Health and Fitness

Sexuality & the Senior By Jennifer FitzPatrick, MSW, LCSW-C

The concept of a grandparent as a sexual being is uncomfortable for many. But sexuality is an important component of any adult’s self-image, including those older than fifty. Seniors have frequently been labeled as asexual in American culture, particularly with stereotypes that older men are impotent and older women as frigid. On the contrary, seniors are one of the rapidly growing groups of online daters.
What Is Sexuality?
Sexuality is not simply about sexual behavior or intercourse. Sexuality has to do with one’s identity as a man or woman, a straight or gay person. It can be about the enjoyment of putting on lipstick, cologne or an attractive outfit. Sexuality can be about romance and companionship. Sexuality for some older adults can mean connecting with someone physically through a variety of sexual behaviors. For single, divorced or widowed older adults, sexuality can be about the hope and possibility of meeting someone with whom they can connect. Sexuality can simply be about enjoying the sensuality of one’s own body through a foot massage or even masturbation.
Sexual activity can also be very good for our overall health. Many studies suggest that sex bolsters the immune system, reduces stress and improves cardiovascular health.
Sexuality As We Age
Most older adults can perform sexually if they would like to, but there are some barriers. Since women tend to live longer than men, older heterosexual women who may desire a sexual or romantic relationship frequently encounter a lack of available partners. Older females are also more frequently caregiving so this may leave them with less energy to pursue or maintain a sexual relationship. The current cohort of older adults tends to be conservatively religious and those beliefs may inhibit initiating a sexual relationship when single, divorced or widowed.
Hormonal changes take place for both men and women. Nearly everyone has heard the jokes about the stereotypical menopausal moodiness. But these jokes can downplay how truly life-altering menopause can be. Menopause occurs when a woman has gone twelve consecutive months without a menstrual period. While the news is filled with reports about how much fertility drops in the thirties and forties, there is still a chance, albeit very slight, for women to become pregnant until menopause is completed. Along with the loss of ability to become pregnant, there is a significant drop in estrogen which typically occurs in the early fifties.
Older women frequently experience some discomfort with intercourse after menopause due to a condition known as urogenital atrophy. Urogenital atrophy is the lessening of lubrication and thinning of skin in the vaginal area. Urogenital atrophy can even cause some light bleeding for sexually active older women. Minimizing symptoms of urogenital atrophy can be accomplished by having regular sex, masturbating and using lubricants when sexually active. Comfortability for older women having sex is truly a “use it or lose it” scenario. If a woman has not been sexually active in a while, it is important for her to use lubricants and discuss with her doctor if she continues to be uncomfortable as there are some other treatments that may be able to help.
Viropause or andropause is sometimes referred to as the male version of menopause. It involves a very gradual decrease in testosterone, beginning usually in the early fifties. Sexual response for older men also changes. Orgasms tend to be less intense, erections are a bit less firm, and refractory periods are longer. Occasional impotence does happen to older men and some may be quick to ask the doctor for performance-enhancing drugs. Older men may want to try being a bit more patient by enjoying additional minutes of foreplay, instead of immediately assuming they require medication for erectile dysfunction. It is going to take more time for an older man to achieve an erection than a younger man but this does not mean that drugs are necessarily required.
Safer Sex Tips For Seniors
Practicing safe sex has many meanings, especially for older adults. Here are some tips to help seniors navigate their sexuality as safely as possible:
1. Prevent pregnancy. Sometimes it is forgotten that men of any age can impregnate a woman. It is important for older men dating or married to women who have not completed menopause to remember that birth control is still crucial if an unplanned pregnancy would be a major disruption to their lives.
2. Use condoms. The use of latex condoms, by far, is the best way to prevent HIV and sexually transmitted infections (STIs), outside of abstinence. Older adults, just like sexually active persons of any age, need to take precautions against HIV, herpes and other STIs. Unfortunately, the Kinsey Institute reports that condom use is low in the over 50 population (only about 1/3 of those older than 50 interviewed for a recent study indicated they used condoms during their last sexual encounter). While much public health education about STIs tends to focus on teens and young adults, the most recent statistics available from Centers for Disease Control and Prevention (CDC) indicate that 15% of all new HIV cases are persons age 50 or older.
3. Consider the impact on acute and chronic conditions. Further, seniors with other health conditions need to consider them in order to have the safest sex possible. If a senior has arthritis or paralysis due to a stroke, it is important to seek positions that will make sex as comfortable as possible. If an older adult has a history of heart attack, discussing any concerns or anxiety with a doctor is important. If a man is experiencing regular impotence even when engaging in lengthy foreplay sessions, it is important to consider if there is a medication side effect or an undiagnosed condition. Sometimes healthcare providers don’t initiate such discussions, especially when the senior is single, because they wrongly assume they are not needed. It is important for an older adult to take initiative with doctors in these discussions when there are concerns.
4. Don’t worry about what everybody else says. Some seniors can be reluctant to date or get involved in new romantic relationships because they worry about what their adult children, grandchildren, friends or even the neighbors might say. Seniors have already lived full lives, raising families and making contributions to the workplace and community. They are adults entitled to make their own decisions about dating and sex. If a single senior has connected with someone, she has every right to reap the health and psychological benefits of sex, romance and companionship. As more seniors date, remain vital, and push against the stereotype, we will see younger generations accepting and looking forward to their own sexually fulfilling golden years.
In conclusion, most older adults can enjoy an active healthy sex life if they want one. While sexual response may change a bit with age, the fun of romance and the comfort of companionship can help seniors feel youthful.
About the Author:
Jennifer FitzPatrick, MSW, LCSW-C is an author, speaker and educator. Founder of Jenerations Health Education, Inc., she has more than 20 years’ experience in healthcare. Jennifer is a frequent speaker at national and regional conferences and is an Adjunct Instructor at Johns Hopkins University. Her new book, “Your 24/7 Older Parent” answers the prayers of those dealing with the care of an elderly parent. For more information on Jennifer FitzPatrick’s speaking, please visit