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Discussing Sex with the Elderly

“One way to think about aging is that older people are younger people later in life.”

This observation is from Dr. Stacy Tessler Lindau, a University of Chicago researcher and lead author of a 2007 study of sexuality and older Americans. And it provides us with a good starting point for discussing sex with the elderly.

There seems to be a disconnect between sex and the older generations, an assumption that the elderly don’t have sex or aren’t interested in it.

But people can enjoy healthy sex lives well into their 70s and even their 80s. Sometimes they need to make some modifications, but overall there’s no reason to believe people’s sexuality changes just because they get older.

Here are some issues to consider as you discuss sex with elderly patients.

Attitudes – Yours and Theirs

Some find the idea of elderly people having sex distasteful, perhaps because sex is almost always depicted in the media as something for the young. A lot of people can’t imagine their parents having sex, never mind their aunts, uncles, or grandparents.

However, if we go back to Dr. Lindau’s quote above, it makes total sense that older people have sex. It’s an idea we need to embrace, if we haven’t already.

Still, older people come with their own attitudes toward sex. Much depends on culture, upbringing, and the social mores in place when they came of age, especially for women. Before the “Sexual Revolution” of the 1960s and 1970s, many women were taught that it wasn’t normal for them to have sexual desire. And if they acted on a human need for sex, they were considered “loose” or “damaged goods.”

This might make it difficult for some patients to open up about what they want or need. Interestingly, as baby boomers – people who did experience the Sexual Revolution – age, they bring a different set of attitudes and may be more forthcoming.

No matter who you’re treating, try to understand where they’re coming from. They might feel reluctant about discussing sex, afraid they’ll be ridiculed. Reassure them that sex is a normal part of life for all ages.

Physical Limitations and Concerns

While sexual interest might be there, for many older people, the “equipment” just doesn’t function the way it used to. For example, most women have problems with lubrication after menopause. Many men find that their erections aren’t as firm as they used to be and may develop erectile dysfunction. Both men and women might need more time to become aroused or reach orgasm.

Diseases and medications may also have an impact. Arthritis may make some positions painful. Some people with coronary artery disease experience chest pain when having sex and might be afraid of a heart attack. Others may have had surgeries, such as a mastectomy, that make them self-conscious in front of their partner. Medications can cause problems with sex drive and performance as well.

If physical limitations are an issue, modifications can be made. Patients should first talk to their physicians. Lubricants can help women. Some men may be able to take erectile dysfunction drugs. Couples can also experiment with different positions so that sex is not painful.

Reassure the elderly that while sex might take more time and more adjustments, they can still enjoy the journey and find intimacy.

Sexually Transmitted Infections

Sexually transmitted infections and diseases are on the rise among older populations. According to the U.S. National Institute on Aging, 25% of people with HIV/AIDS are age 50 and older.

For many older people, the dating world isn’t the same. Many people might be dating again for the first time in decades, after long, committed marriages. While sexually transmitted diseases like herpes, syphilis, and gonorrhea existed many decades ago, HIV is newer.

And some older people are naïve about safe sex, thinking STDs can’t happen to them. Therefore, men who find condoms uncomfortable forgo them. Some women might feel awkward about asking a partner to use one. They may feel it’s not necessary, since after menopause, pregnancy is not a worry. Both men and women may feel uncomfortable asking about a partner’s sexual history, that doing so is rude or intrusive.

Safe sex education applies to all generations. If your patients seem hesitant to talk about safe sex practices, let them know why it’s important. Let them know it’s okay to ask questions – of you or their partners – and be ready to give them more information if they need it.

Availability of Partners

Even though people are living longer than they did generations ago, many elderly people find themselves without partners. They might be coping with the death of a spouse or long-term partner. Or, they may be entering the dating scene again after a divorce. For many, the idea of finding a new partner fills them with anxiety.

Women, especially, tend to be without partners when they’re older. One reason is that women tend to live longer than men. Another is that many men in their age group have relationships with younger women.

If your elderly patients want to find new partners, be encouraging. Suggest ways that they can meet new people; senior centers, book groups, vacation tours, and even the Internet can provide plenty of opportunities. They might also ask their friends to introduce them to others. Even if new relationships don’t develop immediately, the new friendships they make can take the edge off any loneliness.


Getting older isn’t always easy. Sex for the elderly may have its obstacles, but it may also bring much pleasure and happiness.