Aspects of Older Adults and Sexuality

Updated on: March 1, 2023

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For females, most undergo the climacteric transitional period beginning in their 40s and completed by their 50s. At this time, reproductive capacity slows, menopause begins, and the menstrual cycle is completed. Physical age-related changes occur to the reproductive system, such as thinning of vaginal walls as they become dry and less elastic, loss of subcutaneous fat, decreased secretion of estrogen, and loss of elasticity and muscle tone. From a psychosocial perspective, this may influence a woman’s body image, and the loss of reproduction may influence her self-perception. Many women at this age deal with other events such as children leaving home, and caring for elderly parents, which impacts their coping abilities (Saxon et al., 2015). Meanwhile, as men become older, they are likely to experience impotency (also known as erectile dysfunction (ED)), which is the loss of the ability to have or keep an erection or a decrease in the size of the erection. With age, fewer viable sperm are produced, and their mobility decreases, reducing the capacity for reproduction. Testosterone levels will decrease, potentially impacting libido (Saxon et al., 2015).

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Aging brings physical changes for both sexes, which impacts their sexuality and sexual activity. However, that does not remove the need for intimacy for the elderly, and many want to continue an active and satisfying sex life. At the same time, the changes in age may mean that certain adaptations may need to be made both to accommodate physical health as well as psychosocial aspects. This may range from the use of medications or devices for stimulation to using imagination and mood-setting to enhance sexual response. In most cases, physical health factors of normal aging are not preventative of sexual activity. Meanwhile, in cases where health or otherwise is a barrier, modern medicine alongside psychosocial work can help the elderly to fully achieve their potential and sexual expression (University of Michigan Health, n.d.).

As at any age, sex for older adults is pleasurable and results in biological processes such as the release of endorphins and oxytocin, which helps with relieving stress and creating feelings of intimacy and relaxation. Research demonstrates that adults continue to desire and pursue sexual expression in later life (Kalra et al., 2011). However, until recently, both the research and the conversation around it have been largely silent. Society does not easily accept the fact that older adults can continue to have sex as it may be uncomfortable or not fit into the traditional frameworks of how sex is perceived. There are misconceptions that once a certain age is reached with menopause and ED being in play, that sexuality disappears, but that is not the case (Macleod & McCabe, 2017).

Sexuality plays a critical role in relationships, personal well-being, intimacy, and quality of life. For older adults that had already gone through their physical peak, the sexual relationship may be different. It is more focused on affection, touch, and intimacy that contribute to their psychological and emotional state. In an open-ended survey of adults aged 51-89, the major theme that emerged regarding sexuality was that the sexual act has become more meaningful with age. It encompassed aspects such as partner compatibility and pleasure, factors affecting the experience, trust, and respect (Macleod & McCabe, 2017). This information is critical to challenging stereotypes of asexuality with age and providing ways that sexuality can be improved as an experience and expression with age.


Kalra, G., Pinto, C., & Subramanyam, A. (2011). Sexuality: Desire, activity and intimacy in the elderly. Indian Journal of Psychiatry, 53(4), 300.

MacLeod, A., & McCabe, M. (2017). Older people still have sex, but it’s the intimacy and affection that matters more. The Conversation.

Saxon, S.V., Etten, M. J., & Perkins, E.A. (2015). Physical change & aging. A guide for the helping professions (6th ed.). Springer.

University of Michigan Health. (n.d.). Sexuality and physical changes with aging.

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