Excerpted from Sexuality at Midlife and Beyond
from Sexuality at Midlife and Beyond,
SHR June 2003
about sexuality and aging
Fantasies can help rev up your sex life. Myths,
on the other hand, can stop desire dead in
its tracks. Such myths aren’t the legends
from classical history. They’re the stories
we tell ourselves and each other to support
the notion that older people shouldn’t,
can’t, and wouldn’t want
to have sex. This type of myth, however,
bears as little relationship to reality as
do the fanciful sagas of ancient gods and goddesses.
Here are some examples of the most popular
sexual myths and the myth-busting truths.
1. The myth: Only the young are sexually attractive.
The culture we live in exalts youth. Turn
on the TV or open a magazine and you’ll
be barraged with images of supple skin, firm
flesh, and lustrous locks. But if your mirror
is reflecting a different picture these days,
you may feel like the party is going on without
The reality: Older can be quite sexy.
Sure, thinning hair, laugh lines, and a paunchy
midriff are no picnic. But think back on what
it was that made you attractive in your younger
years. Was it your soulful brown eyes, your
crooked smile, or maybe your infectious laugh?
Chances are, those attributes are still as
appealing as ever. In fact, a 1999 survey conducted
by the AARP and Modern Maturity magazine
revealed that the percentage of people age
45 and older who consider their partners physically
attractive increases with age.
2. The myth: Sexuality in later life is undignified.
Whether it’s the white-haired grandmother
fussing with her knitting or the loveable old
codger puffing on a pipe, society is inclined
to desexualize older adults. When older adults
do express their sexuality, it’s often
viewed with derision — for example, the
stereotype of the “dirty old man.”
The reality: It’s healthy for older
adults to express their sexuality.
People are living longer and remaining healthier.
And they are more vigorous than ever before.
Former president George H.W. Bush went skydiving
to celebrate his 75th birthday, John Glenn
returned to space at age 77, and Carol Sing
forged a new world record at 57 by becoming
the oldest woman to swim the English Channel.
With this trend toward later-life vitality,
why shouldn’t seniors be allowed to cast
off outdated and ill-fitting stereotypes in
order to express their normal, healthy sexual
3. The myth: Men and women lose their ability
to perform sexually after a certain age.
Vaginal dryness and erectile difficulties
loom large as you hurtle past 50. You may be
feeling that you should just listen to what
your body is trying to tell you: Sex is a thing
of the past.
The reality: You can still have a satisfying
While a certain degree of physical change
is unavoidable, this fact of life doesn’t
necessarily translate into insurmountable sexual
problems. For men, the Viagra revolution means
most erection problems can be corrected with
little medical intervention. For women, high-tech
vaginal lubricants and hormone creams and rings
are viable substitutes for what nature no longer
supplies. What’s important for both sexes
to remember, though, is that a softer erection,
reduced natural lubrication, or a less intense
orgasm doesn’t mean you’re no longer
interested in your partner or in sex itself.
For many couples, these kinds of changes provide
an impetus for developing a new, rich, and
satisfying style of lovemaking — one
that’s based more on extended foreplay
and less on intercourse and orgasm.
4. The myth: Sex is boring when you
Drooping libido, slower rates of arousal,
and the predictability of having the same partner
for 20 or more years all add up to a ho-hum
The reality: Sex is as good as you make it.
While it’s true that a 19-year-old will
have a faster, harder erection and a more forceful
ejaculation than his 55-year-old counterpart,
it doesn’t mean the quality of the experience
is necessarily better. On the contrary, the
older man has better control of his ejaculations.
Less penile sensitivity means he may be able
to enjoy a wider range of erotic sensations
and maintain his erection longer. And his experience
may pay off in improved sexual technique and
a better understanding of what will please
Many women begin to find sexual confidence
in their 30s, and this blossoms with maturity.
As a woman moves through her 40s, her orgasms
actually become more intense, and she can still
have multiple orgasms. After menopause, when
she’s free of any worry about pregnancy,
she can give herself over to the pure enjoyment
Although longtime partners do have to contend
with issues of familiarity in their relationship,
these problems can be offset by greater emotional
intimacy and trust. Because inhibitions often
lessen with age, sex at 50 or 60 may include
a level of experimentation and playfulness
you wouldn’t have dreamed of in your
the numbers: Statistics on sexuality
and sexual satisfaction
In 1999, Modern Maturity magazine
and the AARP foundation polled 1,384
adults age 45 and older about the role
sex played in their lives. The findings
paint a detailed picture of sexuality
at midlife and later.
The importance of sex
Over all, the majority of men (66.8%)
and women (56.7%) responding felt that
a satisfying sex life was important
to their quality of life. But an even
higher percentage (91.9% of men and
87.1% of women) thought that a good
relationship with their spouse or partner
played a key role in their happiness.
Frequency of sexual activity
Of individuals with partners, just
over 60% in the youngest age bracket
surveyed (45–59) had intercourse
at least once a week. At age 75, the
proportion dropped to one in four.
Still, nearly three-quarters of respondents
of all ages had intercourse once a
month or more, provided they had partners.
However, when the group was examined
as a whole, one out of five men and
two out of five women had not participated
in any form of sexual touching or caressing
over the last six months.
Men tended to think about sex and
feel sexual desire more frequently
than women. While rates of intercourse
were similar for both sexes, more men
than women reported engaging in sexual
touching. Self-s timulation on a regular
basis was also about eight times higher
Factors affecting sexual satisfaction
Not surprisingly, one of the major
factors associated with respondents’ satisfaction
was the availability of a partner.
In the 45–59 age group, roughly
four out of five individuals had partners;
by comparison, only one in five women
over 75 had partners. Declining health
also appeared to have an effect on
sexual activity and satisfaction. On
a list of features that might improve
their sexual satisfaction, the men
ranked better health for themselves
or their partners at the top. Although
impotence emerged as a significant
issue for nearly a quarter of the men,
less than half of those men had ever
sought medical treatment for the problem.
3. Survey facts and figures
said, in a nutshell
A good relationship
with a spouse or partner is important
to quality of life
is physically attractive
sexual relationship is important to my
overall quality of life
is a pleasurable but not a necessary
part of a good relationship
intercourse at least once a week
during the last six months
kissing or hugging at least once a week
during the last six months
with my sex life
for myself would improve my sex life
for my partner would improve my sex life
medication to improve sexual functioning
less important to people as they age
and social issues
“The brain is the body’s most
important sex organ.” This oft-repeated
phrase bears more than a little truth. While
the initial prerequisites for sexual activity
are physiological — functional sex organs,
adequate hormone levels, and freedom from healt
h conditions that interfere with the body’s
ability to respond to erotic cues — these
elements don’t guarantee sexual satisfaction.
Stress, anxiety, self-esteem issues, negative
past experiences, lifestyle demands, loss of
loved ones, and relationship conflicts can
weigh heavily. During midlife and beyond, these
factors, combined with naturally occurring
physical changes, can make you vulnerable to
of a partner
It may seem obvious that not having a partner
is an impediment to an active sex life, but
it’s an especially important issue for
older people. By age 65, many people find themselves
alone, through either divorce or widowhood.
This affects sexuality in a variety of ways.
According to the AARP/Modern Maturity Sexuality
Survey, 64% of men with partners and 68% of
women with partners are primarily satisfied
with their sex lives. This is in sharp contrast
to the small proportion of those without partners
(18% of men and 28% of women) who are pleased
with their sex lives.
The partner gap is a particular problem for
American women because their average life span
(79 years) is more than five years longer than
that of men. Because American women marry men
who are on average three years older, that
can mean even more time alone. Should a woman
want to remarry, her chance of finding a new
mate in her age bracket dwindles yearly; there
is an average of only 7 men for every 10 women
age 65 and above. All this boils down to the
fact that, compared with men, women are likely
to live a greater portion of their lives without
Finally, starting a new sexual relationship
after divorce or the death of a spouse can
present its own dilemmas. People often fear
that they will not become aroused or be able
to have an orgasm with a different partner.
They also may be self-conscious about baring
their body in front of someone new. Because
a new relationship may come along months or
years after their last sexual relationship,
some individuals feel anxious that they have “forgotten
how to have sex” or that “the equipment
doesn’t work anymore.” For those
who have lost a much-loved spouse, feelings
of guilt or disloyalty at starting a new relationship
can be overwhelming.
Tension in a relationship can be deadly to
a couple’s sex life. In many cases, conflict
is at the root of a sexual problem. Other times,
a sexual issue strains a couple’s ability
to get along. The following issues are often
connected to sexual problems.
Anger and frustration. Accumulated
anger, hurt, disappointment, and resentment
can fester, destroying closeness between partners.
These pent-up feelings often extinguish the
flames of desire. For men, anger and frustration
can interfere with arousal and getting an erection.
Likewise, the breakdown of trust can be devastating
to a woman’s ability to reach orgasm.
Both partners can suffer loss of libido in
a conflict-ridden environment. This type of
disappointment turns toxic when one or both
partners resort to criticism and defensiveness — two
of the major harbingers of divorce. In addition,
one member of the couple may unconsciously
withhold sex as a way of expressing anger or
to maintain the upper hand in a situation where
he or she feels otherwise powerless.
Poor communication. Communication
is essential for partners to build the trust
needed for a successful sexual relationship.
By talking frankly about your feelings, you
can foster acceptance and understanding in
your relationship. This makes it easier for
you and your partner to collaborate on finding
solutions to issues, and it can prevent resentments
from piling up. When conversation breaks down,
anger and resentment are likely to build.
Dialogue is especially vital as physical changes
take place. Vaginal dryness or erection difficulties
can be wrongly perceived as waning interest
in sex, which can trigger feelings of rejection
and resentment. By articulating feelings, couples
can sort out the physiological factors from
the emotional and relationship issues, and
address each appropriately.
Boredom. Once the honeymoon
is over, almost every couple has to contend
with boredom sooner or later. The person who
was once so electrifyingly mysterious to you
may become as comfortable — and as alluring — as
an old shoe. While the deep trust and intimacy
created from years of shared experiences are
the building blocks of a truly loving relationship,
such familiarity can take the edge off desire.
Sex may not even seem worth the trouble when
you’re facing the same old lovemaking
When sexual activity wanes, other types of
physical affection often fade, too. This lack
of physical connection can extend the emotional
distance between you and your partner. As a
result, it’s all the more difficult to
resume sexual intimacy later on. But it’s
possible to do so.
Resentment, tension between you and
your partner, a breakdown in communication,
or even boredom can produce sexual
Affairs. While researchers
can’t seem to agree on how many people
seek sex outside their marriage — the
estimates range from 20% to 60% — one
thing is clear: An affair is often an indication
of an unmet need in the relationship.
One frequent motivator for a person to have
an affair is a quest for newness. This yearning
may arise from a need to banish midlife drudgery,
a desire to find out what sex is like with
someone else, or an urge to recapture the heart-pounding
sexual highs of youth. Other times, an individual
searches out a new partner to meet unfulfilled
emotional or intellectual needs. An affair
sometimes occurs because of sexual dysfunction
in the marriage. For example, men who have
erection difficulties or women who can’t
reach orgasm may seek out new lovers to prove
that the sexual problem is their spouse’s
doing, not their own. Likewise, the partners
of those with sexual difficulties may try to
seek reassurance that they’re still sexually
appealing in the arms of someone else.
The reverberations of an affair can extend
throughout a couple’s relationship like
ripples on a pond. Sometimes the straying partner
isn’t able to respond sexually to his
or her spouse because of guilt over the affair,
fatigue from juggling two sexual relationships,
or a negative comparison of the spouse with
the new lover. If the spouse discovers the
affair, he or she may withdraw emotionally.
An affair can be a serious, sometimes fatal,
blow to a relationship. However, it’s
possible for a marriage not only to survive
infidelity, but also to grow from this painful
expe rience. To do this, though, both partners
must face the personal and relationship issues
that led to the affair in the first place.
Couples therapy is a good place to turn for
help in doing this. Sex therapy can
also be useful if the affair has caused or
resulted from sexual problems.
In the years since the famous “little
blue pill” entered the market in March
1999, millions of couples have seen firsthand
what this drug can and can’t do. In many
cases, Viagra (sildenafil citrate) is the answer
to a prayer for men who have been unable to
have an erection. But the drug offers no help
in untangling the emotional and relationship
pressures that frequently accompany erectile
For one thing, Viagra only works if there
is desire to have sex. If emotional issues
are impinging on libido, the pill won’t
help. It’s important that the partner
of a man who has begun taking Viagra understands
this. During a long bout with erectile dysfunction,
many women blame themselves for their partner’s
inability to perform. When Viagra comes onto
the scene, the woman may find it hard to let
go of past feelings of rejection. She may mistakenly
assume that her husband’s newfound erections
are merely a chemical phenomenon, not an outgrowth
of sexual attraction to her.
When intercourse is suddenly a possibility
again, relationship issues can sprout up or
resurface. For example, dramatic differences
in libido sometimes emerge. Also, a woman can
develop problems related to vaginal atrophy
if she hasn’t had sex in a long time.
She may need to undergo a few weeks of therapy
using medication or dilators before she can
comfortably resume intercourse.
The bottom line is that couples should try
to regard Viagra as an opportunity to become
erotic again, while realizing that it is neither
a mandate to have intercourse nor a panacea
for every problem in the bedroom.
Defined as an overwhelming concern about sexual
performance that obscures pleasure and leads
to sexual dysfunction, performance anxiety is
a particularly insidious issue affecting aging
couples. Performance anxiety becomes a particular
problem for men as they move into their 50s.
It’s the most common psychological contributor
to erectile dysfunction.
Here’s how the problem often develops.
The natural effects of aging dictate that a
man needs more time and direct penile stimulation
for an erection. Medications and cardiovascular
disease may also contribute to erection difficulties.
If a man continues to expect the instantaneous
rock-hard erections of his 20s, he may equate
this change in his physical response with the
end of his virility. Once he makes this erroneous
leap, the problem snowballs. After a few incidences
of erection failure, embarrassment and feelings
of defeat leave him unwilling to try again.
He may withdraw from all forms of intimacy
to avoid having to perform. In turn, his partner
feels rejected and fears that she’s no
longer attractive enough to sexually excite
him. She may also suspect him of having an
If this happens, the woman may shy away from
touching her partner sexually out of fear that
another failure will occur. Paradoxically,
her reticence denies the man just the type
of direct stimulation that he needs at this
stage of life to achieve an erection. The result
is that an addressable physical issue becomes
a morass of anger, resentment, and frustration.
Women, too, can experience performance anxiety.
Frank discussion of sexuality has become commonplace
in women’s magazines and on daytime television.
This openness has had the unintended consequence
of making some women worry that they do not
respond quickly or intensely enough to be considered
a “good lover.”
After an instance or two of having
erection problems, many men are reluctant
to initiate sex. This can be the start
of a cycle: performance anxiety leads
to further erection difficulty, which
heightens the performance anxiety.
image and self-esteem
At one point or another, you may have come
to the realization that gravity is not kind
to your body as you age. Nor is childbirth,
a fatty diet, lack of exercise, or the hormone
declines that lead to muscle loss, loose skin,
and thinning hair. But what does this have
to do with your sex life? It can have everything
to do with it if you let it. Worry about having
your partner see your sagging breasts or potbelly
can discourage you from even thinking about
having sex. If you do decide to be intimate,
you may demand that sex take place only under
the covers, with the lights out, while you’re
wearing a T-shirt. Needless to say, these conditions
don’t leave much room for inspired lovemaking.
You may also find that your preoccupation with
your appearance while making love prevents
you from fully enjoying sex.
Relationship conflicts can ensue. When one
partner needs constant reassurance about his
or her attractiveness and becomes overly sensitive
to perceived criticism, it can foster mutual
resentment. The paradox in this dynamic is
that the majority of middle-aged and older
adults responding to the AARP/Modern Maturity Sexuality
Survey said they still found their partners
physically or romantically attractive. What’s
more, the percentage increased with age.
By shifting your focus away from your perceived
flaws to your attributes — for example,
your eyes or your hair — you can boost
your self-esteem and establish your own standards
for attractiveness. Also, try directing your
attention to the experience of giving and receiving
pleasure during sex. This can help you find
the confidence to give yourself over to the
experience. Great sex is often the outgrowth
of a deep emotional connection — something
that’s not guaranteed by having a perfect
A negative self-image isn’t always rooted
in your appearance. Career setbacks or other
disappointments can lead to feelings of failure
and depression, both of which sap desire. For
men, episodes of impotence can undercut confidence
in their manhood. No matter what its cause,
a poor self-image can take a toll on your sex
life. When performance anxiety develops as
a result, it can spark a downward spiral of
repeated sexual failure and diminishing self-esteem. Correcting
this problem demands serious attention to its
origin. Because feelings of low self-worth
are a symptom of depression, you should talk
to a doctor if the problem persists.
A negative body image can impede your
and past experiences
Your sexuality is a natural drive that’s
with you from birth, but your family and cultural
background shape your attitudes toward sex.
As you become an adult, your own experiences
further influence your sexuality. The result
for many is a healthy enjoyment of sex, but
others may have more mixed feelings. The changes
that take place in midlife and beyond often
exacerbate issues about sex. Deeply entrenched
negative associations can also emerge during
For example, women (and men) — particularly
those who came of age before the so-called
sexual revolution in the ’60s — may
cling to the notion that it is improper for “nice
girls” to enjoy sex. This belief can
be damaging for both partners. A woman who
has merely acquiesced to sex as a duty to her
husband or as a necessary step in childbearing
may feel uncomfortable seeking sexual pleasure.
Her partner may interpret this lack of enthusiasm
as a reflection of her feelings about him.
Inexperience and embarrassment over discussing
sexual matters may hamper people from fully
expressing themselves sexually. For example,
intercourse alone does not give many women
the kind of stimulation they need for fulfilling
sex, and uneasiness about discussing the problem
prevents some couples from developing techniques
that could offer the woman greater pleasure.
Compounding the problem, childhood taboos against
masturbation may prevent a woman from ever
discovering the means to her sexual pleasure,
so she’s unable to direct her partner
in this regard. It may be more comfortable
for a woman to forgo her own pleasure than
to confront these matters. She may ultimately
resort to faking orgasms rather than risk asking
for a different approach to lovemaking. When
this pattern exists for years, revealing the
truth would mean admitting to a longstanding
deception, which could shake the trust in the
relationship and injure her partner’s
Alternately, a man may feel his self-worth
depends on his ability to please his partner.
His focus during sex, therefore, is on performing
rather than succumbing to pleasure. If his
partner doesn’t immediately respond to
his efforts, feelings of inadequacy can pervade
the relationship, eroding the couple’s
bond. This dynamic can ultimately lead to performance
anxiety and related sexual problems.
During the early years of a couple’s
relationship, such missed connections are often
masked by priorities outside the bedroom, such
as building a marriage, raising a family, and
launching a career. However, midlife may prove
to be a turning point. Upon reaching menopause,
the long-unsatisfied woman might greet the
physical changes in her body as a sign that
her sexual duties are fulfilled. If her husband
is still interested in sex, a conflict is likely
A much more hopeful scenario is also possible.
Midlife and later may be a time when a woman’s
sexuality blossoms. Menopause means that women
no longer have to worry about pregnancy. Often,
children are grown and family responsibilities
have eased, allowing a couple to engage in
more relaxed and spontaneous lovemaking. In
addition, the changes a man is experiencing
during these years, such as slower erections
and longer time before ejaculation, lend themselves
to the kind of pleasurable play that a woman
may have been missing out on before.
For a couple wishing to embark on the more
positive course, the key is to begin to unravel
negative patterns. To do this, you must open
up a dialogue. It’s also important to
resist succumbing to unproductive beliefs about
aging and sex.
and lifestyle issues
Stress and fatigue are major libido sappers.
During midlife, stress can hit from any direction
and take any form. Challenging teenagers, financial
worries, aging parents, and career woes are
common. Concern over your own health or that
of a loved one, or general anxiety about aging
can also weigh heavily. With so many demands
on your time and attention, you and your partner
may neglect to nurture your relationship. This
inattention can cause your sexual connection
to fray as well.
Sheer lack of time is often a major factor.
The physical changes in sexual response that
occur in both men and women as they age mean
that it will take you and your partner more
time to become aroused and reach orgasm than
it did in your younger years. You may find
it hard to squeeze an extended lovemaking session
into an already packed day. If a couple typically
waits until bedtime to have sex, exhaustion
also can become an obstacle.
Stress has a particularly deleterious effect
on libido, especially in women. Whereas men
can sometimes use sex to relax, women more
often need to be relaxed in order to enjoy
sex. This mismatch can create conflict for
Sexual issues brought on solely by stress
and fatigue often can be remedied simply by
taking a vacation. If you and your partner
are able to resume pleasurable lovemaking in
a pressure-free environment, you’ll be
reassured that the underpinnings of your sexual
relationship are sound.
Midlife and after is also a time when profound
lifestyle changes take place. Events such as
retirement and children leaving home can upset
decades-long patterns in a couple’s life.
For example, many couples go through a period
of adjustment when they retire. If a woman
is used to having the house to herself, her
feeling of control over her domain can be threatened
by her husband’s constant presence. If
both partners worked outside the home, they
must each adapt to having more time together
One bonus is that retirement may allow you
and your partner the opportunity to engage
in leisurely lovemaking — something you
may have lacked for many years. One danger,
however, is that couples who begin spending
a lot of time together may stop making an effort
to include romance in their relationship.
Chronic illness also affects many couples’ sexual
relationships during this stage of life. People
who are ill may find that a condition or its
treatment causes sexual difficulties, while
healthy partners may worry that sexual activity
will make their loved one’s condition
worse. The fatigue and stress of the caretaker
role may also dampen desire. In addition, sexual
interest may wane for both partners if their
caretaker−patient relationship begins
to feel too much like that of a parent and
child. During this time, many people also experience
the loss of someone close — parents,
friends, or siblings. Grieving may make it
difficult to enjoy anything pleasurable, including
For sexual issues linked to stress
and fatigue, sometimes taking a vacation
The physical transformations your body undergoes as you age can have
a major influence on your sexuality. By understanding the crucial physical
and emotional elements that underlie satisfying sex, you can better navigate
problems if they arise. The Sexuality in Midlife and Beyond Report is
an essential tool that can help you remain active, vibrant and vital
as you age. Read more »