UNC Health Care
older couple holding hands

A Guide to a Fulfilling Sex Life for Seniors

Despite what their adult children would like to think, older adults are sexually active. In fact, they can have great sex. Sometimes, they’re having better, more satisfying sex than they did as young people.

If you’re one of these sexually active seniors, you might be nodding in agreement. After all, you know yourself and what you want from life better now than ever before. And while aging often comes with physical limitations, some couples find a way to turn those challenges into opportunities, says Lindsay Wilson, MD, MPH, a geriatrician with the UNC Hospitals Geriatric Specialty Clinic. She specializes in the diagnosis and treatment of diseases in older adults and educates medical students about senior sexuality.

“People who have sex when they’re older will tell you it’s more creative,” Dr. Wilson says. “It’s less about wham, bam and done. There’s more touching. It’s kind of the beauty of being older, people are more open and receptive.”

Dr. Wilson counsels older adults about sexuality regularly in her practice. She shares some of her best advice with us.

Do What You Want to Do, Not What You Feel You Should Do

older men holding handsJust like younger people, some older people have high sex drives, and some don’t. Some don’t want to have sex at all.

All of those feelings are valid and healthy, Dr. Wilson says. If you’re older and still want to experience sexual pleasure, whether in partnered or solo sex, you should. And if you’re not so interested anymore, that’s fine, too.

“It’s so individual, for each person,” she says. “For some people, sexuality is still very much a function of their day-to-day lives. Others have stopped but want to resume sexual intimacy again. And for some, they’re glad that part of their life is over. It’s all OK.”

Know That Sex Can Be Good for You

close-up of older woman looking up at a partnerFor older people, having sex can be a boost to emotional health and self-esteem, Dr. Wilson says.

“It might make you feel better about yourself and your body,” she says. “It can be very affirming to have someone interested in you in that way. It can be a way to build connection and intimacy with a partner.”

Sex also has physical benefits. Wilson encourages seniors to be active and move their bodies, and sex counts, too. For older women, sex helps strengthen their vaginal tissue and pelvic floor muscles, which can help ward off problems such as incontinence and prolapse.

Remember That Your Body Has Changed

older man preparing for a run outsideOlder people face new challenges when it comes to sexual function. Many men find themselves dealing with erectile dysfunction, and postmenopausal women may find penetrative sex uncomfortable because of hormonal changes.

When patients come to Dr. Wilson with these complaints, she assures them that these changes are normal. The body does not respond the same way to sexual stimuli at age 60 as it did at age 20. Doctors can prescribe oral medications for erectile dysfunction and topical estrogen to increase vaginal comfort. Dr. Wilson talks to men and women about the importance of lubricants and taking a slow and gentle approach, as well as alternatives to penetrative sex.

For people with chronic injuries, an occupational therapist can help strategize positions that may make it easier, Dr. Wilson says. She encourages her patients to use the internet to seek solutions and answers to their questions.

Finally, for patients with heart disease, Dr. Wilson advises special care. You know that commercial tag line: “Ask your doctor if your heart is healthy enough for sex”? It generally is if you can walk up a flight of stairs, Dr. Wilson says, but take care not to add stress by drinking excessive alcohol. A first-time experience with a new person can be more inherently stressful, which could be problematic for those with weaker hearts, she adds.

Use Protection

older couple leaning against a wallNo matter your age, if you’re having sex with a new partner or multiple partners, condoms are important, Dr. Wilson says. Just because you won’t conceive a baby doesn’t mean you can’t catch a sexually transmitted infection. In fact, while rates of infection remain low, they’re on the rise in this population.

Water-based lubricant is best, Dr. Wilson says, because it’s safe to use with condoms. Never use an oil-based lubricant with a condom, as it can cause breakage.

Many older people were married and monogamous before the HIV/AIDS epidemic of the 1980s and 1990s, and they need to be reminded that they are at risk for that infection, too, Dr. Wilson says. She tries to educate without causing unnecessary fear: “They don’t have to be alarmed, but this is something to be aware of now.”

Talk to Your Doctor

older man talking to doctorDr. Wilson says her patients are sometimes embarrassed to talk to her, but they don’t need to be. People should choose a doctor who makes them feel comfortable discussing sex, no matter their age or circumstances. Doctors should also ask about sexual health when appropriate.

“If sex is important to you, don’t hesitate to talk to your partner and your doctor,” she says. “It can be a really healthy and enjoyable part of growing older.”


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