Sex and the Older American

Though half report bothersome sexual problems, sexually
active Americans aged 57-85 have sex as often as those aged 18-59.

The findings come from a nationally representative sample of 3,005 U.S.
residents. They show that sexual intimacy remains an important part of most
people's lives as they age, says researcher Stacy Tessler Lindau, MD, of the
University of Chicago.

"Many older and younger men and women make the choice not to be sexually
active. But the majority of people, young and old, do engage in sexuality,"
Lindau said at a news conference.

How sexually activeB are older Americans?

"An interesting finding is among those sexually active, the frequency we
saw of sex two or three times a month or more is not different from 18- to
59-year-olds," Lindau said. "So if one has a partner, the frequency of
sex does not change a lot between age groups."

It is people's health -- not their age -- that ultimately limits their
sexual activity, says researcher Edward O. Laumann, PhD, of the University of
Chicago.

Sexual inactivity is "much more a consequence of health than
otherwise," Laumann said at the news conference. "When sexual health
begins to deteriorate, it is an important warning sign of more profound health
problems."

Inevitably, aging people do reach a point at which sex becomes increasingly
rare, says researcher Linda J. Waite, PhD, of the University of Chicago.

"The one thing that surprised me was that among the oldest adults with
sex partners, only a minority reported being sexually active," Waite said
at the news conference. "There seems to be a point in people's lives when
their health declines. They become frail, and -- although still partnered --
they are not having any kind of sexual activity. That is an important part of
the picture of sexuality in older ages."

(How has
sex changed in your life as you age? Share your experiences on WebMD's
Active Aging: Support Group message board.)

Sex After 60: Key Findings

During the survey, trained researchers interviewed subjects, administered
questionnaires asking intimate questions, and obtained medical data including
blood, saliva, and vaginal swab samples.

The survey unearthed what Lindau calls "a gold mine" of data on the
sexuality of Americans aged 57-85. Some key facts:

• People in "very good" or "excellent" health were far more
  likely to be sexually active than those in "fair" or "poor"
  health: 79% more likely for men, and 64% more likely for women.


• At any age, women were less likely than men to have an intimate partner.
  This disparity "increased dramatically with age," the researchers
  found.


• Few older people not in a relationship are sexually active: only 22% of men
  and only 4% of women.


• 54% of sexually active older people have sex at least two to three times a
  month. Twenty-three percentB report sex once a week or more.


• Oral sex is reported by 58% of sexually active people aged 57-64 and by 31%
  of those aged 75-85.


• Masturbation is reported by 52% of men and 25% of women in an intimate
  relationship and by 55% of men and 23% of women not in relationships. "This
  suggests older adults have a drive or a need for sexual fulfillment,"
  Lindau says.


• Sex is "not at all important" for 35% of older women, but only 13%
  of older men. "Women say, 'On the one hand I am not now interested in sex,
  but if I met the right kind of partner, maybe I would consider it,'" Lindau
  says.


• Half of all older people report at least one bothersome sexual
  problem.


• The most common sexual problems for men are erection difficulty (37%), lack
  of interest in sex (28%), climaxing too quickly (28%), performance anxiety
  (27%), and inability to climax (20%).


• The most common sexual problems for women are lack of interest in sex
  (43), difficulty with lubrication (39%), inability to climax (34%), finding
  sex not pleasurable (23%), and pain (17%).


• The most common reason for not having sex was the male partner's physical
  health.


• Even though most older people report some sexual problems, only 38% of men
  and 22% of women 50 years or olderB ever discuss sex with their
  doctors.

Healthy Sex at Older Ages

The survey suggests that most people eventually will have to negotiate
sexual problems as the age, says John H.J. Bancroft, MD, director emeritus and
senior research fellow at theB Kinsey Institute for Research in Sex,
Gender, and Reproduction, Indiana University, Bloomington.

An editorial by Bancroft, the author of the landmark book Human Sexuality
and Its Problems, accompanies the Lindau study in the Aug. 23 issue of
The New England Journal of Medicine.

Bancroft says that relationships and mental health are more important
predictors of sexual well-being than physical troubles with sexual arousal and
sexual response.

"A key and fundamental issue is, when older men start to lose the
ability for erections, how should they adapt to that? Obviously, this depends
on the partner. So there is a need for negotiation," Bancroft tells
WebMD.

One option is for the couple to shift the emphasis away from erections to
sexual intimacy that does not require an erection. But this may be
difficultB for some people -- men in particular.

"We live in a very phallocentric society in which men grow up to focus
on their erections as being all-important," Bancroft says. "Here is an
important difference between men and women. What the penis is doing is much
more central to the man's sexual experience than the woman's genitalia are to
hers. She tends to focus on her feelings."

An informed doctor, Bancroft says, can help couples explore forms of sexual
intimacy that do not always require a male erection.

"The approach to sex therapy that I and others use gets couples to work
through stages: working with touch at first, and vaginal entry only at the
later stages," he says. "And a lot can happen in those really early
stages in terms of touching and feeling close and intimacy."

A second issue, Bancroft says, is that both men and women find it more
difficult to reach orgasm as they age.

"What is desirable, and what I encourage any couple to do, is to look
for ways to enjoy physical intimacy without having the same expectations they
had when they were younger," he advises. "Much of the bonding effect of
physical intimacy does not depend on sex. Indeed, intimacy can be enhanced for
couples that can embrace changes rather than be threatened by them."

By Daniel DeNoon
Reviewed by Louise Chang
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