Tips for sexual health and happiness

Intimacy doesn't stop as you age. Find out how aging affects your sexuality.

Today's older adults are active, on the go and still doing many of the things they enjoyed in their younger years. That includes enjoying sex and intimate relationships.

Like adults of all ages, you probably want to continue intimacy with your partner and share your life in a fulfilling relationship. A healthy sexual relationship can positively affect all aspects of your life, including your physical health and self-esteem.

Though movies and television might tell you that intimacy and sex are only for younger adults, that isn't true. The need for intimacy is ageless. You'll never outgrow your need for affection, emotional closeness and intimate love. Most people still have sexual fantasies and desires well into their 80s and 90s. Sex may not be the same as it was in your 20s, but that doesn't mean intimacy can no longer be as fulfilling or enjoyable.

Natural changes as you age affect intimacy

As you know, your body changes as you age, and these changes can affect your sexual relationships and your ability to maintain intimacy with your partner. Although your body's physical changes are the changes most often discussed, psychological issues factor in, too.

Physical changes

Testosterone regulates your sex drive whether you're a man or a woman. And most aging men and women produce enough testosterone to maintain their interest in sex. Although your body will go through changes that may make some aspects of sex more difficult as you age, these changes give you reason to try new positions and techniques.

Men and women experience different changes in their bodies as they age:

• Women. Most physical changes in your body are linked to menopause and reduced estrogen levels. As you age, it takes longer for your vagina to swell and lubricate when you're sexually aroused. Your vagina also loses elasticity. Together these can make intercourse less comfortable or even painful. You might also feel a burning sensation during vaginal penetration or discover vaginal bleeding afterward. Longer foreplay sometimes helps stimulate your natural lubrication. You can try a water-based lubricant, such as K-Y jelly, or talk to your doctor about estrogen cream or estrogen replacement therapy. Vaginal penetration helps maintain lubrication and elasticity if done regularly. If you haven't had sex for a while, talk to your partner about taking it slowly to minimize your pain or opt for other ways to be intimate.
• Men. As you age, it might take you longer to achieve an erection. Your erections may be less firm and may not last as long. Aging also increases the time between possible ejaculations. Trying different positions may make inserting your penis easier for you and your partner. Talk to your doctor if you're having problems maintaining an erection or reaching orgasm. He or she can help you adapt to these changes. Your doctor can discuss medications that can help you achieve and maintain an erection. In some cases, your doctor might suggest other ways, such as penile vacuum pumps or vascular surgery.

Psychological changes

Maintaining your ability to have sex as you age depends on your mind as much as your body. If you're embarrassed or ashamed of your sexual needs as an older adult, your anxiety can affect your ability to become aroused.

Changes in your appearance might also affect your emotional ability to connect. As you notice more wrinkles and gray hairs, you might feel less attractive. A poor body image reduces your sex drive because you don't feel worthy of sexual attention from your partner.

The stress of worrying too much about how you'll perform can trigger impotence in men or a lack of arousal in women. Taking things slowly can help you avoid this pressure.

Talk to you partner about your anxiety. He or she can offer reassurance.

Changes due to medications and surgery

Some medical problems can interfere with how you respond sexually to another person. Chronic pain or surgery and illness that can cause fatigue can make sexual activities more challenging or painful.

Some commonly used medications can interfere with sexual function. Drugs that control high blood pressure can reduce desire and impair erection in men and lubrication in women.

Antihistamines, antidepressants and acid-blocking drugs can have side effects that affect sexual function.

Talk with your doctor about how your medications and conditions will affect your sexual abilities and how you can minimize those effects.

Improving sex as you age

Many older adults say their sex lives improve as they age. Yours can, too. Improving your sex life requires more communication with your partner and small changes both of you can make, including:

• Expand your definition of sex. Sex is more than vaginal penetration. As you age, other options might be more comfortable and more fulfilling. Touch can be a good alternative to intercourse. It can simply mean holding each other. It can also mean sensual massage, masturbation or oral sex.
• Communicate with your partner. Communication brings you and your partner close together. Discuss the changes you're going through and what your partner can do to accommodate you during sex. Maybe a different position makes sex easier for you, or other sexual activities, such as massage or cuddling, might interest you. Ask your partner about his or her needs and ways that you can also be accommodating. Communication itself can be arousing.
• Make changes to your routine. Simple changes can improve your sex life. Change the time of day when you have sex to a time when you have the most energy. Try the morning — when you're refreshed from a good night's sleep — rather than at the end of a long day. Because it might take longer for you to become aroused, take more time to set the stage for romance, such as a romantic dinner or an evening of dancing. Try a new sexual position. You might find one that's more comfortable for you and your partner.
• Manage your expectations. If you didn't have sex very often as a younger adult, don't expect to have lots of sex as an older adult. Maybe you and your partner expressed your intimacy in other ways when you were younger. Partners who enjoy frequent sex when they're younger are more likely to continue that as they age.
• Take care of yourself. A healthy diet and regular exercise keep your body finely tuned. This keeps you ready for sex at any age. Eat a balanced diet with plenty of fruits and vegetables. Exercise for at least 30 minutes a day, most days of the week. Avoid alcohol, as excessive use decreases sexual function in both men and women. Illegal drugs such as marijuana and cocaine impair sexual function, also.

Single seniors can have sex, too

Nearly half of the people 65 and older in the United States are single. If you're single, a new romance can be exciting and may lead to sexual intimacy. Women live longer than men do, so looking for a male partner later in life can be frustrating. Meet new people by going to places where other older adults go, such as adult education courses or mall walking. It's never too late to start a new relationship.

If you have a new partner, remember to practice safe sex. Many older adults don't do this because they think they aren't at risk of sexually transmitted diseases (STDs), including AIDS. Contrary to popular belief, AIDS is not a younger person's disease. People over 50 make up about 19 percent of the AIDS cases in the U.S. All sexually active people — no matter what age — can contract STDs. Stay monogamous with your partner or practice safe sex by using condoms. Talk with a new partner about being tested for HIV. Older adults are less likely than are younger adults to have ever been tested.

Talk to your doctor if you have concerns

You might be embarrassed to discuss sex with your doctor. But conversations with your doctor can help you understand the changes your body goes through as you age and how these changes affect your sexual activity.