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Sex and Aging: Survey Finds Sexual Desire and Activity Important to Seniors

Sexual activity may wane, but interest does not

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Older couple kissing on beach
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The first comprehensive national survey of senior sexual attitudes, behaviors and problems in the United States has found that most people ages 57 to 85 think of sexuality as an important part of life and that the frequency of sexual activity, for those who are active, declines only slightly from the 50s to the early 70s.

Data from the University of Chicago's National Social Life, Health and Aging Project (NSHAP), presented in the New England Journal of Medicine, showed that many men and women remain sexually active-participating in vaginal intercourse, oral sex and masturbation-well into their 70s and 80s.

Sex and Aging: Sexual Activity Affected by Health More Than Age
The survey also found that senior sexual activity was closely tied to overall health, which was even more important than age. As health declined steadily after the early 70s, so did the prevalence of sexual activity, particularly for women. Among those who remained sexually active, nearly half reported at least one sexual problem, such as lack of desire (43% of women), vaginal dryness (39% of women) or erectile dysfunction (37% of men).

"We found that older adults remain interested and engage in sex, yet many experience bothersome sexual problems that can compromise both health and relationships," said Stacy Tessler Lindau, MD, assistant professor of obstetrics and gynecology and of medicine-geriatrics at the University of Chicago and lead author of the study.

Sex and Aging: Too Little Known about How Sex Changes as People Age
With the first wave of baby boomers entering their 60s, older adults make up the fastest growing segment of the U.S. population. Yet the "lack of reliable information about how sexual activity and function might change with age and illness, combined with taboos around discussing sex in later life, contributes to worry or even shame for many older adults," she added.

Many medical conditions and treatments can iinterfere with senior sexuality. American men spend more than a billion dollars each year on medications to improve sexual function. Despite such frequent problems, few older men (38%) and even fewer women (22%) had discussed sex with a physician since age 50, the researchers found. Men were more likely to do so, perhaps because effective drugs are available. Nearly 1 in 7 men (14%) reported taking medication to improve sexual function.

Sex and Aging: Many Women Outlive Their Sexual Partners
The survey documented another significant gender difference in senior sexuality. While 78 percent of men ages 75 to 85 have a spouse or other intimate relationship, only 40 percent of women that age do, a consequence of the age disparity of relationships coupled with women's greater longevity.

"Sexuality is an important part of a healthy and engaged life at older ages for both women and men," said co-author Linda Waite, PhD, the Lucy Flower Professor in Urban Sociology at the University of Chicago and Director of the Center for Aging at NORC. For the vast majority of men, aging is a partnered experience, Waite said, "but women's sexuality is more often affected by the death or poor health of their spouse."

NSHAP, funded by the National Institutes of Health, was created to discover how social relationships, especially intimate relationships, influence health as people age. Between July 2005 and March 2006, the researchers interviewed 3,005 people ages 57 to 85 in their homes. They asked about social and marital history, sexual activity and function, and physical and mental health.

Sex and Aging: Sex Questions Don't Bother Seniors
Despite the personal nature of many of the questions, study participants were very forthcoming, as expected from prior clinical and research experience with older adults. Seventy-five percent of those approached agreed to participate. Overall, only 2 percent to 7 percent declined to answer direct questions about sexual activities or problems. (Fourteen percent did not answer questions about masturbation on a self-administered questionnaire.)

"Participants were more likely to refuse questions about income than they were about sex," Lindau said.

Sex and Aging: Many Seniors Stay Sexually Active Despite Health Problems
Many of those seniors who were sexually active found ways to remain active, despite worsening health. The proportion of sexually active couples that engage in oral sex, for example, hovered at around 50 percent for those under 75. More than half of men and a quarter of women, whether they had a sexual partner or not, acknowledged masturbating.

"Although sexuality has long been thought to deteriorate inevitably with age, we found that health is a more important indicator for many aspects of sexuality than is age alone," Lindau said. "This suggests that older adults with medical problems, or those considering treatment that might affect sexuality, should be counseled based on health status rather than just their age."

The most common reported reason for sexual inactivity among individuals with a spousal or other intimate relationship for men (55%) and women (64%) was the male partner's physical health. Women, especially those who were not in a current relationship, were more likely than men to report lack of interest in senior sex.

Sex and Aging: Survey Results May Comfort Seniors and Improve Care
Despite the unprecedented shift in the age of the population, the public, physicians and policymakers lack information on senior sexual behavior and on how sexual activities and problems change with age and illness.

"We hope our findings improve public health by countering harmful stereotypes and allowing older individuals to view their experience relative to others," Lindau said. "It may comfort people to know that they are not alone in enjoying sexual activity as they age or in experiencing sexual problems, some of which could be alleviated with medical attention."

We've learned that sex continues to be important for many older adults. With health and aging concerns, is there a best time for sex? In a Canadian survey, a majority of older adults said they prefer sex in the evening; what's best for you? See below to share your thoughts and find out what other Senior Living readers feels about the best time to have sex.

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