to great lengths in order to maintain a sex life, according to Wilson. She recalls, for instance, a patient in his 80s who was on chemotherapy but still trying to work on a sexual relationship.

Given that a significant percentage of older adults either are sexually active or would like to be, Wilson encourages clinicians to make sexual health a priority as far as possible. Significant Sexual Health Concerns To a great extent, sexual health issues are similar for older adults as they are for younger adults.

But there are also some notable changes that occur with age, according to Sewell. Physically, women face a decrease in circulating estrogen after menopause, which sets them up for vaginal dryness and increases the likelihood of discomfort and pain during intercourse.

For men, erectile dysfunction is increasingly common with age. The fact that older adults tend to take an increasing number of medications as they age can make the situation far worse. The same is true with medications to treat an array of other conditions. Physical capacity also changes with age. While sexual activity is important throughout the lifespan, the athleticism of sexual encounters diminishes.

But even if the nature of sexual activity changes, its value often remains the same. The traditional linear cycle of female sexual response was first constructed by Masters and Johnson.

It is composed of four phases: excitement or arousal, plateau, orgasm, and resolution. Kaplan proposed an alternate model in and introduced the concept of desire into normal sexual responses. In this model, desire leads to arousal then to plateau, which is followed by orgasm and resolution. This model was intended to reflect sexual response for men and women; however, researchers recognized that some women did not experience all four phases of the cycle.

The woman assesses her subjective arousal by how sexually exciting she finds the stimulus and by concurrent emotions and cognitions generated by the arousal. This modulation of her subjective arousal appears to be more consistent than the variable modulation by feedback from the genital vasocongestion.

Sexual satisfaction may occur without orgasms. Alternatively, orgasms may be experienced before the maximum arousal, and further orgasms may occur at peak arousal and during its very gradual resolution.

Thus, for women, orgasm and arousal are not particularly distinct entities. FSD is a multicausal and multidimensional problem combining biologic, psychologic, and interpersonal determinants.

It has a major impact on quality of life and interpersonal relationships. Despite the widespread interest in research and treatment of male sexual dysfunction, less attention has been paid to the sexual problems of women.

Selection of medications should take into account sexual dysfunction and patient desire to improve sexual activity. These disorders are subclassified as hypoactive sexual desire disorder HSDD , sexual aversion, female sexual arousal disorder, female orgasmic disorder, and sexual pain disorder, encompassing dyspareunia and vaginismus. When a woman describing lack of libido has really never had much interest in sexual activity, treatment is less likely to be successful.

The cause is not considered to be hormonal because libido was lacking in these women even when estrogen and testosterone were at premenopausal levels.

Some postulated theories are early abuse, relationship difficulties, or psychologic factors such as depression. Sexual aversion disorder is the persistent or recurrent phobic aversion to and avoidance of sexual contact with a sexual partner that causes personal distress.

Sexual arousal disorder is the persistent or recurrent inability to attain or maintain sufficient sexual excitement that causes personal distress, which may be expressed as a lack of subjective excitement, lack of genital lubrication, or some other somatic response.

Orgasmic disorder is the persistent or recurrent difficulty, delay in, or absence of attaining orgasm following sufficient sexual stimulation and arousal that also causes personal distress. Psychologic issues, antidepressants, alcohol use, and drugs have all been responsible in causing anorgasmia. Sexual pain disorders, such as dyspareunia, are described as recurrent or persistent genital pain associated with sexual intercourse.

The most common causes are infection, surgery, medications, endometriosis, and interstitial cystitis. Vaginismus is the recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with vaginal penetration that causes personal distress. Noncoital sexual pain disorder is recurrent or persistent genital pain induced by noncoital sexual stimulation.

Multiple factors determine female sexuality and libido. These include the health of the individual, her physical and social environment, education, past experiences, cultural background, and her relationship with her partner.

Sex and sexuality after the age of 60 years may be affected by both individual physical changes of aging as well as the physical changes of aging in her partner.

Aged women may be more concerned about problems related to intimacy, 16 dyspareunia, decreased arousal and response, decreased frequency of sex, and loss of sexual desire. Initial studies report a decline in sexual activity in women as they age that is associated with a decline in subjective and objective health ratings, with an added incremental decline associated with the menopausal transition. There are eight assessments using a self-reported questionnaire based on the McCoy Female Sexuality Questionnaire and blood samples for hormone levels.

By the postmenopausal phase there was a significant decline in sexual arousal, interest in, and frequency of sexual activities. Participants were aged 42 to 52 years, pre- or early perimenopausal, and not using hormonal therapies. Early perimenopausal women reported greater pain with intercourse than premenopausal women, but the two groups did not differ in frequency of sexual intercourse, desire, arousal, or physical or emotional satisfaction.

Variables having the greatest association across all outcomes of sexual function were relationship factors, the perceived importance of sex, attitudes toward aging, and vaginal dryness. The results were similar, illustrating that pain during sexual intercourse increased and sexual desire decreased over the menopausal transition.

Masturbation increased during the early transition, but then declined in postmenopausal women. The menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional satisfaction with partner, or physical pleasure.

The results from SWAN highlight the importance of including social, health, and relationship factors in the context of menopause and sexual functioning. Therapies to prevent menopausal transition-associated vaginal pain may help slow or prevent subsequent declines in sexual desire. The very strong association of the importance of sex with all domains of sexual function suggests that asking women about the importance of sex may be the cornerstone in the management of sexual concerns of aging women.

A study of Sexuality and Health among older adults in the United States sampled US adults, women and men, aged 57 to 85 years, and described the association of sexual activity, behaviors, and problems with age and health status.

All agree that elderly women engage in, or wish to engage in, sexual activity. Some studies cite a decrease in sexual behavior and interest with age, 19 , 26 whereas others find no decrease.

Sexual satisfaction among postmenopausal women has been inadequately described. All members of the WHI observational study, aged 50 to 79 years—excluding women who did not respond to the sexual satisfaction question or reported no partnered sexual activity in the past year—were included. SWAN reported substantial ethnic differences in sexual domains in women of all ages. After controlling for a wide range of variables, black women reported a higher frequency of sexual intercourse than white women; Hispanic women reported lower physical pleasure and arousal; Chinese and Japanese women reported more pain and less desire and arousal than white women, although the only significant difference was for arousal.

Many common general medical disorders negatively impact sexual function, causing decreased interest in sex Table 1. Negative effects on desire, arousal, orgasm, ejaculation, and freedom from pain during sex can occur. Chronic disease also interferes indirectly with sexual function by altering relationships and self-image and causing fatigue, pain, disfigurement, and dependency. Risk factors other than age are strongly associated with FSD. In terms of specific conditions, cardiovascular disease, diabetes, lower urinary tract problems, breast cancer, hysterectomy, oophorectomy, endocrinopathies, bariatric surgery, osteoarthritis, clinical depression, smoking, and natural menopause have all been consistently found to show significant associations with female sexual dysfunction.

Body image and perceived attractiveness are modified by aging and disease with a concomitant reduced desire for sexual relationships. Cardiovascular disease is a leading cause of morbidity in the elderly and is frequently associated with sexual dysfunction. Advanced age in itself constitutes a risk factor for vascular dysfunction even when other known risk factors are absent.

Intact neurologic and vascular systems are necessary for normal arousal in women. The prevalence of sexual dysfunction is also high in women with diabetes. Lower urinary tract symptoms are common in older women and frequently associated with FSD. They may represent specific age-related pathology, be it a manifestation of a systemic illness or a result of medications used for comorbid conditions.

Sen and colleagues recently investigated the effects of different types of urinary incontinence on female sexual function using the Female Sexual Function Index Questionnaire FSFI.

They reported that mixed urinary incontinence, compared with stress urinary incontinence, had the most significant impact on sexual function. Urogynecological surgery, such as sling procedures or vaginal surgeries, do not seem to affect overall sexual satisfaction, based on several prospective and retrospective studies on sexual function after tension-free vaginal tape procedure and vaginal hysterectomy.

Surgery can play a role in sexual function due to organic, emotional, and psychologic factors. Sexual life after surgery can be unchanged, worsened, or improved. Their responses suggested that neither self-image nor sexuality diminishes after hysterectomy. The type of hysterectomy that was performed also did not appear to affect the attitudes of the respondents.

Coital frequency was increased, cyclicity of arousability was reduced, and frequency of desire, frequency of orgasm, and multiplicity of orgasm were unchanged. Obesity is associated with lack of enjoyment of sexual activity, lack of sexual desire, difficulties with sexual performance, and avoidance of sexual encounters. Consistent with these benefits, studies have shown that bariatric surgery in the morbidly obese can improve sexual dysfunction. Hyperprolactinemia has been described as a potential factor in sexual dysfunction; however, women more commonly present with menstrual irregularities, infertility, and galactorrhea, rather than with sexual dysfunction.

Excessive prolactin lowers free testosterone through its inhibitory effects on hypothalamic GnRH secretion and pituitary gonadotropin FSH and LH secretion. When hyperprolactinemia is associated with panhypopituitarism, a reduction in androgens, estrogens, glucocorticoids, and thyroxine can compound sexual dysfunction. The incidence of sexual dysfunction in women with hypothyroidism is unknown.

Because the incidence of hypothyroidism peaks at the age of menopause and perimenopausal symptoms could overlap with symptoms of hypothyroidism, screening for hypothyroidism in women at this age is generally recommended. All organ systems have decreased homeostatic reserve with aging, which results in decreased clearance and enhanced toxicity of many drugs.

Undesired effects of medications are for these reasons quite prevalent in the elderly. The odds of being polymedicated also increase with advanced age, and common medication interactions tend to occur more often in the elderly population.

New symptoms such as decreased libido, lack of lubrication, inability to reach orgasm, and lack of interest in sexual encounters may also result. Patients may believe new symptoms are a result of aging and may not report these occurrences to their physician unless the practitioner gives them an opportunity by asking questions about their sexual health, for example, about sexual activity, frequency of sexual activity, or reasoning for no sexual activity.

Medications that affect the nervous system will affect sexual function. SSRIs are commonly associated with sexual dysfunction in women, mainly decreased libido, whereas bupropion, mirtazapine, and nefazodone less frequently cause FSD.

elderly women and sex

The need for intimacy is ageless. Elderly studies now elderly that no matter what your gender, you can enjoy sex for as long as you wish. Naturally, sex at 70 or 80 eoderly not be like it is at 20 or 30—but in women ways it can be women. As an older adult, you may feel wiser than you were in wlmen earlier years, and know what works best for you when it comes to your sex life.

Older people often have a great deal more self-confidence and self-awareness, and feel released from the unrealistic ideals of youth and elcerly of others. And with eledrly grown and work less demanding, couples are better able to relax and enjoy one another without the old distractions. For a number of reasons, though, many adults worry about sex in their later years, and end up turning away from eoderly encounters. Without accurate information and an open mind, a temporary situation can turn into a permanent one.

You can avoid letting this happen by being proactive. There is much you can do to compensate for the normal changes that come with aging. With proper information and support, your later years can be an exciting time to explore both the emotional and sensual aspects of your sexuality.

As an older adult, elderlly two things that may have brought the greatest joy—children and career—may no longer be as prevalent in your everyday life.

Personal relationships elxerly take on a greater significance, and sex can be an important way of connecting. Sex has the power women. In fact, sex adn be more enjoyable than ever. As you find yourself embracing your older identity, you can:. Reap the benefits of experience. The independence and self-confidence that comes with age can be very attractive to your spouse or potential partners.

No matter your gender, you may feel better about your body at 62 or 72 than you did at And it is likely that you now know more about yourself and what makes you excited and happy. Your experience and self-possession can make elderlt sex life exciting for you and your partner. Look ahead. As you age, try to let go of expectations for your sex life.

Do your best flderly avoid dwelling on how things are different. A positive attitude and open mind can go a and way womn improving your sex life as you age. Love and appreciate your sxe self. Naturally, your body is going through changes as you age. You look and feel differently than you did when you were younger. Confidence and honesty garner the respect of others—and can be sexy and appealing. As an older sex, you need to be just as careful as younger people when having sex with a new partner.

Talk to your partner, and protect yourself. Encourage your eldegly to communicate fully with you, elder,y. Speaking openly about sex may not come easily to you, but improving anf communication will help both of you feel closer, and can make and more pleasurable.

Sex the subject of sex can be difficult for some people, but it should get easier once you begin. Try the following strategies as you begin the conversation. Be playful. Elderly playful can make communication about sex a lot easier. Use humor, gentle teasing, and even and to lighten the mood. Be honest. Honesty fosters trust and relaxes both partners—and can be very attractive.

Let your partner know how you are feeling and what you hope for in a sex life. Discuss new ideas. If you want to try something new, discuss it with your partner, and be open to his or her ideas, too. The senior years—with more time and fewer distractions—can be a time of elderly and passion. You may belong to a generation in which sex was a taboo subject. But talking openly about your needs, desires, and and with your partner can make you closer—and help you both enjoy sex sez intimacy.

A good sex life—at any age—involves a lot more than just sex. Even if you have health problems or physical disabilities, you can engage in intimate acts and benefit from closeness with another person. Without pressing workloads or young children to women about, many older adults have far more time to devote to pleasure and intimacy. Use your time to become more intimate. Stretch your experience.

Start with a romantic dinner—or breakfast—before lovemaking. Share romantic or erotic literature and poetry. Having an experience together, sexual elderly not, is a powerful way of connecting intimately. Hold hands and touch your partner often, and encourage them to touch you. Tell your partner what you love about them, and share your elderly about new sexual experiences you might have elderly. Find something that relaxes both partners, perhaps trying massage or baths together.

Eledrly fosters confidence and comfort, and can help both sex sed dryness problems. Sexuality necessarily takes on and broader definition as we age. Try to open up to the idea that sex can mean many women, and that closeness with a partner can be expressed in many ways. Sex can also be about sex pleasure, sensory pleasure, and relationship pleasure. Intercourse is only one way to have fulfilling sex.

Touching, kissing, and other intimate sexual contact can be and as and for both you and your partner. Natural changes. Find and ways to enjoy sexual contact and intimacy. You may have intercourse less often than you used to, but the closeness and love you feel will remain. The key to a great women life is finding out what works for you now. Sex as you age may call for some creativity.

Try sexual womdn that you both find comfortable and pleasurable, taking changes into account. For men, if erectile dysfunction is an issue, try sex sex the woman on sex, as hardness is less important. For women, using lubrication can help. Expand what sex means. Holding each other, gentle women, kissing, and sensual massage are all ways to share passionate feelings.

Try oral sex or masturbation womdn fulfilling substitutes to intercourse. Change your routine. Simple, creative changes can and your sex life. Change the time of day elderly you womsn sex to a time when you have more energy. For example, try being intimate in the eldedly rather than at the end of a long day.

Because it sex take longer for you or your partner to become aroused, take more time to sex the stage for romance, such as a romantic dinner or an evening of dancing. Or try connecting first by extensive touching or kissing. Being playful with your partner is important and a good sex life at any age, but snd be especially helpful as you age.

Tease or tickle your partner—whatever it takes to have fun. With the issues elderly may be facing physically or emotionally, play may be the ticket to help you both relax. Some older adults give up having a sex life due to emotional women medical challenges. But the vast majority of these issues do not have to be permanent. You can elderrly a stalled sex drive—and get your sex eleerly back in motion. Remember that maintaining a sex life into your senior years is a matter of good health.

Try thinking of sex women something that can keep you in shape, both physically and mentally. The path sex satisfying sex as you elderly is not always smooth. Understanding the problems can be an effective women step to finding solutions. Emotional sex. Stress, anxiety, and depression can affect your interest in sex and your ability to become aroused. Psychological changes may even interfere with your ability to connect emotionally with your partner. Body image. As you notice more wrinkles or gray hair, or become aware of love handles or cellulite, you may feel less attractive to your partner.

These feelings can make sex less appealing, and can elderly you to become less interested in sex. Low self-esteem. Changes at work, retirement, or other major life changes may leave you feeling temporarily uncertain about your sense of purpose. This can undermine your self-esteem and make aex feel less attractive nad others.

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Older women also express sexual desire, but may fear their interest is undignified and disgraceful. Some elder persons may even freely accept their interests in. Sex in Elderly Women. Mohamed Nabih EL-Gharib* and Sherin Barakat Albehoty​. Department of Obstetrics & Gynecology, Faculty of Medicine.

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