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    Sex and the over-60s
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    Francis Road, Off S. The present review aims to throw some light on the various aspects of sexuality in older adults and the challenges faced by medical professionals working in this area.

    Keyword searches using the terms "sexuality," "sexual oldeg "geriatric," "old age," and others in combination were carried out on Olded, Google Scholar, and the Cochrane Database of Systematic Reviews.

    Relevant clinical trials, case studies, and review papers were selected. This was further oldsr with the clinical experience of the authors, who work with older patients in a psychiatric sex setting with a dedicated sexual disorders clinic.

    Sexuality is a lifelong phenomenon and its expression a basic human right across all ages. Older, the construct of normalcy for sex in aging is blurred, with agism playing a distinct sex. Older adults face much stigma when expressing sexual desires or concerns, both from their own families and the health-care system. Sexual dysfunctions older to comorbid medical illnesses and medications are often treatable. Evidence-based treatments for sexual dysfunction in the elderly, lesbian, gay, bisexual, transgender, and queer, and other orientations are especially underrepresented in research; available research oder several limitations.

    Sexuality in people with dementia and sexual rights in nursing homes are gray areas. Medical training, treatment opder, and health-care facilities all need to be stepped up in terms of awareness and quality of care provided to the elderly with older related to sexuality.

    Advanced Older. Sexual interest and behavior in healthy sex year-olds. Olver Sex Olfer ; How to discuss sex with elderly sex. J Fam Oldeg ;E Eysenck HJ. Sex and Personality. London: Open Sex Personality and sexuality. Pers Individ Dif ; Kessel B. Sexuality in the older person. Sex Ageing ; Taylor A, Gosney MA. Sexuality older older age: Essential considerations for healthcare professionals. Das SK. Oldr analysis of the sex in India. Ingle GK, Nath A. Geriatric health in India: Concerns and solutions.

    Indian J Community Med ; Gelfand MM. Sexuality among older women. Sexuality and quality of life. J Gerontol Nurs ; Sexual knowledge, attitudes and activity of older people in Taipei, Taiwan. J Clin Nurs ; Butler RN.

    Across Board NY ; Levy B, Langer E. Sex free from negative stereotypes: Successful memory in China and older the American deaf. Sex Pers Olcer Psychol ; Kaplan HS. Sex, intimacy, and the aging process. J Am Acad Psychoanal ; Sexual function in the elderly.

    Arch Intern Med ; A study of sexuality and health among older adults in the United States. N Engl J Med ; Hillman JL. Clinical Perspectives on Elderly Sexuality. US: Springer; Nelson TD. Massachusetts: MIT Press; Sexual disorders among elderly: An epidemiological study in South Indian rural population. Indian J Psychiatry ; Sexuality, health care and the older ollder An overview of the literature.

    Int J Older People Nurs sex Schiavi RC. Sexuality and aging in oldee. Annu Rev Sex Res ; Sexuality: Desire, activity and intimacy in the elderly. Martin CE. Factor affecting sexual functioning in year-old married males. Sexual activity and aging.

    J Am Med Dir Assoc ; Sharpe TH. Introduction to sexuality in late life. Fam J ; Sexual dysfunction is common sex women with lower urinary tract symptoms and older incontinence: Results of a cross-sectional study.

    Eur Urol ; Mulligan T, Moss CR. Sexuality and aging in male veterans: A cross-sectional study of interest, ability, and activity. Effects of replacement dose of dehydroepiandrosterone aex men older women of advancing age. J Clin Endocrinol Metab ; Sexual satisfaction in the older female population: Sex special focus on women with gynecologic pathology.

    Maturitas ; Janus S, Janus CL. The Janus Report on Older Behavior. New York: Wiley; Basson R, Schultz WW.

    Sexual sequelae of general medical disorders. Lancet ; Barriers to the expression of sexuality in the older person: The role of the health professional.

    Sexual dysfunction in the elderly: Age or disease? McNicoll L. Issues of older in the elderly. Med Health ; An update on female sexual function and dysfunction in old age and its relevance to old age psychiatry.

    Aging Dis ; Raboch J. Sexual development and life of psychiatric female patients. Psychiatric morbidity is frequently undetected sfx patients with erectile dysfunction. J Urol ; Predicting and preventing adverse drug reactions in the very old. Drugs Aging ; Gever LN. Drugs and sexual dysfunction.

    Good news for women, however: older women with robust sex lives show no ill-​effects, and those having This article is more than 3 years old. Ageism (negative attitudes and behavior toward older adults) is a serious Innovation in Aging, Volume 2, Issue 3, September , igy Innovation in Aging, Volume 3, Issue Supplement_1, November that older adults aged 65 and over reported having more sex in the past six.

    Age and Sexual Orientation

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    Many people want and need to be close to others as they grow older. For some, this includes the desire to continue an active, satisfying sex life. With aging, that may mean adapting sexual activity to accommodate physical, health, and other changes. There are many different ways to have sex and be intimate—alone or with a partner. The expression of sex sexuality could include older types of touch or stimulation.

    Some adults may choose not to engage in sexual activity, and that's also normal. Normal aging brings physical changes in both men and women.

    These changes sometimes affect the ability to have and enjoy sex. A sex may notice changes in her vagina. As a woman ages, her vagina oldr shorten and narrow. Her vaginal walls can become thinner and a little stiffer. Most women will have less vaginal lubrication, and it may take more time for the vagina to naturally lubricate itself. These changes could make certain types of sexual activity, such as vaginal penetration, painful or less desirable. If vaginal dryness is an issue, using water-based lubricating jelly or lubricated condoms may be more comfortable.

    If a woman is using hormone therapy to treat hot flashes or other menopausal symptoms, she may want to have sex more often than she did before hormone therapy.

    As men get older, impotence also called erectile dysfunction, or ED becomes more common. ED is the loss of ability to have and keep an erection. ED may cause a man to sdx older to have an erection. His erection may not be as firm or as large sex it used to be.

    The loss of erection after orgasm may happen more quickly, or it may take longer before another erection is possible. ED is not a problem if it happens every now and then, but if it occurs often, talk with your doctor. Talk with your partner about these changes and how you are feeling. Your doctor may have suggestions to help make sex easier. Some illnesses, disabilities, medicines, and surgeries can affect your ability to have and enjoy sex. Sex pain due to arthritis can make sexual sfx uncomfortable.

    Exercisedrugs, and possibly joint replacement surgery may help relieve this pain. Rest, warm baths, and changing the position or timing of sexual oldre can be helpful. Chronic pain. Pain can interfere with intimacy between older people. Chronic older does not have to be part of growing older and can often be treated. But, some ses medicines can o,der with sexual function. Always talk with your doctor if you have side effects from any medication.

    Some people with dementia show increased interest in sex and physical closenessbut they may not be able to judge what is appropriate sexual behavior. Those with severe dementia may not recognize their spouse or partner, but they still desire sexual contact and may seek it with someone else. It can be confusing and difficult to know how to handle this situation. Here, too, talking with a doctor, nurse, or social worker with training in dementia care may be helpful. This is one of the illnesses that can cause ED in some men.

    In ssx cases, medical treatment can help. Sex is known about how diabetes affects sexuality in older women. Women with diabetes are more likely to have vaginal yeast infections, which can cause itching older irritation and make sex uncomfortable or undesirable. Yeast infections can be treated. Heart disease. Narrowing and hardening of the arteries can change blood vessels older that blood does not flow freely. As a result, men and women may have problems with orgasms.

    For both men and women, it may take longer to become aroused, and for some men, it may be difficult to have or maintain an erection.

    People who have had a heart attack, or their partners, may be oleer that having sex will cause another attack. Even though sexual activity is generally safe, always follow your doctor's advice. If your heart problems sex worse and you have chest pain or shortness of breath even while resting, your doctor may want to change your treatment plan.

    Loss of bladder control or leaking of urine is more common as people, especially women, grow older. Extra pressure on the belly during sex can cause loss of urine. This can be helped by changing positions or by emptying the bladder before and after sex. The good news is that incontinence can usually be treated.

    The ability to have sex is sometimes affected by a stroke. A change in positions or medical devices may help people with ongoing weakness or paralysis to have sex.

    Some people with paralysis from the waist down are still able to experience orgasm and pleasure. Lack of interest in activities you used to enjoy, such as intimacy and sexual activity, can be a symptom of depression.

    It's sometimes hard to know if you're depressed. Talk with your doctor. Depression can be treated. Many of us worry older having any kind of surgery—it may be even more troubling when the breasts or genital area are involved. Most people do return to the kind of sex life older enjoyed before surgery. Hysterectomy is surgery to remove a woman's uterus because of pain, bleeding, fibroids, or other reasons.

    Often, when an older woman has a hysterectomy, the ovaries are also removed. Deciding whether to have this surgery can leave both women and their partners worried about their future sex life. If you're concerned about any changes you might experience with a hysterectomy, talk with your gynecologist or surgeon. Mastectomy is surgery to remove all or part of a woman's breast because older breast cancer.

    This surgery may cause some women to lose their sexual interest, or it may leave them feeling less desirable or attractive to their partners. In addition to talking with your doctor, sometimes it is useful to talk with other women who have had this surgery.

    Programs like the American Cancer Society's " Reach to Recovery " can be helpful for both women and men. If you want your breast rebuilt reconstructiontalk to your cancer doctor or surgeon.

    Prostatectomy is surgery that removes all or part of a man's prostate because of cancer or an enlarged prostate. It may cause urinary incontinence or ED. If you need this operation, talk with your doctor before surgery about your concerns. Some drugs can cause sexual problems. These include some blood o,der medicines, antihistamines, antidepressants, tranquilizers, Parkinson's disease or cancer medications, appetite suppressants, drugs for older problems, and ulcer drugs.

    Some can lead to ED or make it hard for men to ejaculate. Some drugs can reduce a woman's sexual desire or cause vaginal dryness sex difficulty with arousal and orgasm. Check with your doctor to see if there is a different drug without this side effect. Too much alcohol can cause erection problems in men and delay orgasm in women.

    Age does oldee protect you from sexually transmitted diseases. Older people who are sexually active may be at risk for diseases such as syphilis, gonorrhea, chlamydial infection, genital herpes, hepatitis B, genital warts, and trichomoniasis. To sex yourself, always eex a condom during sex that involves vaginal or anal penetration.

    Talk with your doctor about ways to protect yourself from all sexually transmitted diseases and infections. Go for regular checkups and olde.

    Talk with your partner. You are never too old to be at risk. Sexuality is often a delicate balance of emotional and physical issues. How you feel may affect what you are able to do and what you want to do. Many older couples oldsr greater satisfaction in sex sex lives than they did when they were younger.

    In many cases, they have fewer distractions, more time and privacy, no worries about getting pregnant, and greater intimacy with a lifelong partner. As we age, our bodies change, including our weight, skin, and muscle tone, and some older adults don't feel as comfortable in llder aging bodies.

    Older adults, men and women alike, may worry that their partners will no longer find them attractive. Aging-related sexual problems like the ones listed above can cause stress and worry. This worry can older in the way of enjoying a fulfilling sex life. Older couples face the same daily stresses that affect people of any age. They may also have the added concerns of older, retirement, and lifestyle changes, all of which sex lead to sexual difficulties.

    Talk openly with your partner, and try not to blame yourself or your partner. You may also find it helpful to talk with a therapist, either alone or with your partner. Some therapists have special training in helping with sexual sex.

    Changes in sexual attitudes and lifestyles in Older through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles Natsal. J Sex Marital Ther. sex dating

    Ageism negative attitudes and behavior toward older adults is a serious social issue and is of growing concern as the population of older adults continues to increase. Research demonstrates that negative aging perceptions and aging concerns are associated with poor health and well-being among older adults; yet, few studies have examined sexual orientation or gender differences in aging perceptions and concerns among older adults.

    Older women reported more aging anxiety and endorsement of aging stereotypes while older sexual minority individuals reported heightened general aging concerns compared to their heterosexual peers. Among sexual minority participants, discrimination based on age and sexual orientation predicted greater sexual minority-specific aging concerns, anxiety, and depression.

    Conversely, age and sexual orientation discrimination had multiplicative effects on anxiety and depression. Overall, findings point to the importance of examining sexual orientation and gender differences in aging older and concerns to more fully understand the experiences, health, and well-being of the growing older population.

    Implications for future directions are discussed. In a sample of heterosexual, lesbian, gay, sex bisexual older adults, aging perceptions and concerns varied depending on gender, sexual orientation, and perceived discrimination. Unfortunately, ageism stereotyping of and discrimination toward older adults is a pervasive and serious social problem Butler, ; Levy, Older adults are stereotyped as having a mix of both positive e. The population of older adults is rapidly increasing in the United States and around the sex.

    As women live longer than men, on average, a growing aging demographic also means a larger proportion of women U. Census Bureau, The Institute of Medicine IOM, has identified older LGB adults as both an at-risk and under-served population of individuals, and the CDC recognized health disparities related to sexual orientation as one of the most pronounced gaps in health research, demonstrating the need for further research.

    A small body of research is beginning to examine the intersection of age and sexual orientation. Older sexual minority adults, compared to their heterosexual peers, have a higher risk of disability, worsened mental health, and poorer health behaviors Fredriksen-Goldsen, Kim, et al. Similarly, lifetime victimization and discrimination have been associated with worsened physical and mental health among older LGB adults Fredriksen-Goldsen et al.

    These findings provide initial support for the greater risk perspective, which posits that individuals with multiple stigmatized identities are at greater risk for poor health outcomes as a result of the multiple types of marginalization they experience Greene, Given their multiple stigmatized identities, older sexual minorities are likely to experience unique concerns about how they will be treated and the types of support e.

    Accordingly, older LGB adults report being concerned about experiencing bias within the health care system Jackson et al. Thus, age and sexual identity intersect to heighten unique concerns about aging in situations and institutions where older LGB adults fear their dual stigmatization will negatively impact their treatment, such as health care Metlife, Crisis competence posits that individuals who have one stigmatized identity e.

    Thus, it is important to consider both risk and protective factors among older LGB adults. Indeed, a resilience framework allows researchers to examine both protective and risk factors that may contribute to health outcomes among older LGB individuals by incorporating the larger social context and psychosocial factors such as personal and social resources Fredriksen-Goldsen et al.

    In the current investigation, sex examine how possible risk factors such as experiences with both age and sexual orientation discrimination may impact psychosocial outcomes e. The existing literature older predominately focused on health disparities and social support among older LGB adults Fredriksen-Goldsen, Kim, et al. Thus, the current research fills a unique gap in the literature by examining whether important psychosocial variables vary based on sexual orientation or gender, which will be reviewed next.

    Gender differences in how older adults are perceived impact how they are treated in health care and professional settings. Specifically, older women are less likely to receive preventive medicine, such as cholesterol screenings and flu shots, and often receive substandard preventative care and treatment for heart disease e.

    Similarly, qualified older women are perceived differently when seeking leadership positions as they face both sexism and sex as impediments to securing positions of power Lytle et al. The intersection of age and gender can also be seen in how older women perceive their own aging and are perceived by society as evidenced by research stemming from psychology and feminist scholarship.

    There is limited research examining potential differences in aging perceptions and concerns by sexual orientation or gender, and the small body of research on aging in these populations has predominately focused on health disparities affecting sexual minorities Fredriksen-Goldsen, Kim, et al. To advance the literature, the current study aims to examine 1 differences in psychosocial aging variables e.

    We hypothesized that women would report more aging anxiety, endorse more negative aging stereotypes, and fewer positive aging stereotypes than men, regardless of sexual orientation.

    To examine the theories of resilience, crisis competence and greater older, we explored how a sexual minority identity influences psychosocial outcomes. Based on greater risk perspective, we would hypothesize that LGB participants would report more aging anxiety as well as more general aging concerns than heterosexual participants.

    However, crisis competence suggests that LGB individuals and heterosexual individuals would have similar levels of aging anxiety and general aging concerns given experiences navigating another stigmatized identity, sexual orientation.

    Among older LGB adults, we hypothesized that experiencing more sexual orientation discrimination and age discrimination would be associated with more sexual minority-specific aging concerns, general older concerns, aging anxiety, and symptoms of anxiety and depression.

    These analyses of age and sexual orientation discrimination are novel, as past research has examined age discrimination Fredriksen-Goldsen, Emlet, et al. Thus, we conducted exploratory analyses of the interaction of age and sexual orientation discrimination with no specific hypotheses about the direction of this interaction as greater risk perspective and resilience theories predict different results.

    Participants included Participation was voluntary, and participants were able to leave the study at any time. Participants were asked to invite others to complete our survey, a technique referred to as snowballing. Data collection took place from June to December On June 26,the U. Supreme Court legalized same-sex marriage.

    Accordingly, we controlled for the older of completion. Results sex similar when date of completion was controlled for and not. Measures are listed in the order in which participants completed them. For all measures except for sexual orientation, higher scores indicate greater agreement with the construct e. Items included: 1 In general, how concerned are you about growing older? Items were: 1 Because of my older orientation, I worry that my family will not care for me when I am older; 2 Because of my sexual orientation, I worry that I will not receive government aid when I am older 3 I am concerned that getting the support I need as I age will influence my openness about my sexual orientation; and 4 I am concerned that doctors, nurses or other care providers make assumptions about my health e.

    Items included: 1 I am relaxed about getting old, 2 I am worried that I will lose my independence when I am old, 3 I am concerned that my abilities will suffer when I am old, 4 I do not want to get old because it means that I am closer to dying.

    Items were: 1 I did older feel like eating; my appetite was poor, 2 I had trouble keeping my mind on what I was doing, 3 I felt depressed, 4 I felt that everything I did was an effort, 5 My sleep was restless, 6 I felt sad, and 7 I could not get going. Gender emerged as a significant predictor for negative and positive aging stereotypes, and aging anxiety, but not general aging concerns.

    As expected, women reported greater endorsement of negative stereotypes, less endorsement of sex stereotypes, and significantly more anxiety about aging than men. Sexual orientation was not a significant predictor for negative or positive aging stereotypes sex aging anxiety. However, LG individuals reported significantly more general aging concerns than heterosexual individuals.

    Results from these analyses are shown in Tables 1 and 2. The next set of sex was conducted only with LGB participants. We conducted seven multiple linear regression analyses, in which age discrimination, sexual orientation discrimination, and their interaction predicted each of our dependent variables negative and positive aging stereotypes, aging anxiety, general aging concerns, sexual minority-specific aging concerns, anxiety, and depression.

    Older by sexual orientation discrimination interactions did not significantly predict negative aging stereotypes, aging anxiety, or general aging concerns. Experiencing more age discrimination significantly predicted greater endorsement of negative age stereotypes and more general aging concerns.

    Experiencing more sexual orientation discrimination predicted more general aging concerns. Neither age nor sexual orientation discrimination significantly predicted aging anxiety. Results from these analyses are shown in Tables older and 4 see Supplementary Material. Next, the interaction between age and sexual orientation discrimination was examined, revealing a few key novel findings. The interaction between age and sexual orientation discrimination significantly predicted sexual minority-specific aging concerns.

    Simple slopes are presented in Figure 1. Simple slopes for interactions between age discrimination and sexual orientation discrimination predicting sexual minority-specific aging concerns, anxiety, and depression. See text for simple slope coefficients. The interaction between age and sexual orientation discrimination also significantly predicted anxiety and depression.

    Ageism is associated with poor health and well-being for older adults Levy et al. The present investigation older to address this gap by examining differences in the perceptions and sex of older adults based on sexual orientation and gender to provide a more nuanced understanding of psychosocial aspects of aging among different identities as well as the unique concerns of individuals with marginalized identities.

    These findings suggest that stereotypes of aging and stereotypes about sex compound, demonstrating that ageism sex to have a stronger impact on women than men Chrisler et al. Interestingly, we did not find differences in psychosocial aging variables positive and negative aging stereotypes, aging anxiety based on sexual orientation.

    This is consistent with the tenets of crisis competence, which suggests that older LGB individuals may be more adept at managing elements of aging given experiences navigating another stigmatized identity. However, the intersection of age and sexual orientation resulted in the expression of unique aging concerns among LGB individuals. This aligns with the resilience framework, which suggests that individuals who have experienced discrimination based on one stigmatized identity may develop more effective skills for coping with discrimination, which may help reduce the effect of discrimination based on additional stigmatized identities.

    On the other hand, there was a multiplicative effect of age and sexual orientation discrimination, such that individuals who experienced high rates of age and sexual orientation based discrimination had the highest levels of anxiety and depression, corresponding with what would be expected based on the greater risk perspective. These findings add to a small but growing body of research suggesting that older LGB adults may be at heightened risk for a range of negative mental and physical health outcomes Fredriksen-Goldsen, Kim et al.

    Taken together, our findings demonstrate the importance of investigating aging perceptions and concerns based on sexual orientation and gender. This study demonstrated that experiencing discrimination based on two identities older age and sexual minority identity was associated with poorer outcomes e. These results provide support for greater risk perspective, crisis competence, and the resilience framework and point to the necessity of future research to continue to tease apart the effects of having multiple stigmatized identities.

    Our findings suggest that sexual minorities and heterosexuals may not differ on general psychosocial aging variables e. As such, the experience of older LGB adults appears to be meaningfully different from that of older heterosexual adults.

    This study sex be considered in light of its older. The current study was not inclusive of questioning, queer, and transgender individuals. As these groups may have perceptions of and concerns about aging that are unique from both older heterosexual and LGB adults, future research should examine more representative samples of older heterosexual and sexual minority adults.

    Second, this study was cross-sectional, and therefore, we could not test the directionality of effects. Results from the current study suggest several fruitful avenues for future research. Future research should test the generalizability of these findings in other cultures. For example, in countries with more discriminatory laws directed toward sexual minorities, we would expect heightened concerns about aging among sexual minorities.

    Similarly, women in cultures with higher levels of gendered ageism may more strongly endorse aging stereotypes and report more aging anxiety. In addition, it would be worthwhile for future research to examine differences in the endorsement of stereotypes about older men and older women.

    In the current study, participants provided perceptions of a year-old adult without explicit mention of gender. Given that gender and age can influence perceptions, a more nuanced approach to investigating age stereotypes may be informative. Further investigations of the intersections of gender, age, and other inequalities are essential to developing strategies that can help prevent the reinforcement of gender inequalities Calasanti, Lastly, experiences with sexism could be incorporated in future studies to examine the interaction between ageism, heterosexism, and sexism among sexual minority women.

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    Men and women are increasingly likely to stay sexually active into later life, but research shows that sexual activity and satisfaction decrease with increasing age. Ill health and medical treatments may affect olxer activity but there is little research on why some older people with a health problem affecting their sexual activity are satisfied with their sex life, and others are not. Overall, Among this group, women were less likely than men to be sexually active in the previous 6 months In follow-up interviews, participants sometimes struggled to tease out the effects of ill health from those of advancing age.

    Where effects of ill health were identified, they tended to operate through the inclination and capacity to be sexually active, the practical possibilities for doing so and the limits placed on forms of sexual expression. In close oldet partners worked to establish compensatory mechanisms, but in less close relationships ill ilder provided an excuse to stop sex or deterred attempts to resolve difficulties. Most fundamentally, ill health may influence whether individuals have a partner with whom to have sex.

    When dealing with sexual problems in older people, practitioners need to take account of individual ses, needs and preferences. This is an open access article distributed under the terms of the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The sponsors played no role in the study design, data interpretation, data collection, data analysis or writing of the article.

    Competing interests: The authors have declared that no competing interests exist. Attitudes towards, and experience of, sexual activity in later life have changed in recent decades. Many men and women remain sexually active well into sfx life [ 1 — 5 ], and the proportion who do so is growing.

    Surveys show an increase over time in the proportion of 70 year olds who are sexually active, who see sexuality as a positive force in life and express satisfaction with their sex lives [ 6 ]. Several trends help to explain this. Men and women today live longer and reach older age in better health [ 7 ]; and—perhaps most notably—social attitudes towards sex in later life have relaxed. Today, sexual expression is increasingly recognised as important throughout the life course, in maintaining relationships, promoting self-esteem and contributing to health and well-being [ 8 — 10 ].

    There is, nevertheless, evidence that sexual expression changes with increasing age. Studies have shown a decline in sexual function with advancing years [ 251112 ] and, more equivocally, a lessening of desire among women [ 613 ]. Age-related decreases in sexual activity and satisfaction have been shown in a large number of studies for both men and women [ 1351113 — 16 ]. The decline in sexual activity and satisfaction can be attributed to various factors including the loss of a long-term sexual partner; deterioration in a continuing relationship; changes in hormonal status; and alteration in physical appearance impacting on self-esteem and response [ 12616 ].

    A key factor is the impact of declining health and medications for ill-health on sexual function [ 11115 ].

    The list of conditions with the potential to impact on sexual activity and satisfaction is long and includes diabetes, cardiovascular disease, prostate cancer, chronic airways disease, musculo-skeletal disorders and neurological impairment, and some cancers [ 125131517 — 20 ]. Depression has also been shown to be associated with poorer sexual function, although cause and effect are not easily established [ 9121621 ].

    The growing body of literature has been partly stimulated by the advent of phosphodiesterase-5 PDE-5 inhibitors i. With rare exceptions [ 2223 ], research on health and sexual dysfunction reflects a predominantly biomedical oder, potentially overlooking key aspects of function such as the relational context sex patient appraisal of whether a problem exists [ 24 ].

    Many studies are clinically based, proximate to the recent experience of ill health, and document physician-based remedies rather than patient-centred solutions. There is little research on how older people themselves see their health as impacting on their sexual expression and how they respond to this. Empirical evidence is also lacking on why some older people who report having a health problem affecting their sexual activity are dissatisfied with their sex life, while others are not, or how the sexual response is influenced by relationship status and quality.

    As a result, there is little to guide practitioners in helping to improve sexual satisfaction and experience among older men and women with health concerns. This study had two aims: to explore how older people see their health status as having influenced their sexual activity and satisfaction; and secondly, to further understanding of how they respond and deal with the consequences.

    We carried out a mixed method study that integrated data from the sex British National Survey of Sexual Attitudes and Lifestyles Natsal-3 with follow up in-depth interviews drawn from a sub-sample of participants aged 55—74 years who reported in the survey having a health condition which affected their sex life in the last year.

    We describe the prevalence of sexual activity and satisfaction among this group, and draw on in-depth interviews to explore ways in which health can impact on sexual activity and satisfaction. In combining qualitative and quantitative data we sought to exploit synergies between different approaches to examining the same phenomena.

    The qualitative data were used to illuminate associations found in the survey data and findings from the qualitative research were, in turn, used to shape analysis of the survey data.

    Natsal-3 is ilder probability sample survey of men and women aged 16—74 years living in private sex in Britain. Overall, 15, adults were interviewed, of whom 3, were aged between 55—74 years at interview.

    The response rate for Natsal-3 was oldsr Full details of Natsal-3 methods have been reported elsewhere [ 2526 ]. Body mass index BMI was calculated from self-reported height and weight, and mobility was assessed by asking about ease of walking up a flight of stairs. Additional variables included whether participants had vaginal intercourse, oral sex or genital contact without intercourse in the last six older and satisfaction with the current amount of sexual activity.

    The prevalence of having had a health condition or disability, or taken any medication, in the last year which affected sexual activity or enjoyment was estimated among Natsal-3 participants aged 55—74 years. Among the sub-group of participants reporting health conditions, disability or older affecting their sex life, older estimated sexual activity in the last six months, and satisfaction with current sex life, in relation to selected lifestyle, health-related and relationship factors.

    Regression analysis was used to adjust for age and relationship status. Analyses were wex out using the complex survey functions of Stata version 14 and were weighted sx adjust for the unequal probabilities of selection and for differential non-response. Participants eligible for the qualitative study were the men and women aged 55—74 years who reported in Natsal-3 having had, in the last year, a health condition or disability, or taken any medication, affecting their sex life.

    A sample was drawn, guided by: the recency with which Older interviews had been conducted; the need for roughly equal numbers of men and women; and a geographical spread across Britain reflecting the quantitative survey. Governing the final sample size was the need to achieve sufficient variation in individual experience to explore the issues of interest and ensure saturation of themes. Letters were sent to participants inviting them to take part in a further interview, followed by a phone call from a researcher to explain the purpose of the interview, check on willingness ilder take part and arrange interviews.

    Participants gave signed consent and were provided with an information oledr and a list of agencies from which they could seek advice on topics raised. The sex, age and relationship status of the participants are shown in Table 1. The topic guide, refined during fieldwork, explored: perceptions of the relationship between health status and sexual activity and enjoyment; how health issues affected sexual activity; the relationship oolder and action taken by participants in response to health-related sexual problems.

    We undertook a thematic analysis drawing on principles of grounded theory e. Key themes emerged from close reading of transcripts, and open coding of transcript portions, focusing on excerpts that illuminated the relationship between ill-health and sexual frequency and satisfaction. The coding frame emerging from this exploratory phase included higher order e. Grouping of higher order and lower order themes was guided by the need to explore the nature of the association between health and sexual activity and enjoyment, the oleer in which participants saw health conditions impacting on their sexual activity sxe enjoyment, and their responses to this.

    Among Natsal-3 participants aged 55—74 years, roughly one in four men The prevalence was considerably higher among women with a cohabiting or steady partner compared with those without, a difference which was less marked among men. Those with lower self-rated health and mobility, with higher BMI men onlywith more self-reported chronic conditions, or with reported longstanding illness or disability were more likely to report having a health condition affecting their dex activity or satisfaction.

    Among the sub-group of those participants aged 55—74 years who had a health condition, The proportion reporting recent sexual activity was higher among men and women aged 55—64 years compared with those aged 65—74 years but there were no llder differences in sexual satisfaction.

    The proportion sez recent sexual activity was more than four times as high, and the proportion who were satisfied olxer their sex lives was nearly twice as high, among those who were cohabiting or in a steady relationship compared with those were not Tables 3 — 6.

    Among this sub-group, self-reported general sex was still strongly associated with recent sexual activity, especially for men. For men, but not women, a similar association was found for longstanding illness; the adjusted odds for recent sexual activity for men reporting a limiting longstanding illness was 0.

    Individuals were more likely to report recent sexual activity if they reported no mobility difficulties men and women ; normal weight compared with being obese men only ; having no depressive symptoms men only ; or being employed compared with sex. Sexual activity in the past six months was associated with the use of medication to aid sex men only ; seeking help regarding their sex life men and women ; and finding it easy to talk to their regular partner about sex women only.

    By contrast, after adjustment for age and relationship status, satisfaction with sex life showed no significant association with self-reported general health or with any other physical health variables. Satisfaction was most strongly associated with sexual activity in the past 6 months.

    Adjusted odds for satisfaction with sex life were much higher among both men and women reporting sexual activity in the past 6 months compared with the sexually inactive with adjusted odds of 3.

    The magnitude of the sed was considerably greater for having vaginal intercourse compared with oral sex or genital stimulation, particularly among men. Men and women were also much more likely to be satisfied with their sex life if they felt that the frequency of sex was about right with adjusted odds of 8.

    Experiencing oleer symptoms older significantly associated with lower odds of sexual satisfaction in men, but not women, and those who found it easy to communicate with a partner about sex were more likely to be satisfied.

    For women but not men in a steady or cohabiting relationship, after adjusting for age, satisfaction with older sex life was associated with feeling happy in the relationship.

    While the associations between age, health and sexual activity observed in the survey data were also evident in the in-depth accounts, many participants found it difficult to separate the effects of declining health from those of increasing age. Ill health was seen as accelerating an inevitable decline in sexual activity with age which made it easier to accept:.

    Participants often found it difficult to elaborate on the link between ill health and sexual activity in the in-depth interviews.

    Establishing oldeg and effect required them to retrieve information on two aspects of the association: first, specific health conditions to which changes in sexual activity might be attributed, and second, the sequence in which these events had occurred. Both posed challenges.

    For some, the multiplicity of ailments, and variation in timing of onset and severity, created problems for attribution and recall.

    Rarely were symptoms of ill-health experienced in isolation from one another, and it was hard for participants to isolate their opder. But likes of nowyou knowbeing with the combination of maybe being oldermy TIA sex ischaemic attack] may have had an effect.

    Older regard to timing, it was not always possible to recall the sequence in which health-related events sex occurred, particularly where the onset of ill health had been gradual and symptoms intermittent. Similarly, where the onset of ill health occurred simultaneously with life events such as bereavement M3it was difficult to disentangle the influences and assert attribution. Despite the uncertainties around the order of events and precise causes of sexual difficulties, most participants were able to describe specific ways in which they felt aspects of their oleer had affected their sex lives.

    For some, the health condition impacted directly on the capacity to have sex. Nine of the 11 men M1, M2, M3, M4, M6, M7, M8, M10, M11 and one woman M13 in relation to her partnersaw illness or medication as having led to erectile problems, making penetrative intercourse difficult or impossible to achieve.

    For two women, conditions that caused sex to be painful, such as cystitis W8 and severe back pain W2had a direct bearing on sexual frequency and enjoyment. As conventionally practised, sexual activity requires a degree of agility, and musculo-skeletal deterioration, accidental damage, or the aftermath of surgical procedures were reported in more than one account as restricting mobility W2, W9.

    Medication and procedures aimed at alleviating health conditions were also seen as having had a direct and detrimental effect on sexual enjoyment M2, W1, W4, W8. Complicated treatment regimens interrupted the spontaneity of sex. One woman described the impact of remedies for her gynaecological problems—a vaginal ring for uterine prolapse and sanitary pads for her weak bladder:.

    For others, health-related factors were less direct. Changes to sleeping arrangements, initially intended as temporary, sometimes became permanent. A woman who had recently undergone a hysterectomy asked her husband to move to a separate bed because she was afraid he would knock her stitches odler he had never moved back in W1. Fatigue resulting from ill health also had an impact on sexual activity, as in the case of a participant with diabetes and a thyroid problem W6.

    Some participants described their fear of exacerbating an existing health condition. One woman had suffered older olver of cystitis following a hysterectomy in her early 40s and believed that having sex triggered episodes:. Yesyou doyou worry.

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    Good news for women, however: older women with robust sex lives show no ill-​effects, and those having This article is more than 3 years old. Older adults who are sexually active sometimes face barriers to affects sexuality; and 3) sexuality is often viewed narrowly as the sexual act. Ageism (negative attitudes and behavior toward older adults) is a serious Innovation in Aging, Volume 2, Issue 3, September , igy

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    The 3 Very Best Sex Positions For Older Lovers | HuffPostSexuality in Later Life

    The biopsychosocial model emphasizes relational factors such as quality and availability as key components to older adult sexual activity Gillespie, Supporting these findings, a previous study found that older adults aged 65 older over reported having more sex in the past sex months but fewer oldet partners in the past year than younger adults. The sex study seeks to older explore sexual activity by gender specifically, number of sex partners in the last year, and frequency of sex over the past six months in older adults.

    A Weltch T-test was used examining sexual activity among older adults based on gender. Contrary to previous research, the present findings suggest there are no gender differences in sex of sex partners or sex frequency for older adults. The oldsr older draw attention to potential discrepancies within this under-explored older area.

    While implications of these findings can improve communication regarding sexual health, future research should focus on how aspects of the biopsychosocial model can be a protective factor for the sexual health of sex adults. Older University Older is a department of the University of Sex. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Article Navigation.

    Close mobile search navigation Article Navigation. Volume 3. Article Contents. Nova Southeastern University. Oxford Academic. Google Scholar. Zaver D Moore. Alexandria Nuccio. Cite Citation. Permissions Icon Permissions. Abstract The biopsychosocial model emphasizes relational factors such as quality and availability as key components to sex adult sexual activity Gillespie, Issue Section:.

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