Today men and women are living longer. healthier lives. As a result of this improvement in health many older couples continue to enjoy intimacy and sexually fulfilling lives. This fact-sheet will help you with some queries that you may have.

Does sex change as you get older?

Sexuality is a complex issue. It involves the whole experience of self. including relationships with others, feelings about one's self and the functioning of the body. It includes issues of self-esteem and the roles that we take or have been given. Sex often tends to be seen as something that can only be experienced and enjoyed by young people. and if you agree with that notion then you may find difficulty adapting to your sexuality as you age. Like many activities in life, sexual expression is highly variable. Sexual function may well be different from that of a younger couple. but that doesn't mean that it has to be any less pleasurable. While a good sexual relationship is seen as important to quality of life for a majority of older adults. the quality of interpersonal relationships is even more important.
The issues surrounding mature sexuality are still not openly discussed in the public arena. Cultural biases have tended to stereotype older people as asexual, devoid of feelings or emotion. Couples who have been in longterm relationships do not necessarily find it any easier than others when it comes to discussing sexual difficulties.

What changes can I expect, as I get older?

The ageing process involves many normal physical changes. some of which naturally affect the sexual response. but sexuality is much more than a focus on the genital nature of sex. Often couples can find new ways to stimulate each other, such as erotic reading or videos. Partner communication and frank discussion of sexual desires. fantasies and experimentation are important if fulfilling sexual relationships are to be maintained into old age. Some women may find that they take longer to become aroused than when they were young, and this is a normal part of sexual response in older women.
The issues relating to responsiveness are complicated by the fact that each woman is different. A woman's concept of herself as a sexual being may be tied to her ability to reproduce- an ability she loses after the menopause. During menopause, women may experience a wide variety of conditions that may cause changes in sexual function. The drop in oestrogen levels (female hormone) during menopause may account for some (though not all and not exclusively) of the changes in arousal and desire. Changes in lubrication may occur as the walls of the vagina become thinner and less elastic; lubrication is slower and there is less volume in older women. This may cause pain if intercourse is attempted too soon before adequate arousal occurs, the use of additional lubricants such as Senselle and KY jelly are recommended. You may find that the vaginal area and breasts become less sensitive to touch. and that orgasm may take longer. You may require different stimulation than before.

Can I have good sex without intercourse?

Yes. most definitely. For men and women. sex in later years may change, but can be just as emotionally satisfying as before and perhaps more so. The importance is in learning to communicate in a way that will lead to emotional and physical fulfillment for you.

Does illness affect sex?

Yes. it can. As people grow older they are more likely to experience disabling conditions and illnesses that may affect how they respond sexually. Arthritis. stroke. coronary disease, diabetes. Parkinson's, surgery and the side effects of drugs can all affect how they respond. The psychological effects of illness can also have an impact on sexual function, especially if the diagnosis of a life threatening or life- limiting illness has been made. or if the illness affects self~steem or alters body image drastically. Illness can bring change in the structure of a couple's relationship, as previously independent people become dependent on their partner/carer. One partner may feel it is inappropriate to still have sexual desire if their partner is ill. For many carers the sheer stress and exhaustion of the role may adversely affect desire. Lifestyle can also have an impact how you may see yourself.
Retirement and children leaving home is viewed by some as an end of a chapter in their lives, whereas for others it can mean the freeing up of time for each other. Lifestyle factors also have to be taken into consideration, smoking, excessive alcohol. use of recreational drugs, poor diet and lack of exercise can contribute to sexual dysfunction. Talk to your doctor if you find that illness is preventing you from enjoying sex with your partner; they may be able to help and offer solutions or put you in touch with a therapist.

I am a widow: is it wrong to look for love again?

We all need to be loved and wanted. These needs do not diminish over time, but you may find you are seeking other forms of attachment than when you were younger. You may just require companionship and someone to share your favourite TV programs with. If you are looking to rekindle your love life, you may feel awkward and embarrassed, not knowing where or how to set off. These are perfectly normal feelings. particularly if your partner had a long illness, and you may have profound feelings of guilt and betrayal. It will help to talk to someone about those feelings. To help you to move forward in a new relationship. you may like to speak to your doctor or contact a therapist. When sexuality is affected. it is often a matter of learning to adapt and adjust rather than accepting an end to all forms of sexual expreSSion.

I am embarrassed to seek help: what can I do?

The only person who will find this embarrassing is your self; you have nothing to be afraid of and everything to gain by seeking help. Discussing sexuality in midlife can sometimes be difficult, but there is no reason to think that because you are older. you cannot use all the services that are available to younger people. Sex is not abnormal after middle age. and for many individuals it does not just cease because procreation is no longer possible. Older age should not prevent you from seeking or receiving help from whatever source is most suitable for you.

About ESHA
The European Sexual Health Alliance (ESHA) is an umbrella organisation for patient support groups across Europe. The main role of this patient focused organization is to assist patients suffering from sexual dysfunction. to inform them about the solutions available as well as to provide awareness and understanding of the condition to their partners, media and other interested parties.

ESHA's purpose is to help every couple affected by sexual dysfunction to communicate openly about their sexual concerns in order to find a solution that improves the patient's sexual function and the couple's quality of life.